Objective To evaluate the clinical anesthetic efficacy of a combination of propofol and remifentanil for ultrasound-guided transvaginal oocyte retrieval.Pharmacodynamic (PD) model was established and its characteristics were analyzed based on the simulated concentrations of propofol and remifentanil in respective pharmacokinetic models, so as to guide further study.Methods Forty-two female patients undergoing transvaginal oocyte retrieval were divided into groups PR15 (n=24) and PR10 (n=18), who were received intravenous bolus of remifentanil 1.5 μg/kg + propofol 1.5 mg/kg and remifentanil 1.0 μg/kg+propofol 1.0 mg/kg, respectively.The anesthesia quality evaluation was based on the following indicators: onset time (loss of eyelash reflex), recovery time of orientation, the incidence of hypoxemia (SpO2 < 92%) and adverse reactions.Nonlinear mixed-effects model was used to evaluate the time courses of the simulated propofol and remifentanil concentrations-effect and to establish the PD model with NONMEM software.Results The time of recovering orientation in the patients of group PR10 was significantly faster compared with the patients in group PR15;the time of loss of eyelash reflex , incidence of hypoxemia (12.5% vs 16.7%) and cough (16.7% vs 11.1%) had no significant differences between the both groups.With the final PD model, the estimated parameters as following: EC50 of propofol and remifentanil for effective sedation and analgesia were 1.71 μg/ml and 2.57 ng/ml, respectively.EC95 of propofol and remifentanil for effective sedation and analgesia were 4.30 g/ml and 4.57 ng/ml, respectively.The effect site concentration of propofol 1 mg/kg was lower than EC50, but the effect site concentration of 1.5 mg/kg was higher than EC50.The peak effect site of 1.0 μg/kg and 1.5 μg/kg remifentanil was higher than EC50, and 1.5 μg/kg concentration was close to EC95.Conclusion Based on patients' recovery time, propofol 1.0 mg/kg combined with fentanyl 1.0 μg/kg is appropriate in patients undergoing transvaginal oocyte retrieval.

OBJECTIVETo study the polysaccharides contents and monosaccharide compositions in parent root, daughter root and rootlet of Aconitum carmichaeli.

METHODThe conversion coefficient of A. carmichaeli polysaccharide to glucose was obtained by refined polysaccharides, and then the contents of crude polysaccharides in parent root, daughter root and rootlet were determined by sulfuric-phenol spectrometry method; analysis of monosaccharide compositions in polysaccharides from A. carmichaeli was carried out by pre-column derivatization high performance liquid chromatography with 1-phenyl-3-methyl-5-pyrazolone (PMP).

RESULTThe contents of polysaccharides in parent root, daughter root and rootlet were 22.02%, 33.53% and 6.10%, respectively. Parent root, daughter root and rootlet mainly contained glucose, and in addition they contained a small amount of galacturonic acid, galactose and arabinose. Daughter root contained mannose yet, and rootlet still contained mannose, rhamnose and xylose.

CONCLUSIONThe method is simple, rapid, and accurate. The content of polysaccharide in rootlet is lowest, and monosaccharide compositions in rootlet are significantly different from parent root and daughter root.

Objective To investigate methods and results of endovascular treatment in TASC (Ⅱ) D-type femoral artery occlusion. Methods From January 2012 to May 2013, 26 cases (26 branches) of superficial femoral artery occlusion with endovascular treatment of TASC (Ⅱ) D-type superficial femoral artery occlusion were retrospectively reviewed. The effi-cacy was evaluated through ABI, CTA, DSA and symptoms improved. Results 26 branches were treated with endovascular methods. Technical success rate was 80.7%(21/26), including 13 branche with stent implantation, 6 branches with Silver-hawk atherectomy and 2 branches with Viabahn stent implantation. All patients were followed up for a mean period of (10.3 ± 1.2)months, primary patency rates at 6 months were 69.2%in stent group, 66.7%in Silverhawk atherectomy group and 100%in Viabahn stent group. Conclusion Endovascular treatment of TASC (Ⅱ) D-type femoral artery occlusion can lead to satisfactory short term patency rates, and Viabahn stent is the latest treatment.

BACKGROUND: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord can induce differentiation into islet-like cells.OBJECTIVE: To verify the possibility of human umbilical cord derived mesenchymal stem cells co-cultured with rat pancreatic cells differentiate into islet-like cells, and to observe the effects of transplantation of islet-like cells on blood glucose of diabetic rats.METHODS: Mesenchymal stem cells in Wharton's Jelly of the human umbilical cord was separated, induced, passaged, and co-cultured with pancreatic cells to induce differentiation into islet-like clusters. Rats were divided into the normal control, model and experimental groups. Rats in the model group were prepared for diabetic models, and those in the experimental group were transplanted islet-like cells after model preparation. RESULTS AND CONCLUSION: There were cells crawled out of cultured Wharton's Jelly of the human umbilical cord, and morphology of adhered cells turned into fusiform shape at 7 days. The isolated cells are characterized by expressing specific surface markers of mesenchymal stem cells, such as CD44, CD29, CD105, but not expressing CD34, CD45 or CD14. The cells were strongly stained by PDX-1 and human insulin at 7 and 10 days. Compared with the simple culture group, the expression of human insulin and concentration of C-peptide were obviously increased; PDX-1 and human insulin mRNA expressions were highly expressed at 7 and 10 days after induction. Compared with the model group, the streptozotocin test of rats in the experimental group was obvious decreased (P < 0.01), but extremely higher than that of the normal control group at 1 week after transplantation (P < 0.01). Brdu positive nuclei and insulin positive kytoplasms could be seen in the experimental group at 8 weeks after transplantation. The results demonstrated that, umbilical cord derived mesenchymal stem cells existed in Wharton's Jelly. The co-cultured cells promote mesenchymal stem cells differentiating into islet-like cells, which can dramatically decrease blood glucose in diabetic rats.

Objective: To investigate the effects of aerobic exercise and nutritional education on blood lipids, physical fitness and exercise behavior among students with high cholesterol level. Methods: A total of 140 male college students with total cholesterol higher than 200 mg/dl were randomly divided into cycling + nutrition education (BE) group; control group (C). The BE group received 6-weeks intervention (3 times a week, 60 minutes each time, exercise intensity of 50%-70% HRR and 60 minutes of nutrition education per week). Blood lipids, physical fitness, daily dietary intake, and exercise behavior before and after intervention was assessed. Results: BMI and waist-to-hip ratio in the BE group were significantly lower than those in the group C[(25.57±1.77) kg/m2 vs (28.88±2.10) kg/m2], [(0.81±0.03) vs (0.87±0.06)]; Cardiopulmonary fitness was significantly better than group C [(54.45 ± 5.31) vs (50.00 ± 5.29)]. The level of TC of group C was significantly higher than that of group BE [(229.90±25.63) mg/dL vs (195.90±34.79) mg/dL], and the HDL-C of group BE was significantly better than group C [(70.30±8.06) mg/dL vs (58.60±10.42) mg/dL]. The conscious activity of the group BE was significantly better than that of the group C[(78.90±4.58) vs (74.10±5.48)], and the conscious dyskinesia in the group C was significantly higher than that in the group BE[(57.30±5.54) vs (51.40±4.87)], group BE The exercise self-efficacy was better than that of group C [(66.80±8.75) vs (57.10±9.09)], and the difference was statistically significant(t=5.33，4.11，6.22，P<0.05). The daily intake of potato, vegetables, fruits, livestock and poultry, fish and shrimp, eggs, milk and beans in the group BE was in a reasonable range, which was significantly better than that before intervention and group C(P<0.01). Conclusion In summary, intervention combined with moderate-intensity exercise and nutrition education shows significant effects in improving cardiopulmonary fitness, HDL-C level, and lowering BMI, waist-to-hip ratio, and total cholesterol value; 6-week exercise intervention improves self-conscious sports interests, conscious movement disorders and cognitive self-efficacy; nutrition education intervention helps guide college students to take reasonable dietary behavior and reasonable intake of food.

Objective:To investigate the specific effect of minimally invasive hard channel intracranial hematoma crush suction flow on patients with cerebral hemorrhage, and to analyze the prognostic factors.Methods:A total of 80 patients with primary intracerebral hemorrhage who were treated in Bengbu First Peopl′s hospital from Aug. 2014 to Aug. 2018 were selected, with 52 males and 28 females, aged from 48 to 81 years and averaged (66.07±13.34) years. The prognosis of patients was assessed using the Bathel Index (BI), and the patients were divided into a control group (BI≥ 60 point considered a good prognosis, n=54) and an experimental group (BI<60 point considered a poor prognosis, n=26). Suspicious prognostic factors were formulated, including gender, age, average drainage time, average puncture needle indwelling time, average hospital stay, Glasgow score, time from injury to operation, bleeding volume, cause of disease, bleeding site, postoperative rebleeding to carry out univariate analysis between groups, and incorporate the difference items in univariate analysis into multivariate logistics regression analysis to explore related prognostic factors were compared by single factor analysis, and the difference items in the single factor analysis were included into the multivariate logistics regression analysis for the related prognostic factors exploring. Results:The hemorrhages was successfully cleared in all patients, and the average drainage time was (5.07±1.25) days. Mean needle retention time was (4.84 ± 1.37) d. Mean length of stay time was (15.26±1.44) days. Allpatients completed follow-up after operation. During 1 year of follow-up, 12 patients showed obvious brain atrophy, subdural broadening and effusion. All patients were followed up for 3 years, and their symptoms completely disappeared and their daily living ability recovered. No death was occured during the follow-up. According to the BI assessment results, the scores of 54 patients were ≥60, with an average score of (74.57±4.36). The scores of 26 patients were <60, with an average score of (48.24±5.12). The age, time from injury to operation and amount of blood loss of control group were significantly lower than those of experiment group, and Glasgow scores were significantly higher than those of experiment group, with statistically significant differences ( P<0.05). The percentage of patients in control group with infratentorial hemorrhage (14.81%) was significantly lower than that in experiment group (34.62%), and the rate of postoperative re-bleeding (1.85%) was significantly lower than that in experiment group (23.08%), with statistically significant differences ( P<0.05). Glasgow score was positively correlated with the prognosis of patients ( OR=3.449, P=0.005). The time from injury to operation was negatively correlated with the prognosis ( OR=0.580, P=0.023). Supratente hemorrhage was a protective factor for patient prognosis ( OR=3.813, P=0.024). Postoperative re-bleeding was correlated with the patients ( OR=19.963, P=0.008). A ROC curve was drawn with Glasgow score and the time from injury to operation. Glasgow score was selected as cut-off point at 7.5 point, with sensitivity of 96.30% and specificity of 88.46%. The time from injury to operation was selected as the cut-off point at 8.35 h, with sensitivity of 84.62% and specificity of 92.59%. Conclusion:Minimally invasive hard channel crush suction flow is effective and safe in the treatment of intracranial hematoma. The severity of cerebral hemorrhage, infratentorial hemorrhage and postoperative re-bleeding are prognostic factors.

Objective:To investigate factors associated with acute kidney injury(AKI) in postoperative colorectal cancer patients.Methods:The clinical data of 376 colorectal carcinoma (CRC) patients at Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University from Jan 2018 to Jun 2021 were retrospectively analyzed. Patients were divided into acute kidney injury (AKI) ( n=29) and non-AKI groups ( n=347). The demographic information, perioperative status, laboratory results and other relevant data of the two groups were compared . Binary logistic regression was used to analyze the independent risk factors for postoperative AKI. Results:Twenty-nine CRC patients (7.7%) had postoperative AKI. Binary Logistic regression analysis showed that preoperative hypertension ( OR=3.487, 95% CI: 1.081-11.251, P=0.037), anemia ( OR=3.158, 95% CI: 1.114-8.953, P=0.031), inadequate intraoperative crystalloid infusion ( OR=0.998, 95% CI: 0.997-0.999, P=0.007), low intraoperative mean arterial pressure ( OR=0.915, 95% CI: 0.863-0.970, P=0.003) and moderate to severe postoperative decline in hemoglobin levels ( OR=4.105, 95% CI: 1.487-11.335, P=0.006) were independent risk factors. Conclusion:Preoperative hypertension, anemia, inadequate intraoperative crystalloid infusion, low intraoperative mean arterial pressure, and moderate to severe postoperative decline in hemoglobin levels were independent risk factors for AKI development in colorectal cancer patients.

【Objective】 To verify the results of HBV DNA and HCV RNA screening under different brands of vacuum collection tubes for blood samples, storage temperature and storage time. 【Methods】 Experiment 1 was conducted as follows: blood samples were collected simultaneously from 52 voluntary blood donors using two brands(divided into group A and group B) of vacuum collection tubes for blood samples. The plasma separation of group A and group B were compared, and the effects of storage time on the NAT yield of HBV DNA and HCV RNA were statistically analyzed. Experiment 2 was conducted as follows: the effects of different storage temperature, time and tubes on the NAT yield of HBV DNA and HCV RNA samples with low viral load in group A and B were verified and compared in the simulated phlebotomy condition. 【Results】 In Experiment 1: After centrifugation, blood plasma layer and cells layer were separated completely in group A(100%, 52/52), but one sample was not well separated in group B(1/52, 1.92%). After 4 to 10 h after collection, blood samples of two groups were centrifuged and screened for HBV DNA, HCV RNA within 24 h. No positive samples were yielded and the Ct values of internal control(IC-DNA and IC-RNA) were uniform. In Experiment 2: Whole blood samples, stored for either 4 h or 6~10 h at 4 ℃ or 25℃ before centrifugation, showed no difference on the NAT-yield of HBV DNA nor HCV RNA samples with low viral load(P>0.05). Ct values of HBV DNA and HCV RNA of group A was similar to those of group B as centrifuged samples were stored for 24 h or 72~104 h at 4℃(P>0.05), but all increased as the storage time prolonged. Ct values of HBV DNA in group A increased from 33.45±0.29(24 h) to 33.82±0.08(72~104 h) and HCV RNA from 35.21±0.20 to 36.12±0.43; HBV DNA from 33.46±0.25 to 34.30±0.60 and HCV RNA from 35.47±0.24 to 36.49±0.51 in group B. 【Conclusion】 Under certain laboratory condition, different storage time, storage temperature and tubes shed few effect on the NAT-yield of HBV DNA and HCV RNA samples with low virus loads. However, it is suggested that the blood sample be detected within 72 h after centrifugation at 4 ℃ storage.

【Objective】 To investigate the characteristics of NAT reactive(R) population among voluntary blood donors in Zhengzhou, and analyze the residual risk of NAT and the infection in different ages, educational levels, and occupations. 【Methods】 The samples of voluntary blood donors in Zhengzhou from 2018 to 2019 were comprehensively screened (samples reactive by duplicate ELISA reagents excluded), and the occupation, gender, education level and marital status of voluntary blood donors were analyzed. 【Results】 A total of 488 365 samples were detected, 323 were NAT R samples (0.66‰), including 318 HBV R samples (0.65‰) and 5 HIV R samples (0.01‰), but no HCV R was detected. Statistical analysis showed that NAT R rate in male voluntary blood donors was 0.78‰ (252/321 196), higher than 0.42‰ (71/167 439) in female (P<0.05); the NAT R rates of 18~25, 26~35, 36~45, 46~55, and over 55 years old group were, 0.21‰ (39/187 816), 0.56‰ (61/108 481), 1.03‰ (101/97 872), 1.27‰ (112/87 943), and 1.53‰ (10/6 523), respectively, showing an upward trend with age(P<0.05). The NAT R rate of donors of junior middle school education and below, high school education, secondary vocational education, college education, undergraduate education and above were 1.00‰(27/26 921), 0.99‰(62/62 375), 0.97‰(28/28 908), 0.37‰(43/117 643)and 0.43‰(55/126 992), respectively, showing a downward trend (P<0.05). Among different occupations, the NAT R rate of farmers was the highest as 1.10‰ (49/44 430), and those of medical personnel and students were rather low as 0.32‰ (4/12 666) and 0.21‰ (31/145 563), respectively (P<0.05). The NAT R rate in repeated blood donors was 0.75‰ (192/257 077), which was higher than 0.57‰ (131/231 558) in first-time blood donors (P<0.05), but no significant difference was noticed in blood group and ALT (P>0.05). 【Conclusion】 Some blood samples were negative by ELISA but reactive by NAT. Therefore, NAT is an effective supplement to missed detection of ELISA and can reduce the risk of transfusion transmitted infection diseases. The characteristics of NAT R population in Zhengzhou are worth studying, which can provide reference for health consultation and further improve blood safety.

【Objective】 To explore the quantitative value of key points for ABO blood group initial screening in fixed blood donation sites, so as to provide reference for standardized testing process of sliding method. 【Methods】 Several groups of experiments were carried out to illustrate the optimal conditions, including the serum dosage of monoclonal reagent, red blood cell dosage of blood sample, and reaction time in ABO blood group initial screening, by sliding method, and the quantitative value of key points of sliding method was preliminarily determined. Blood typing tests of 310 blood donor samples including type A, B, O, AB, subtype A and subtype AB were conducted to evaluate the effects of quantitative value of key points in the initial screening procedure. The test tube method would be conducted if the results are inconsistent with the fully automated blood grouping analyzer. The ABO subtypes suspected are identified by serological and molecular biological methods. 【Results】 The quantitative value of key points in initial screening procedure of sliding methods was as follows: 2 drops of reagent serum, 5-10 μL of whole blood and 3 minutes of reaction time. The concordance rate of ABO blood type screening comparison experiment in 310 blood donors was 100%. 【Conclusion】 ABO blood group initial screening by sliding method with quantitative value can effectively standardize the pre-donation blood type screening in fixed blood donation sites, and can meet the requirements of ABO blood group initial screening.