Objective:To investigate the clinical application of ultrasound-guided cervical plexus block combined with superior laryngeal nerve block in tracheotomy for burn patients.Methods:A total of 88 burn patients who underwent tracheotomy from January 2022 to December 2022 were divided into observation group(44 cases)and matched group(44 cases).The matched group received conventional general anesthesia,while the observation group underwent ultrasound-guided cervical plexus block combined with superior laryngeal nerve block.The operation time,anesthetic effect,intraoperative hemodynamic parameters,postoperative complications,and patient satisfaction were compared.Results:The surgery time in the observation group was shorter than that in the matched group(P＜0.05).The anesthetic effect in the observation group was superior to that in the matched group,with more stable intraoperative hemodynamics,and smaller fluctuations in heart rate and mean arterial pressure(P＜0.05).The incidence of postoperative cough reflex,hoarseness,postoperative pain score,and respiratory complications in the observation group were lower than those in the matched group(P＜0.05).Patient satisfaction in the observation group was higher than that in the matched group(P＜0.05).Conclusion:Ultrasound-guided cervical plexus block combined with superior laryngeal nerve block for tracheotomy in burn patients can effectively improve anesthetic effect,reduce operation time,stabilize intraoperative hemodynamics,reduce postoperative complications,and improve patient satisfaction,which is worthy of clinical application.

Objective:To investigate the clinical application of ultrasound-guided cervical plexus block combined with superior laryngeal nerve block in tracheotomy for burn patients.Methods:A total of 88 burn patients who underwent tracheotomy from January 2022 to December 2022 were divided into observation group(44 cases)and matched group(44 cases).The matched group received conventional general anesthesia,while the observation group underwent ultrasound-guided cervical plexus block combined with superior laryngeal nerve block.The operation time,anesthetic effect,intraoperative hemodynamic parameters,postoperative complications,and patient satisfaction were compared.Results:The surgery time in the observation group was shorter than that in the matched group(P＜0.05).The anesthetic effect in the observation group was superior to that in the matched group,with more stable intraoperative hemodynamics,and smaller fluctuations in heart rate and mean arterial pressure(P＜0.05).The incidence of postoperative cough reflex,hoarseness,postoperative pain score,and respiratory complications in the observation group were lower than those in the matched group(P＜0.05).Patient satisfaction in the observation group was higher than that in the matched group(P＜0.05).Conclusion:Ultrasound-guided cervical plexus block combined with superior laryngeal nerve block for tracheotomy in burn patients can effectively improve anesthetic effect,reduce operation time,stabilize intraoperative hemodynamics,reduce postoperative complications,and improve patient satisfaction,which is worthy of clinical application.

OBJECTIVES: To study the effects of parent-child painting and creative crafting therapy on the core symptoms of preschool children with mild-to-moderate autism spectrum disorder (ASD) and the parenting stress and hope level of their mothers. METHODS: A total of 56 preschool children with mild-to-moderate ASD and their mothers were divided into an experimental group and a control group using the block randomization method, with 28 pairs in each group. The subjects in the control group received an applied behavior analytic intervention and those in the experimental group received parent-child painting and creative crafting therapy in addition to the intervention in the control group. The intervention time was 20 weeks for both groups. Autism Behavior Checklist (ABC), Social Responsiveness Scale (SRS), Parenting Stress Index-Short Form (PSI-SF), and Herth Hope Index (HHI) were used to evaluate the core symptoms of children and the parenting stress and hope level of their mothers before and after 20 weeks of intervention. RESULTS: Forty-nine child-mother pairs completed the study (25 pairs in the intervention group and 24 pairs in the control group). The children in the experimental group had significantly lower scores of social interaction, language, social communication, and social motivation and total scores of ABC and SRS compared with those in the control group ( CONCLUSIONS The combination of applied behavior analytic intervention with parent-child painting and creative crafting therapy can more effectively improve the core symptoms and social interaction of preschool children with mild-to-moderate ASD, reduce the parenting stress of mothers and improve their hope level.
Autism Spectrum Disorder/therapy* ; Child, Preschool ; Female ; Humans ; Mothers ; Parent-Child Relations ; Parenting ; Prospective Studies

Objective: To explore the influencing factors for serum potassium >4.4 mmol/L in the morning of parathyroidectomy in hemodialysis patients with secondary hyperparathyroidism (SHPT). Methods: The clinical data of 72 patients with SHPT who received regular hemodialysis and underwent parathyroidectomy in Guangdong Provincial People's Hospital from January 2012 to December 2018 were analyzed retrospectively. There were 37 males and 35 females, aged from 25 to 69 years, and the dialysis timespan was from 0.5 to 11 years. The levels of parathyroid hormone, serum potassium and serum calcium before hemodialysis were examined one day before operation, and hemodialysis time and dewatering volume after hemodialysis without heparin were recorded, and also the level of serum potassium in the morning of parathyroidectomy was detected. The occurrences of hyperkalemia during and after operation were studied. The factors related to hyperkalemia in the morning of parathyroidectomy were evaluated by Pearson or Spearman correlation analysis, and the cut-off values of risk factors were calculated by receiver operating characteristic (ROC) curve. Results: Serum potassium >4.4 mmol/L in the morning of parathyroidectomy existed in 23 of 72 patients. Correlation analysis showed that serum potassium one day before operation ((4.93±0.56)mmol/L, r=0.656, P<0.001) and dehydration volume ((2.37±0.75)L, r=0.261, P=0.027) were positively correlated with serum potassium in the morning of parathyroidectomy((4.16±0.54)mmol/L). Serum potassium before hemodialysis one day before operation was a main predictor for serum potassium in the morning of parathyroidectomy (AUC=0.791, P<0.001). The cut-off value of serum potassium before hemodialysis one day before operation was 5.0 mmol/L. Conclusion: Serum potassium before hemodialysis one day before operation in patients with SHPT can predict serum potassium in the morning of parathyroidectomy, offering imformation for the safety of operation.
Calcium ; Female ; Humans ; Hyperkalemia/etiology* ; Hyperparathyroidism, Secondary/surgery* ; Male ; Parathyroid Hormone ; Parathyroidectomy ; Renal Dialysis ; Retrospective Studies

OBJECTIVE: To investigate the clinical manifestations pathologic features, treatment options and prognosis of patients with bone lymphoma. METHODS: The clinical characteristics, pathologic features, treatment and prognosis of 34 BL patients diagnosed by histopathologic method or/and PET-CT and treated in first hospital of peking university from January 2004 to April 2018 were analyzed retrospectively. RESULTS: The median age of 34 BL patients was 56 years old, the male and female ratio was 1.43∶1 (24 /10). Among 34 patients, the patients with primary bone lymphoma(PBL) were 8 cases, the patients with secondary bone lymphoma(SBL) was 26 cases, the PBL and SBL ratio was 0.31∶1. Bone lymphoma lacks typical systemic symptoms, and its onset began mostly from bone pain and pathologic bone fracture. The most frequent pathological type of bone lymphoma in our study was diffuse large B-cell lymphoma (DLBCL), accounting for 55.88%. At present, the conventional treatment for bone lymphoma includes chemotherapy, or chemotherapy combined with radiotherapy and surgery, as well as hematopoietic stem cell transplantation. The average and median OS time of BL patients were 349 years and 3 years respectively, meanwhile the OS rate for three years and two years were 56.25% and 78.16%, respectively. Factors that affect survival of BL patients were PBL and SBL classification, pathological type, blood LDH level, and treatment methods. CONCLUSION Bone lymphoma is usually concealed onset，an adequate and adequate combination therapy can improve the survival rate and transplantation therapy plays an important role. Primary bone lymphoma is rare, the prognosis of patients with primary bone lymphoma is good, whereas the prognosis of patients with secondary bone lymphoma is poor.
Bone Neoplasms ; Female ; Hematopoietic Stem Cell Transplantation ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Male ; Middle Aged ; Positron Emission Tomography Computed Tomography ; Prognosis ; Retrospective Studies

Objective To explore the effects of artesunate on the proliferation,cell cycle,apoptosis and apoptosis-related protein of bortezomib-resistant multiple myeloma (MM) cells.Methods Human MM cell line NCI-H929 was treated with bortezomib in a dose-dependent manner to establish a bortezomib-resistant cell line NCI-H929BR.The logarithmic growth phase NCI-H929BR cells were divided into control group(blank culture medium)and two concentration experimental groups (artesunate,25,50 μg · mL-1)and treated for 48 h.The inhibitory role of artesunate on NCI-H929BR proliferation was measured by MTT assay.Cell apoptosis and cell cycle were determined by flow cytometry.The Bcl-2 family proteins (Bcl-2,Bcl-Xl,Bax) were detected by Western blot.Results Bortezomib resistance index of NCI-H929BR is 20.12 times than NCI -H929.After administration artesunate for 48 h,the proliferation rate of NCI-H929BR in the low and high concentration experimental groups were 62.46％,33.48％;there was significant difference compared with control group (all P＜0.05).The artesunate dramatically decreases NCI-H929BR proliferation in a dose-dependent manner (P ＜ 0.05).After treatment for 48 h with artesunate,the proportion of G1 phase cell cycle in high concentration experimental group was increased compared with control group [(51.63 ± 4.02) ％ vs (34.72 ± 2.43) ％,P ＜ 0.05].The proportion of apoptosis cell was increased,early apoptosis in high concentration experimental group and control group were (13.10 ± 1.53)％,(2.32 ± 1.02)％;and late apoptosis in the two groups were (10.26 ±2.42)％,(1.93 ± 0.69) ％;comparison between two groups,the difference had significantly (all P ＜ 0.05).In addition,artesunate significant decreased of Bcl-2 and Bcl-Xl protein expression and increased of Bax protein expression in a dose -dependent manner.Conclusion Artesunate could inhibit NCI-H929BR proliferation,increase apoptosis,cause G0/G1-arrest and down-regulate Bcl-2 and Bcl-Xl expression,while up-regulate Bax expression.

OBJECTIVETo compare the effects of Bushen Jiedu Recipe (BJR) and Jianpi Jiedu Recipe (JJR) containing plasma on dendritic cells (DCs) of chronic hepatitis B virus (HBV) infection patients under different immune states.

METHODSRecruited were 36 chronic HBV infection outpatients from First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from April 2010 to January 2011. They were assigned to the immune tolerance group (18 cases) and the immune clearance group (18 cases).Another 10 healthy subjects were recruited as the healthy control group. Their anticoagulated peripheral venous blood was respectively collected. The peripheral blood mononuclear cells (PBMCs) were isolated and further extracted for incubating DCs. The DCs were intervened by BJR and JJR containing plasma. The morphology of DCs was identified. The expressions of CD1alpha, CD80, CD86, and HLA-DR were detected. The level of interferon-alpha (IFN-alpha) in the supernatant was observed by ELISA.

RESULTSThe CD80 expression level was lower in the immune clear group than in the healthy control group before intervention (P < 0.05). The expression levels of CD80, CD86, and HLA-DR were lower in the immune tolerance group than in the healthy control group before intervention (P < 0.05).The IFN-alpha expression level was lower in the immune tolerance group and the immune clearance group than in the healthy control group before intervention (P < 0.05). The expression levels of CD80, HLA-DR, and IFN-alpha were lower in the immune tolerance group than in the immune clearance group before intervention (P < 0.05). Compared with the same group before intervention, the CD80 expression significantly increased in each treatment group (P < 0.05). After intervention the expression levels of CD80 and HLA-DR were higher in the immune tolerance group than in the immune clearance group in the same time phase, and the CD86 expression level was higher in the BJR group than in the immune clearance group in the same time phase, showing statistical difference (P < 0.05).

CONCLUSIONSThe middle dose BJR and the small dose JJR both could promote the recovery of DCs in chronic HBV infection patients. Besides, BJR showed more prominent effects on the function of DCs in chronic HBV infection patients in the immune tolerance stage.

Adult ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; Case-Control Studies ; Dendritic Cells ; drug effects ; immunology ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; HLA-DR Antigens ; metabolism ; Hepatitis B, Chronic ; blood ; drug therapy ; immunology ; Humans ; Immune Tolerance ; drug effects ; Interferon-alpha ; metabolism ; Male ; Phytotherapy ; Plasma ; Young Adult