Objective To compare the anesthetic effect and safety of Ciprofol and Propofol combined with Fentanyl in painless bronchoscopy for conscious patients in intensive care unit(ICU).Methods 60 conscious patients who underwent painless bronchoscopy from October 2022 to January 2023 were selected.According to the random number table method,30 cases were divided into the control group(Propofol 1.5 mg/kg + Fentanyl 1 μg/kg)and 30 cases were divided into the experimental group(Ciprofol 0.4 mg/kg + Fentanyl 1 μg/kg).Systolic blood pressure,diastolic blood pressure,heart rate,respiratory frequency,and percutaneous arterial oxygen saturation(SpO2)were recorded before anesthesia(T1),during the examination(T2),and at the completion of the examination(T3)in the two groups,and the success rate of induction of general anesthesia,the time of induction of anesthesia,the time of bronchoscopy,the time of eye-opening,the total dosage of medications used,the incidence of injection pain,and the incidence of intraoperative adverse reactions(hypotension,respiratory depression,bradycardia,and bucking)in the two groups were compared.Results Analysis of the data revealed significant group,time,and interaction effects for systolic blood pressure,diastolic blood pressure,heart rate,and respiratory frequency at different time points(P<0.05).The experimental group had a shorter induction time of anesthesia[1.40(1.10,1.62)min]in comparison to the control group[1.60(1.30,2.10)min](P<0.05),and the experimental group required a less amount of drug to achieve the desired outcome[(21.40±1.82)mg]compared to the control group[(78.75±6.71)mg](P<0.05).Furthermore,the incidence of injection pain(3.33%)and respiratory depression(6.67%)was significantly reduced in the experimental group compared to the control group(36.67%)and(30.00%)(P<0.05).Conclusion The use of Ciprofol in combination with Fentanyl has been found to provide effective anesthesia during bronchoscopy,while also increasing safety and decreasing the incidence of adverse events.It is worthy of clinical application.

【Objective】 To investigate the practice and benefit of national standardized management of type 2 diabetes in Yulin City. 【Methods】 We recruited the adult type 2 diabetes patients who sought medical help at our hospital from May 2020 to October 2022 as subjects. We collected their basic information (sex and age); measured height, weight, waist and hip circumference, and blood pressure; calculated body mass index (BMI); and detected blood glucose, c-peptide, HbA1c, biomarkers, urinary microalbumin, sensory nerve conduction velocity of lower limbs, ABI, and subcutaneous and visceral fat at the time of MMC recruited and the end of six months. T test and Mann-Whitney U rank sum test were used for measurement data and χ² test or Fisher’s exact probability method for counting data to analyze the data. 【Results】 After 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, and visceral and subcutaneous fat in all the patients decreased, but the level of fasting c-peptide increased compared with the baseline (all P<0.05). Secondly, compared with the baseline, the control rate of HbA1c (35.21% vs. 13.71% ) and the comprehensive control rate (13.97% vs. 7.26% ) were both significantly increased at six months (P<0.05). Thirdly, after 6 months, the levels of fasting blood glucose, postprandial blood glucose, HbA1c, TG, TC, and UA were decreased more, while the fasting c-peptide and postprandial c-peptide were increased more in the patients of the HbA1c standard group (HbA1c<7% ) than those of the non-standard group. 【Conclusion】 The multiple benefits of blood glucose, blood lipid, uric acid and islet function can be achieved by taking type 2 diabetes patients into MMC. Meanwhile, the rates of HbA1c control and comprehensively reaching the standard are significantly increased. Therefore, MMC can explore a new way for the management of type 2 diabetic patients in this area.

Objective To study the method of gray-scale blood flow imaging and image processing in condition of high frequency ultrasound,and the implementation of the system.Methods On the base of research of scattered signals of red blood cells in high frequency ultrasound,20 MHz ultrasound mechanical and linear scanning probe was used to transmit a number of pulses on a scan line.Pulse-echo subtraction method was used to obtain the blood flow information.At the end,simulated blood vascular was used to conduct flow imaging,and the obtained images were analyzed.Results Experiment results showed that clear blood flow images were obtained using this system.The noise from perivascular tissue could be filtered and the signals from blood flow could be enhanced after image processing.Conclusions In the detection of superficial blood vessel,blood flow signals can be obtained even using single pulse emitting via high frequency ultrasound.The blood flow imaging system can be implemented after image processing.

Objective To study the serotype , biochemical characteristics , virulence gene and multilocus sequence typ-ing(MLST) of S.flexneri 4c in Beijing, Shanghai and Shenyang .Methods Seventy-six strains of S.flexneri 4c isolated from stool samples which had been collected from above-mentioned cities of China were identified with Denka Seiken serum and MASF monoclonal serum .Biochemical characteristics of each strain were identified by API 20E test strip and PCR technology was used for detecting 12 pair virulence genes of S.flexneri.MLST was used to analyze the characteristics . Results The serum agglutination antigen structure of S.flexneri 4c was(Ⅳ:7,8).MASF:B+,Ⅳ:Ⅰ+,7 (8) +.S.flexneri 4c developed different results in biochemical reactions and carried different rates of virulence genes , respectively .The IND test positive rate was 17.11%; MEL weakly positive rate was 3.9%, and ARA test weakly positive rate was 22.37%. Virulence genes were carried at a rate of 89.47% -100%, MLST typing was ST245.Conclusion S.flexneri 4c with serum agglutination antigen structure (Ⅳ:7,8) is a new serotype of S.flexneri.The main biochemical reactions are glucose fermentation and mannitol decomposition .A variety of Shigella related virulence genes are carried .MLST generation is consistent,suggesting that the bacteria might have evolved from ST 270 cloning.

Objective To investigate the effect of continuous hemofiltration in patients with acute renal injury induced by rhabdomyolysis and summarize the nursing experience.Methods Ten patients with acute kidney injury induced by rhabdomyolysis were managed with continuous hemofiltration,corresponding nursing care performed.Results After treatment,the renal function of 7 patients resumed normal,the function of 2 were improved,and only 1 needed long-term hemodialysis.After treatment,the levels of serum creatine phosphokinase(CPK),myoglobin(Mb),blood urea nitrogen(BUN),creatinine(Scr),aspartate aminotransferase(AST) were gradually decreased,K+resumed normal and urine volume increased to normal level,with significant difference as compared to those before treatment(P<0.05).Conclusions Continuous hemofiltration together with pertinent nursing measures can ensure the curative effect.It is of great significance for improving the prognosis of rhabdomyolysis.

Objective To explore the endoscopic features and careinoembryonic antigen (CEA) ex-pressions of colorectal serrated adenomas (SA). Methods From June 2005 to July 2008, 27 patients with colorectal polyps and 26 cases of advanced colorectal cancer (ACC) were enrolled in the study. The pit pat-tern of the suspected lesions were observed with 0. 4% indigo carmine sodium stain and classified according to Kudo classification. The polyps were removed by biopsy, high-frequency electrical excision or endoscopic mucosa resection and the samples of ACC were collected with biopsy forceps. All specimens underwent rou-tine pathological examination and CEA expression was detected by immunohistochemistry. Results There were 47 SAs and 27 other types of polyps in polyp group. Most SAs located in left-side colon and were char-acterized by the bulge semipedunculation. The diameters of 45 serrated adenomas ranged from 3 to 8ram, and the maximal diameter of other 2 were more than 10ram. The most common type of pit pattern in SA was mixed type Ⅱ and ⅢL, with type Ⅱ predominant in a certain percentage. Expression of CEA in SA glands was significantly higher than that in proliferative polyps (P < 0. O1). Candnsion SA is an unique type of colorectal adenoma, which is capable of expressing CEA, and displays malignant potential and deserves great attention.

The human resistin expression vector was constructed and transfected into cells to observe its effects on glucose uptake in adipocytes,cell proliferation and differentiation.The results suggested that human resistin impaired glucose uptake in adipoeytes via stimulating proliferation of preadipocytes and suppressing adipocyte differentiation.Metformin reversed the inhibition imposed by resistin on adipogenesis.

Objective To investigate the inhibitory effect of silencing survivin gene with siRNA on the growth of gastric cancer cells and its mechanism,and provide evidence in treatment for gastric cancer.Methods DNA template coding survivinspecific siRNA was designed and synthesized.Two recombinant plasmids (pGCsilencerU6/GFP/survivin-siRNA-1 and-2) were constructed.The gastric carcinoma cel1 line SGC-7901 were divided into three groups: liposome-treated control group,empty plasmid-transfected control group and survivin-siRNA-1 transfected group.In order to observe the effect of survivin-siRNA,the expressions of survivin mRNA and protein were detected by RT-PCR and Western blotting,respectively.Methyl thiazolyl tetrazolium(MTT) assay was applied to determine the cell growth status.Apoptotic rates were evaluated by flow cytometry(FCM).Results The results of Western blotting and RT-PCR indicated that the inhibitory rates of protein and mRNA in pGCsilenerU6/GFP/survivin-siRNA-1 transfected group(78.25% and 88.75%) were higher than those in liposome-treated control group(5% and 2%) and empty plasmid-transfected control group(1% and 6%)(P

Objective:The experiment researched relation between applying p38MAPK inhibitor(SB203580) and pulmonary injury during CPB.Methods:18 pigs randomly distributed three groups(n=6). We perfused the lung of the second group with SB203580 during CPB. The first group(n=6) and the second group(n=6) are control group. Lung samples were collected. Activated forms of P38 were measured by Western blot. Pulmonary injury was determined by histology. Tissue water percentage was measured. Pulmonary function was measured.Results:Phospho-P38 of the first group were increased compared with both the second group and the third group(P

Objective To assess the overall diagnostic value of computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism with the pulmonary angiography as the gold standard.Methods A search in Cochrane Library,PubMed,OVID,and China National Knowledge Infrastructure (CNKI) was performed to identify relevant English and Chinese-language articles from 01/01/1992 to 01/01/2003 (English) and from 01/01/1994 to 01/01/2003 (Chinese),respectively.Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta-Test version 0.9.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity.Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated.Finally,sensitivity analysis was performed.Results Ten of 407 retrieved articles were included,with a total of 855 patients.The reported sensitivity of CTPA ranged from 0.57 to 1.00,and specificity ranged from 0.78 to 1.00.The pooled weighted sensitivity and specificity for CTPA with 95% confidence interval (95% CI) after correction for standard error were 0.84 (0.73,0.91) and 0.91 (0.87,0.94),respectively.The AUC of SROC was 94.95%. Sensitivity analysis demonstrated no disproportionate influences of individual study.Conclusion CTPA has a highly accurate sensitivity and specificity with a strong ROC curve making it an alternative non-invasive method of pulmonary angiography in the diagnosis of PE.