Objective To construct a lactoferrin-modified brain-targeted propofol-sodium hydroxybutyrate dual-anesthetics starch nanocomposite(Lf-SNPs)and evaluate its brain targeting and optimized anesthetic property.Methods In this study,natural starch was selected as the nanomaterial,lactoferrin as the brain targeting protein,and Lf-SNPs was prepared by inverted phase emulsion method.The dual-loading and brain-targeted delivery of propofol and sodium hydroxybutyrate were achieved by hydrophobic and electrostatic forces,respectively.Lf-SNPs'particle size,potential,distribution in vivo were measured.Twenty C57BL/6 mice were randomly divided into two groups:Control group(same concentration of mixed anesthetics)and Lf-SNPs group,with 10 mice in each group.The duration of anesthetic efficacy was recorded after caudal vein administration.Results The Lf-SNPs had a particle size of(330.6±22.6)nm and average potential of(-23.4±0.5)mV,respectively.The distribution of Lf-SNPs in the brain was visible 30s after intravenous administration,the reaching peak at 3 min,and sustainable distributing for 30 min.The duration of anesthetic efficacy of single bolus infusion was(38.7±5.9)min,which was significantly longer than that of the same concentration of control group(P＜0.05).Conclusion Lf-SNPs has the dual-loading capacity of propofol and sodium hydroxybutyrate,which can realize the targeted delivery in brain and enhance the anesthetic effect.

Objective:To investigate the clinical efficacy and prognostic influencing factors of open abdomen technique for acute pancreatitis with abdominal compartment syndrome (ACS).Methods:The retrospective cohort study was conducted. The clinical data of 186 patients of acute pancreatitis with ACS who were admitted to 6 hospitals, including 65 cases in the 910th Hospital of Joint Logistics Support Force of Chinese People′s Liberation Army, 46 cases in the First Affiliated Hospital of Wenzhou Medical University, 33 cases in the Fujian Provincial Hospital, 31 cases in the Second Affiliated Hospital of Fujian Medical University, 7 cases in the People′s Hospital Affiliated to Quanzhou Medical College, 4 cases in the Shishi General Hospital, from January 2013 to December 2020 were collected. There were 142 males and 44 females, aged (43±8)years. Observation indica-tors: (1) patients conditions after being treatment with open abdomen technique; (2) analysis of clinical characteristics in patients with different treatment outcomes; (3) changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes; (4) influencing factors for prognosis of patients. Measurement data with normal distribution were represented as Mean± SD, and compari-son between groups was analyzed using the t test. Measurement data with skewed distribution were represented as M( Q1, Q3), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test or the continuity correction chi-square test. Repeated measurement data were analyzed using the repeated ANOVA. Spearman correlation analysis was used for correlation analyses. The COX regression model was used for univariate analysis and COX regression model with forward regression was used for multivariate analysis. Results:(1) Patients conditions after being treatment with open abdomen technique. Intra-abdominal pressure, oxygena-tion index, levels of lactic acid and sequential organ failure score of the 186 patients were (23.3±1.9)mmHg (1 mmHg=0.133 kPa), (121±24)mmHg, (5.0±3.4)mmol/L and 10.4±3.6 before the treatment with open abdomen technique and (11.2±2.9)mmHg, (222±38)mmHg, (3.2±2.1)mmol/L and 4.4±2.3 at postoperative 168 hours, showing significant differences in time effects before and after the treatment ( Ftime=855.26,208.50, 174.91,208.47, P<0.05). (2) Analysis of clinical characteristics in patients with different treatment outcomes. Of the 186 patients, 166 cases survived and were discharged, and 20 cases died during hospitalization. Age, sequential organ failure score, duration of ACS and levels of lactic acid during hospitalization before the treatment with open abdomen technique were (41±7)years, 9.4±3.4, 13(10,21)hours and (4.2±0.6)mmol/L in surviving patients, versus (45±6)years, 11.5±2.4, 65(39,84)hours and (5.2±0.5)mmol/L in dead patients, respectively, showing significant differences between them ( t=-2.10, -2.71, Z=-5.36, t=-7.16, P<0.05). Duration of postoperative acute gastro-intestinal injury, duration of continuous renal replacement therapy, time to liberation from mech-anical ventilation, duration of vasoactive drugs therapy, cases undergoing early abdominal closure, cases without intestinal fistula or with postoperative high-order intestinal fistula and low-order intestinal fistula during hospitalization after the treatment with open abdomen technique were 4(2,6)days, 4(3,7)days, 34(21,41)days, 3(2,6)days, 126, 131, 23, 12 in surviving patients, versus 13(10,17)days, 10(8,18)days, 0(0,3)days, 8(6,12)days, 1, 2, 15, 3 in dead patients, respectively, showing significant differences between them ( Z=-5.60, -3.75, -3.64, -3.06, χ2=41.43, 45.86, P<0.05). (3) Changing trend of the volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in patients with different treatment outcomes. The volume of urine output, levels of lactic acid, levels of enteral nutrient intake and the sequential organ failure score in surviving patients during hospitalization were (0.29±0.10)mL/(kg·h), (4.2±0.6)mmol/L, 0.0 kcal/(kg·d) and 9.4±3.4 before the treatment with open abdomen technique and (2.22±0.15)mL/(kg·h), (1.9±0.7)mmol/L, (20.7±2.9)kcal/(kg·d) and 3.7±2.2 at postoperative 168 hours. The above indicators in dead patients during hospitalization were (0.28±0.08)mL/(kg·h), (5.2±0.5)mmol/L, 0.0kcal/(kg·d) and 11.5±2.4 before the treatment with open abdomen technique and (0.28±0.09)mL/(kg·h), (7.7±0.8)mmol/L, (4.6±1.8)kcal/(kg·d) and 12.4±2.1 at postoperative 168 hours. There were significant differences in time effects in the above indicators in surviving patients and dead patients before and after the treatment with open abdomen technique ( Ftime=425.57, 188.59, 394.84, 37.52, P<0.05). There were interactive effects between the above indicators and the treatment outcome at different time points ( Finteraction=383.14, 233.04, 169.83, 36.61, P<0.05). There were signifi-cant differences in the change trends of the above indicators between the surviving patients and the dead patients during hospitalization ( Fgouprs=2 739.56, 877.98, 542.05, 240.85, P<0.05). (4) Influen-cing factors for prognosis of patients. Results of univariate analysis showed that age, sequential organ failure score, duration of ACS before surgery, procalcitonin, lactic acid, postoperative high-order intestinal fistula, abdominal hemorrhage, duration of postoperative acute gastrointestinal injury, duration of continuous renal replacement therapy, duration of vasoactive drugs therapy, early abdominal closure were related factors influencing prognosis of patients under-going treatment with open abdomen technique ( hazard ratio=1.07, 1.18, 1.39, 1.16, 8.25, 12.26, 2.83, 1.29, 1.56, 1.41, 0.02, 95% confidence interval as 1.00-1.15, 1.45-2.27, 1.22-1.57, 1.02-1.32, 1.75-38.90, 7.37-41.23, 1.16-6.93, 1.22-1.37, 1.23-1.99, 1.08-1.84, 0.00-0.16, P<0.05). Results of multivariate analysis showed that extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury were independent risk factors influencing prognosis of patients undergoing treatment with open abdomen technique ( hazard ratio=1.05, 7.95, 1.17, 95% confidence interval as 1.01-1.32, 2.05-30.87, 1.13-1.95, P<0.05) and early abdominal closure was an independent protective factor ( hazard ratio=0.10, 95% confidence interval as 0.01-0.89, P<0.05). Results of Spearman correlation analysis showed that duration of ACS was positively correlated with sequential organ failure score before surgery ( r=0.71, P<0.05). Conclusions:Open abdomen technique is effective for acute pancreatitis with ACS. Extended duration of ACS before surgery, postoperative high-order intestinal fistula and extended duration of postoperative acute gastrointestinal injury are independent risk factors for prognosis of patients during hospitalization and early abdominal closure is an independent protective factor.

Objective:To evaluate the feasibility of early litter water intake in patients after general anesthesia.Methods:Totally 130 patients undergoing laparoscopic salpingectomy under general anesthesia in Yantai Yuhuangding Hospital were selected from December 2018 to May 2019, and divided into the control group ( n=65) and the experimental group ( n=65) . Patients in the control group were routinely abstained from drinking and fasting, while patients in the experimental group were conscious after surgery and took in a small amount of water after cough and swallowing reflexes recovered. The incidence of nausea, vomiting, dry mouth, and hunger within 24 hours after surgery was recorded in both groups, and the time of anal exhaust was recorded. Results:The anal exhaust time of patients in the experimental group was (12.0±1.22) h, while that in the control group was (15.1±1.05) h, and the difference between the two groups was statistically significant ( t= 15.527, P<0.01) . Patients with dry mouth and hunger in the experimental group accounted for 38.5% (25/65) and 13.8% (9/65) , while those in the control group were 58.5% (38/65) and 32.3% (21/65) , and the differences between the two groups were statistically significant (χ 2=5.205, 6.240; P<0.05) . Conclusions:Patients undergoing laparoscopic salpingectomy under general anesthesia are conscious in the recovery room and take in water immediately after recovery of cough and swallowing reflexes, which can increase the patient's comfort, reduce adverse reactions and help promote the early recovery of gastrointestinal function.

OBJECTIVE:To construct surgery base drug management system,and to realize efficient and accurate drug man-agement in surgery room. METHODS:The functions of surgery base drug management system exploited by our hospital were intro-duced,and the effect of the system was evaluated in department of anesthesiology. RESULTS&CONCLUSIONS:The system pos-sesses the functions of surgery drug automated affiliated charge,standardized narcotics prescription autogeneration,discarded nar-cotics prescription auto-prescribing,and drug information summary statisticing and checking,etc. After the application of the sys-tem,nonstandard rate of prescription decreased from 12.7% of handwritten prescription to 0.1% of electronic prescription;the time of drug requisition and checking decreased from(8.5±1.6)min to 0 min and(7.6±1.0)min to(2.9±0.9)min(P<0.05 or P<0.01). The system standardizes medication behavior of physicians and improve their work efficiency,avoid the loophole of drug charge management,realize the consistency between the accounts and the real numbers of narcotics,improve the rate of quality pre-scriptions and narcotics management, and realize integration,automation,intellectualization and whole-course supervision of drug management in pharmacy and clinical departments.

OBJECTIVESTo investigate a survey about acceptance of central slaughtering of live poultry in residents of Guangzhou.

METHODSWe conducted a telephone survey by sampling residents with fixed-line telephone and with normal hearing, whose age is more than 15 years, by Mitofsky-Waksberg two-stage method during Jan 6(th) to 8(th), 2014. 358 residents finished the telephone questionnaire by 12 320 health hot line. We investigated the acceptance rate of city-wide central slaughtering permanently. We compared the difference between the respondents and the 2010 Guangzhou census data by Cohen's effect sizes (w) and weighted by population age and sex. We used χ(2) test to compare the acceptance rate of central slaughtering in residents with different characteristic. We used multiple logistic regression analysis to analyze the factors.

RESULTSThe difference in gender and age was small between respondents and the 2010 Guangzhou census data (w value was 0.13, 0.28, respectively), but that in education and marital status was large (w value was 0.52, 0.31, respectively). 49.0% (95% CI: 43.7%-54.3%) accept city-wide central slaughtering permanently. The acceptance rate of city-wide central slaughtering permanently in those who bought fresh, chilled and frozen poultry in their family in previous year was 54.3% (133/245), 60.0% (57/95) and 59.8% (49/82), respectively. It was more than those who didn't buy fresh, chilled and frozen poultry (38.1% (43/113), 44.9% (118/263) and 45.7% (126/276); χ(2) values were 8.15, 6.40 and 5.03; P values were 0.004, 0.011 and 0.025, respectively). The acceptance rate of city-wide central slaughtering permanently in those who deem fresh poultry taste better than live poultry was 64.9% (24/38). It more than those who deem not (47.0%, 151/320) (χ(2) = 4.22, 6.02, P = 0.040, 0.014, respectively). The acceptance rate of city-wide central slaughtering permanently in the male (OR = 2.68, 95% CI: 1.64-4.37) and those who deem getting sick due to buying live birds from LPM (OR = 1.72, 95% CI: 1.05-2.82), who can accept only fresh poultry carcass supply (OR = 2.39, 95% CI: 1.33-4.30), Who bought live poultry in their family in previous year (OR = 0.29, 95% CI: 0.11-0.74), who will decrease the consumption after ban on live poultry sale (OR = 0.50, 95% CI: 0.30-0.83) was 58.6% (109/186), 59.0% (92/156), 60.7% (139/230), 44.9% (132/295), 36.6% (68/186), respectively.

CONCLUSIONIn the early stage of avian influenza A(H7N9) epidemic in Guangzhou, the rate of acceptance of central slaughtering permanently in residents was not so high. Who deem getting sick due to buying live birds from LPM, who could accept only fresh poultry carcass supply and the male more accept city-wide central slaughtering permanently.

Animals ; Attitude to Health ; Birds ; Epidemics ; Humans ; Influenza A Virus, H7N9 Subtype ; Influenza in Birds ; Influenza, Human ; Male ; Meat-Packing Industry ; Poultry ; Surveys and Questionnaires

Adenoviridae ; Adenovirus Vaccines ; China ; Humans ; Vaccination ; Vaccines

Objective To evaluate the effect of intrathecal ganglioside GM-1 on chronic central pain (CCP) following spinal cord injury in rats.Methods Thirty-two adult male Sprague-Dawley rats,weighing 220-250 g,in which intrathecal catheters were successfully implanted,were randomly divided into 4 groups (n =8 each) using a random number table:control group (group C); group CCP; normal saline group (group N) and ganglioside GM-1 group (group GM).CCP was induced according to modified Allen method in CCP,N and GM groups.In group GM,ganglioside GM-1 20 mg/kg was injected intrathecally once a day,for 5 consecutive days,starting from 14th day after CCP,while the equal volume of nomal saline 10 μl was injected intrathecally in group N.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 4,8,16,24 and 48 h after the end of administration.The rats were then sacrificedat at 7 d after the end of adminmistration and L1 segment of the spinal cord was removed for determination of the expression of NMDA receptor 1 (NR1) by immuno-histochemistry.Results Compared with group C,MWT and TWL were significantly decreased,and NR1 expression was up-regulated in CCP and N groups (P ＜ 0.01),and no significant changes were found in MWT,TWL and NR1 expression in group GM (P ＞ 0.05).Compared with group CCP,no significant changes were found in MWT,TWL and NR1 expression in group N (P ＞ 0.05),and MWT and TWL were significantly increased,and NR1 expression was down-regulated in group GM (P ＜ 0.05).Conclusion Ganglioside GM-1 can alleviate CCP following spinal cord injury in rats and inhibition of expression of NR1 in the spinal cord may be involved in the mechanism.

Objective To evaluate the effects of ischemic postconditioning (IPO) on c-fos protein expression during renal ischemia-reperfusion (I/R) in rats.Methods Seventy-five adult male Sprague-Dawley rats,aged 8-12 weeks,weighing 200-250 g,were randomly allocated into 3 groups (n =25 each) using a random number table:sham operation group (group S),I/R group and IPO group.Renal I/R injury was induced by clamping the bilateral renal pedicles for 1 h followed by 24 h of reperfusion in I/R and IPO groups.Five animals were sacrificed at 1,3,6,12 and 24 h of reperfusion and the left kidneys were removed for microscopic examination and for determination of the expression of c-fos protein by immunohistochemistry.Results Compared with S group,the expression of c-fos protein was significantly up-regulated at each time point during reperfusion in I/R and IPO groups.Compared with I/R group,the expression of c-fos protein was significantly down-regulated at each time point during reperfusion in group IPO.The pathologic changes were significantly attenuated in group IPO as compared with group I/R.Conclusion The mechanism by which IPO attenuates renal I/R injury is related to down-regulation of c-fos protein expression in the renal tissues of rats.

Objective To discuss the value of bronchofiberscopy laryngeal mask airway coupled with foreign body forceps in the removal of children airway foreign bodies.Methods Bronchofiberscopy laryngeal mask airway and its mating foreign body forceps were designed.Ninety-two children with airway foreign bodies were hospitalized from Jan.2011 to Oct.2013 underwent removal surgeries through bronchofiberscopy via laryngeal mask airway coupled with the mating foreign body forceps under fast induction general anesthesia.The fluctuation of the patients' blood pressure (BP),heart rate (HR),saturation of pulse oxygen (SpO2) and pressure of end-tidal carbon dioxide (PetCO2) were recorded.SPSS 13.0 software was used to analyze the data.Results All the operations were successful,and the haemodynamics indexes of the patients were stable with good ventilation.No side effect and complications were found.Compared with the basic value before anesthesia,there was no statistically significant difference in pulse blood pressure PetCO2 between immediately after laryngeal mask,laryngeal mask after 3 minutes,bronchoscope into the glottis instantly,immediately after laryngeal mask.SpO2 increased after laryngeal mask(F =3.04,P ＜ 0.05).Conclusion Bronchofiberscopy laryngeal mask airway coupled with foreign body forceps applied in the removal surgery of children airway foreign body is safe,effective and with less complication.

OBJECTIVETo evaluate the effectiveness of small interfering RNA (siRNA) on inhibiting severe acute respiratory syndrome (SARS)-associated coronavirus replication, and to lay bases for the future clinical application of siRNA for the treatment of viral infectious diseases.

METHODSVero-E6 cells was transfected with siRNA before SARS virus infection, and the effectiveness of siRNA interference was evaluated by observing the cytopathic effect (CPE) on Vero-E6 cells.

RESULTSFive pairs of siRNA showed ability to reduce CPE dose dependently, and two of them had the best effect.

CONCLUSIONsiRNA may be effective in inhibiting SARS-associated coronavirus replication.

Animals ; Cercopithecus aethiops ; RNA, Small Interfering ; pharmacology ; SARS Virus ; drug effects ; Transfection ; Vero Cells ; Virus Replication ; drug effects