Objective:To evaluate the effect of different doses of compound sodium chloride injection combined with norepinephrine on prevention of hypotension after lumbar anesthesia in the patients undergoing caesarean section.Methods:A total of 150 patients with a singleton fetus, aged 18-45 yr, at ≥37 weeks of gestation, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, with height ≥150 cm, weighing ≤100 kg, with body mass index < 40 kg/m 2, scheduled for elective caesarean section under lumbar anesthesia, were divided into 3 groups ( n=50 each) by the random number table method: compound sodium chloride injection 4, 8 and 12 ml·kg -1·h -1 groups (group A, group B, group C). Compound sodium chloride injection 4 ml/kg was intravenously injected for liquid preload before lumbar anesthesia, and 0.5% hyperbaric bupivacaine 12.5 mg was injected to the subarachnoid space for lumbar anesthesia. Norepinephrine was intravenously injected at a dose of 6 μg immediately after intrathecal injection, followed by an infusion of 0.05 μg·kg -1·min -1, and infusion was stopped at 5 min after delivery. Compound sodium chloride injection was intravenously infused simultaneously at a rate of 4, 8 and 12 ml·kg -1·h -1 in A, B and C groups, respectively. The maximum diameter of inferior vena cava (IVCmax) and the minimum diameter of inferior vena cava (IVCmin) were measured by ultrasound, and inferior vena cava collapse index (IVC-CI) was calculated at 1 min before fluid preload (T 1), immediately after fluid preload (T 2), at 5 min after anesthesia (T 3), at 5 min after fetal delivery (T 4) and immediately before leaving the operating room (T 5). The incidence of intraoperative adverse events (hypotension, severe hypotension, bradycardia, hypertension, nausea, and vomiting) and neonatal outcomes (umbilical artery blood gas index and Apgar score at 1 and 5 min after birth) were recorded. Results:Compared with group A, IVCmin was significantly increased and IVC-CI was decreased at T 5 in group B, and IVCmin and IVCmax were significantly increased and IVC-CI was decreased at T 5 in group C ( P<0.05). There was no significant difference in IVCmax, IVCmin and IVC-CI at each time point between group B and group C ( P>0.05). There was no significant difference in the incidence of hypotension, severe hypotension, bradycardia, hypertension, nausea and vomiting among the three groups ( P>0.05). There was no significant difference in the results of blood gas analysis of the umbilical artery and Apgar score at each time point after birth among the three groups ( P>0.05). Conclusions:Compound sodium chloride injection 4, 8 and 12 ml·kg -1·h -1 combined with norepinephrine can effectively prevent the occurrence of hypotension after lumbar anesthesia in the patients undergoing caesarean section without increasing maternal and infant adverse events, and the effect of 8 and 12 ml·kg -1·h -1 for volume supplementation is better than that of 4 ml·kg -1·h -1.

Adult ; COVID-19 ; China/epidemiology* ; Epidemics ; Female ; Humans ; Male ; SARS-CoV-2

Objective To understand the radioactivity level of food surrounding a uranium mine in Xinjiang, to supplement the baseline database of food radionuclides in Xinjiang, to analyze the content of radionuclides and to estimate the internal exposure dose of residents caused by dietary intake. Methods The specific activity of ²³⁸U, ²³²Th, ²²⁶Ra, ⁴⁰K and ¹³⁷Cs of interest nuclides was measured, statistically analyzed by high purity germanium γ spectrometer, and the annual effective dose of these nuclides was estimated. Results No nuclide ²³⁸U was detected in food samples from 2018 to 2020. The average activity concentration and detection rate of other radionuclides were ²³²Th: 0.428 ± 0.038 Bq/kg (18.3%)、²²⁶Ra: 0.477 ± 0.063 Bq/kg (38%)、⁴⁰K: 162 ± 7 Bq/kg (100%)、¹³⁷Cs: 0.071 ± 0.011 Bq/kg (29.6%). The annual effective dose of residents due to food radionuclides was about 0.198 mSv. Conclusion The radioactivity level of food in the vicinity of a uranium mining mountain in Xinjiang is within the national standard limit, and the average annual effective dose caused by the diet of residents is consistent with the report of UNSCEAR in 2000. The content of artificial radionuclide ¹³⁷Cs detected in food samples will not cause harm to the health of residents.

Objective:To study the clinical and genetic characteristics of Gitelman syndrome in children.Methods:Four children diagnosed with Gitelman syndrome in the Baoding Children′s Hospital from January 2017 to October 2018 were enrolled, and their clinical data and pathogenic gene carrying status were analyzed.Results:There were 2 males and 2 females in the enrolled patients.Two children complained of short stature and 2 children were diagnosed as hypokalemia by accident.All the 4 children showed constipation, short stature, repeated hypokalemia, hyponatremia, hypochloremia, normal urinary calcium/creatinine ratio, elevated renin and angiotensin Ⅱ levels in supine position, and normal aldosterone.Three children had hypomagnesemia and 1 child had a normal blood magnesium level.All of the 4 children had a compound heterozygous mutation of SLC12A3 gene.The mutations of c. 1670-7G>A and c. 1698C>A were not reported in the literature. Conclusions:Constipation and short stature are common clinical manifestations of Gitelman syndrome in children.Typical cases show hypokalemia, hypomagnesemia, hyponatremia and hypochloremia, etc.The blood magnesium level can be normal in few children.Most children with Gitelman syndrome carry SLC12A3 compound heterozygous mutations.

No abstract available.
Breast Neoplasms* ; Breast* ; Phenobarbital*

Objective To construct the permanent colostomy patients with rectal cancer in archives information module content. Methods Using expert meeting,semi- structured interview, literature review, Delphi expert consultation method, establish the system of permanent rectal cancer patients file information specific module. Results In two- round consultation authority coefficient was 0.847. Kendall coordination coefficient (Kendall′s W) was 0.195-0.331, the difference had statistical significance (P<0.01); through the expert consultation method to construct the file information module for permanent colostomy patients with rectal cancer, which contained 4 first-level indicators (colostomy patient information module, stoma nursing modules, stoma patients transitional care modules, colostomy patients with network platform module), 11 secondary indicators, 36 third grade indicators. Conclusions This study established file information module content for permanent stoma patients with rectal cancer. It has good scientificity and reliability, and can provide a theoretical basis for the clinical development of a file information system network for transitional care of permanent stoma patients with rectal cancer.

Purpose To investigate the diagnosis and differentail diagnosis of metastatic small cell carcinoma of bone in needle biopsy, especially for the differentail diagnosis with Ewing sarcoma of bone. Methods Clinicopathological informations of 11 cases of metastat-ic small cell carcinoma and 20 cases of Ewing sarcoma were collected, and markers for differentail diagnosis were detected in two groups by immunohistochemistry of EnVision. Results The positive rates of CD99 and FLI-1 were 27. 3% and 54. 5% in metastatic small cell carcinoma group, while the positive rate of CK was 15. 0% in Ewing sarcoma group. Patient′s age, single lesion, expression of CK, vimentin, CD99, FLI-1, CD56 were significantly different in two groups. Conclusions Metastatic small cell carcinoma and E-wing sarcoma share similar histopathologic features in needle biopsy, no single immunohistochemical marker can specifically distinguish small cell carcinoma from Ewing sarcouma. The correct diagnosis should comprehensive analyze clinicopathologic characters and a se-ries of immunohistochemical markers.

Purpose To evaluate three-dimensional strain changes of the left ventricle in patients with type 2 diabetes and poor blood glucose control using real-time three-dimensional speckle tracking imaging (RT3D-STI), and to assess the correlation between three-dimensional strains and hemoglobin A1C (HbA1c). Materials and Methods Sixty-nine patients with type 2 diabetes and forty-two control subjects were recruited in this study. The patients were divided into DM1 group (patients with well blood glucose control, HbA1c<6.5%) and DM2 group (patients with poor blood glucose control, HbA1c ≥ 6.5%) according to the glycosylated hemoglobin level. Parameters including global longitudinal strain (GLS), global circumferential strain (GCS), global radial strain (GRS), global area strain (GAS), left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular mass (LVM) were obtained from cardiac apex full volume images by using RT3D-STI. The parameters of three groups were compared, and the correlation between the cardiac parameters and HbA1c were analyzed. Results The GAS, GLS, GCS, GRS, LVEDV, LVESV, LVM and LVEF showed no statistic difference between DM1 group and control group (P>0.05). LVM of DM2 group was higher than that in control group (P<0.01), but GAS and GLS of DM2 group were lower than those in control group (P<0.05). LVM of DM2 group was higher than that in DM1 group (P<0.01), but GAS and GLS of DM2 group were lower than those in DM1 group (P<0.01). HbA1c was negative correlated with GAS and GLS (r= - 0.773 and 0.465, P<0.01). Conclusion The reduced GAS and GLS of the patients with type 2 diabetes and poor blood glucose control may indicate damaged myocardial function.

ObjectiveTo investigate the condition of hospital staff in surgery and internal medicine department in a specified hospital for consent of patients. MethodsThis study included 50 hospital staff in surgery and internal medicine department in specified hospital at the second level in Chongqing city in May 2010. We also analyzed the dealership of children and psychopath, consent of patients or relatives for choosing hospitals. ResultsThe ratios of cognition of hospital staff for consent of patients were 68％ and 46％, which had statistical difference ( P＝0.026 ). The main ways were radio and television. About 97％ hospital staff knew that it's hospital staff s duty to inform relative information to patients. ConclusionMedical legislation department and medical institutions should enhance the study of hospital staff on relative laws and regulations. Thus hospital staff have a in-depth understanding on information of consent of patients.

Objective To design a new portable vital signs monitor for family use. Methods TMS320F2812, a kind of digital signal processor, was applied as the main processor to control the functional mod-ules including A/D convertor, LCD display. Bluetooth communication module was introduced to achieve real-time fast transfer of data between the system and the PC. Results Not only can the system monitor electrocardiogram (ECG), breath rate, pulse rate, body temperature and other vital signs accurately, but also it runs stably. Conclusion The features of DSP and Bluetooth were well combined in the design of the family-oriented, easy to use, multi-functional monitor with small size, low power consumption and convenience. A broad application and market prospects can be predicted.