[Preoperative video distraction alleviates separation anxiety and improves induction compliance of preschool children: a randomized controlled clinical trial].

Objective: To explore the effect of video distraction on preoperative separation anxiety and induction compliance of preschool children receiving strabismus surgery under general anesthesia. Methods: In this prospective trial, 80 children aged 3 to 6 years scheduled for strabismus surgery under inhalation anesthesia were randomly allocated to one of two groups, a control group and a video distraction group, with 40 cases in each group. Children in the video distraction group continuously watched videos from waiting in the holding area, separating with parents, entering the operating room and induction of anesthesia, while children in the control group didn't watch videos during the same process. The modified Yale Preoperative Anxiety Scale (mYPAS) of children were recorded upon arriving at the holding area(T1)and separating with parents(T2). Induction Compliance Checklist (ICC) score was recorded when the anesthesia induction was performed. The emergence time, the occurrence rate of adverse events in post-anesthesia care unit (PACU) including nausea and vomiting, laryngospasm, severe cough, hypoxemia and sinus bradycardia, incidence of postoperative adverse reactions such as pain, dizziness, nausea and vomiting and lethargy, the parents' satisfaction of anesthesia were also assessed. Results: There were no significant difference in mYPAS score and the proportion of mYPAS score>30 between 2 groups at T1 (all P>0.05). At T2, the mYPAS score and the proportion of mYPAS score>30 in video distraction group were (34.41±13.23) and 52.50%, which were lower than those in control group (50.64±20.96, 87.50%) with statistically significant difference (all P<0.05). The ICC score of video distraction group was lower than that of the control group, which was (1.83±2.26) vs (4.03±2.99), and the difference was statistically significant (P<0.05). The proportion of children with ICC score=0 in video distraction group was 37.50%, which was higher than that in the control group (12.50%), while the proportion of children with ICC score=4-10 was lower than that of the control group, which was 17.50% vs 45.00%, and the difference was statistically significant (P<0.05). No significant intergroup differences were observed in emergence time, incidence of adverse events in PACU, and incidence of postoperative adverse reactions (P>0.05). The parents' satisfaction of anesthesia in the video distraction group was (9.23±0.89), which was higher than that in the control group (8.63±1.23), with statistically significant (P<0.05). Conclusion: Preoperative video distraction alleviates separation anxiety, improves induction compliance of preschool children receiving strabismus surgery under general anesthesia, and increases the parents' satisfaction of anesthesia.

[Study of the effects of hydromorphone on emergence agitation of children anesthetized by sevoflurane].

Objective: To observe the effect of hydromorphone on emergence agitation of children anesthetized by Sevoflurane. Methods: One hundred patients without any analgetic, aged 3 to 7 years, ASA Ⅰ-Ⅱ, undergoing strabismus surgery in Beijing Tongren Hospital from March, 2017 to December, 2017 were selected and they were randomly divided into two groups(n=50), H group and F group by random number table. After standardized tidal volume method induction by 8% sevoflurane and oxygen, suiltable laryngeal mask was inserted, and each patient was left spontaneously breathing anesthetized by 2.5%-3.0% sevoflurane.Ten minutes before the surgery, patients in H group were administered a dose of 0.01 mg/kg hydromorphone (diluted to 5 ml with normal saline) by pump control injection in 10 min, whereas patients in F group administered a dose of 1 µg/kg fentanyl in the same way. After the surgery , the patient was sent to postanesthesia care unit. A nurse who was blinded measured the vital signs, pediatric anesthesia emergence delirium(PAED) score, face legs activity cry consolability behavioral pain assessment tool(FLACC) score, the time of opening the eyes and departing from postanesthesia care unit(PACU), and the occurence rates of hypoxemia, swirl or nausea, drowsiness, and other scores. Results: The incidence of emergence agitation(EA) in H group was lower than in F group, whether EA was defined as PAED>10 (18.0% vs 28.0%, P>0.05) or PAED>12(12.0% vs 24.0%, P>0.05), there were not significant differences between them. The ratio of patients whose PAED>15 in F group was 12.0%, while the ratio of H group was 0, there was significant difference between the two groups(P=0.027). The occurrence rates of swirl, glossocoma in H group were 0 and 10.0% while those of F group were all 6.0%, there were no significant differences between the two groups(P>0.05). Conclusions: Comparing with fentanyl, hydromorphone can prevent the occurrence rate of EA of the children anesthetized by sevoflurane equally, even decrease the occurrence rate of the severe EA more observably, and reduce postoperation pain more significantly with less occurrence rate of swirl or nausea. Glossocoma need be paid attention to when HM is administered.

Linkage in cultured Chinese hamster cells of two genes, emtB and leuS, involved in protein synthesis and isolation of cell lines with mutations in three linked genes.

We have determined via segregation analyses from appropriate hybrids that two genes involved in protein synthesis, one encoding for a ribosomal protein (emtB) and one encoding for leucyl-tRNA synthetase (leuS), cosegregate at a very high frequency and are linked in both Chinese hamster ovary and lung cells. In contrast, the emtA locus, defined by a second complementation group of emetine-resistant mutants which also have alterations affecting protein synthesis and probably the ribosome, is not linked to leuS. In addition, we have determined that a third gene, one that can be altered to give rise to chromate resistance, is syntenic with emtB and leuS. We have selected cell lines with mutations in each of these three linked genes and have shown that the three loci cosegregate at a high frequency. Because the mutations in these three linked genes provide easily distinguishable phenotypes, these cell lines should provide a powerful tool for examining several important questions concerning mitotic recombination in somatic cells.

[Behavior change of a primipara with cesarean section during early postpartum period].

The focus of this study was to understand the process of behavior change in a cesarean section primipara during her early postpartum period. The study was conducted by the field method with the researcher as the subject's primary nurse. Content analysis was employed to analyze and categorize the 6 sections of the behavioral process record, which were taken down in narrative form by the researcher during the nursing process. Three stages of behavior change were identified: (1) Lack of confidence and uncertainty about self care and newborn care. (2) Actively intending to explore and learn about self care and newborn care. (3) Adjusting caring methods and planning for the future. In this study, the researcher provided information and caring to the subject individually. It assisted the new mother in becoming a competent mother.

Translational recognition of the 5'-terminal 7-methylguanosine of globin messenger RNA as a function of ionic strength.

The translation of rabbit globin mRNA in cell-free systems derived from either wheat germ or rabbit reticulocyte was studied in the presence of various analogues of the methylated 5' terminus (cap) as a function of ionic strength. Inhibition by these analogues was strongly enhanced by increasing concentrations of KCl, K(OAc), Na(OAc), or NH4(OAc). At appropriate concentrations of K(OAc), both cell-free systems were equally sensitive to inhibition by m7GTP. At 50 mM K(OAc), the reticulocyte system was not sensitive to m7GMP or m7GTP, but at higher concentrations up to 200 mM K(OAc), both nucleotides caused strong inhibition. The compound in m7G5'ppp5'Am was inhibitory at all concentrations of K(OAc) ranging from 50 to 200 mM, although more strongly so at the higher concentrations. Over the same range of nucleotide concentrations, the compounds GMP, GTP, and G5'ppp5'Am were not inhibitors. The mobility on sodium dodecyl sulfate-polyacrylamide electrophoresis of the translation product was that of globin at all K(OAc) concentrations in the presence of m7GTP. Globin mRNA from which the terminal m7GTP group had been removed by chemical treatment (periodate-cyclohexylamine-alkaline phosphatase) or enzymatic treatment (tobacco acid pyrophosphatase-alkaline phosphatase) was translated less efficiently than untreated globin mRNA at higher K(OAc) concentrations, but retained appreciable activity at low K(OAc) concentrations.

A polypeptide which reverses cap analogue inhibition of cell-free protein synthesis. Purification and binding to capped oligonucleotides.

An assay was developed to detect the component which recognizes the methylated 5'-terminus of messenger RNA (cap) during initiation of translation. Globin mRNA translation in a reticulocyte cell-free system was partially inhibited with cap analogues, and protein fractions were added to the system in an attempt to reverse inhibition. Such an activity was detected in the 500 mM KCl extract of rabbit reticulocyte ribosomes. The activity (cap analogue inhibition reversal) was purified 800-fold by precipitation with ammonium sulfate saturation, batchwise chromatography on DEAE-cellulose, centrifugation on sucrose gradients containing 100 and 500 mM KCl, and column chromatography on DEAE-cellulose and phosphocellulose. At some stages multiple peaks of activity were detected. Electrophoretic analysis of the final preparation revealed a single polypeptide of 24,000 daltons, making it likely that it is the same as the cap-binding protein detected by Sonenberg et al. (Sonenberg, N., Morgan, M. A., Merrick, W. C., and Shatkin, A. J. (1978) Proc. Natl. Acad. Sci. U. S. A. 75, 4843-4847), using a cross-linking assay. Direct binding of purified fractions of cap analog inhibition reversal factor to capped oligonucleotides of the form m7Gppp(Np)6-8G[32P]Cp could be demonstrated by both gel filtration on Sephadex G-50 and nitrocellulose membrane filtration. Binding was stimulated by MgCl2 and nucleoside triphosphates. An approximate association constant between oligonucleotide and protein of 3 X 10(8) M-1 was obtained.

Arthritis as a manifestation of self-mutilation in childhood.

Traumatic arthritis resulting from self-aggression is rarely encountered in children. Differentiation from child abuse and common causes of childhood arthritis is difficult and rests upon a high level of suspicion. We describe a 10-year-old girl with hand deformities associated with joint pain and swelling managed as juvenile rheumatoid arthritis for 3 years. Reevaluation revealed both physical and radiographic evidence of recurrent trauma. Psychiatric assessment confirmed the diagnosis of autoaggression leading to self-mutilation and psychosocial rehabilitation was essential in successful management.

[Measurements of the lumbar spinal canal of Chinese by computed tomography].

The study of the lumbar canal sizes in Chinese has not been reported before. Thirty adult patients, aged 20 to 40 years, who sustained thoracolumbar or lumbar fracture-dislocation and needed further computed tomographic (CT) scanning were included in this study. There was no significant back pain or sciatica on these patients before. Measurements of the med-sagittal anteroposterior (A-P) and interpedicular (I-P) diameters of the spinal canals L1 to L5 were requested at the same time during CT scanning. The results show that the lowest normal limits of the A-P and I-P diameters of the lumbar canals in Chinese are 11 mm and 19 mm respectively. The I-P diameters increase progressively from the first to the fifth vertebrae. The A-P diameters, however, are more variable and shortest at L2, L3 and L4 vertebrae.

Back pain after thoracolumbar fracture treated with long instrumentation and short fusion.

The purposes of this retrospective study are to evaluate the degeneration of facets in unfused segments immobilized by Harrington rods and to see how often back pain developed after treatment with this method. Sixty patients with thoracolumbar fracture were treated with the Harrington rod long-fuse short technique. Harrington rods are removed an average of 14 months after initial surgery. Every case showed solid fusion during implant removal exploration. Thereafter, all cases were followed for a minimum of 5 years. Roentgenographic studies and a bone scan were performed to evaluate the degeneration of facet joints. Back pain complaint was found in 11 patients (18.3%). The degeneration of unfused facets was visualized in six patients by roentgenograms. Increased activity in the instrumented spine by bone scan examination also was noted in six patients: three cases were at unfused area, one at a fused area, and two at fused and unfused areas. In conclusion, degeneration in the immobilized and unfused segments after rod long and fused short was rarely seen clinically after long-term follow-up. Back pain was experienced in only 18.3% of the patients and seldom required medication.

Cell-free translation of tobacco vein mottling virus RNA.

Tobacco vein mottling virus (TVMV), a member of the potyvirus group, was translated in a rabbit reticulocyte cell-free system. The RNA was approximately 5% as active as rabbit globin mRNA in directing protein synthesis. Translation was stimulated approximately 15% by the cap analog pppm7G, a phenomenon which has also been observed with uncapped viral RNAs. Treatment with NaIO4 and NaB(3H]4 under conditions which label the caps of globin and ovalbumin mRNA failed to produce labeled cap structures in TVMV RNA. Approximately 20 polypeptides, ranging from 20,000 to 100,000 daltons, were produced in the reticulocyte system programmed with TVMV RNA. The predominant species (P75) had a molecular weight of 75,000. The same major polypeptides were produced in the wheat germ system, but there was relatively greater synthesis of the smaller polypeptides. Incubation of the reticulocyte system in the presence of cycloheximide following an initial period of synthesis failed to cause breakdown of larger polypeptides into smaller polypeptides. Preincubation of TVMV RNA with the reticulocyte system before addition of labeled amino acids caused greater synthesis of the smaller polypeptides, suggesting that they are derived from fragments of the RNA produced during the incubation. Translation of TVMV RNA which had been bound to oligo(dT)-cellulose yielded nearly the same spectrum of polypeptides, but synthesis of polypeptides smaller than 52,000 daltons was reduced. At low ionic strength, only polypeptides of 52,000 daltons and smaller were synthesized. At high ionic strength, P75 was essentially the only product synthesized. Antibody to whole virus precipitated many of the polypeptides, including P75, suggesting that they contain the coat protein sequence. No polypeptide with the electrophoretic mobility of authentic coat protein, however, was precipitated. Comparison of partial proteolytic digests of P75 and authentic coat protein provided further evidence for sequence homology.