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Objective:To study risk factors and clinical outcomes of nosocomial infection (NI) in extremely premature infants (EPIs).Methods:From January 2017 to December 2021, EPIs admitted to NICU of our hospital were retrospectively studied. The infants were assigned into NI group and non-NI group. The NI group were further assigned into survival group and death group. Single factor analysis was conducted using chi-square test, t-test and non-parametric test. Multiple logistic regression was used to analyze risk factors of NI and death.Results:A total of 115 cases were enrolled, including 67 (58.3%) in NI group, 54 in survival group and 12 in death group. One case gave up treatment. 48 cases were in non-NI group. 81 episodes of nosocomial infections occurred in NI group and the case infection rate was 70.4% (81/115). 48 cases (41.7%) had late-onset sepsis, 14 (12.2%) neonatal necrotizing enterocolitis, 13 (11.3%) pneumonia, 1 (0.9%) urinary tract infection and 1 (0.9%) thrush. Hemodynamic significant patent ductus arteriosus (hsPDA) and long duration of parenteral nutrition were independent risk factors for NI in EPIs ( P<0.05). The incidence of bronchopulmonary dysplasia (BPD) (100.0% vs. 70.8%) and mortality (17.9% vs. 2.1%) in NI group was higher than non-NI group ( P<0.05). Septic shock was an independent risk factor for the death due to NI. Conclusions:The incidence of NI in EPIs is high. hsPDA and long duration of parenteral nutrition are independent risk factors for NI in EPIs. EPIs with NI have high incidence of BPD and mortality and septic shock is an independent risk factor for death.
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Alzheimer's disease (AD) is an irreversible neurodegenerative disorder that damages patients' memory and cognitive abilities. Therefore, the diagnosis of AD holds significant importance. The interactions between regions of interest (ROIs) in the brain often involve multiple areas collaborating in a nonlinear manner. Leveraging these nonlinear higher-order interaction features to their fullest potential contributes to enhancing the accuracy of AD diagnosis. To address this, a framework combining nonlinear higher-order feature extraction and three-dimensional (3D) hypergraph neural networks is proposed for computer-assisted diagnosis of AD. First, a support vector machine regression model based on the radial basis function kernel was trained on ROI data to obtain a base estimator. Then, a recursive feature elimination algorithm based on the base estimator was applied to extract nonlinear higher-order features from functional magnetic resonance imaging (fMRI) data. These features were subsequently constructed into a hypergraph, leveraging the complex interactions captured in the data. Finally, a four-dimensional (4D) spatiotemporal hypergraph convolutional neural network model was constructed based on the fMRI data for classification. Experimental results on the Alzheimer's Disease Neuroimaging Initiative (ADNI) database demonstrated that the proposed framework outperformed the Hyper Graph Convolutional Network (HyperGCN) framework by 8% and traditional two-dimensional (2D) linear feature extraction methods by 12% in the AD/normal control (NC) classification task. In conclusion, this framework demonstrates an improvement in AD classification compared to mainstream deep learning methods, providing valuable evidence for computer-assisted diagnosis of AD.
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Humans , Alzheimer Disease/diagnostic imaging , Neural Networks, Computer , Magnetic Resonance Imaging/methods , Neuroimaging/methods , Diagnosis, Computer-Assisted , Brain , Cognitive DysfunctionABSTRACT
The pathogenesis of Alzheimer's disease (AD), a common neurodegenerative disease, is still unknown. It is difficult to determine the atrophy areas, especially for patients with mild cognitive impairment (MCI) at different stages of AD, which results in a low diagnostic rate. Therefore, an early diagnosis model of AD based on 3-dimensional convolutional neural network (3DCNN) and genetic algorithm (GA) was proposed. Firstly, the 3DCNN was used to train a base classifier for each region of interest (ROI). And then, the optimal combination of the base classifiers was determined with the GA. Finally, the ensemble consisting of the chosen base classifiers was employed to make a diagnosis for a patient and the brain regions with significant classification capability were decided. The experimental results showed that the classification accuracy was 88.6% for AD
Subject(s)
Humans , Alzheimer Disease/diagnosis , Brain/diagnostic imaging , Cognitive Dysfunction/diagnosis , Early Diagnosis , Magnetic Resonance Imaging , Neural Networks, Computer , Neurodegenerative DiseasesABSTRACT
Purpose@#Four and a half LIM protein 1 (FHL1) is involved in breast cancer (BC) development, but the regulatory mechanism involved remain unclear. In the present study, we examined the role of FHL1 in BC development. @*Methods@#The expression of FHL1, miR-183-5p, and miR-96-5p in BC tissues was analyzed using StarBase analysis. FHL1 expression in BC tissues, a normal human breast epithelial cell line, and BC cell lines was detected using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The relationship between FHL1 and miR-183-5p/miR-96-5p was analyzed via Pearson's rank correlation, TargetScan, and a dual-luciferase reporter assay. BT549 and MDA-MB-231 cells were transfected with either FHL1 and miR-183-5p mimics, or siFHL1 and a miR-183-5p inhibitor, respectively. The viability, colony number, migration, invasion, and tube length of BT549 and MDA-MB-231 cells were examined using cell counting kit-8, colony formation, wound-healing, Transwell, and tube formation assays, respectively. The levels of FHL1, vascular endothelial growth factor (VEGF), p53, E-cadherin, N-cadherin, and vimentin were quantified using western blotting and qRT-PCR. @*Results@#FHL1 expression was downregulated in BC tissues and cells, whereas miR-183-5p and miR-96-5p were upregulated in BC tissues (negative correlation with FHL1 expression).FHL1 overexpression inhibited the viability, colony number, migration, and invasion of BC cells and the expression of VEGF, N-cadherin, and vimentin, and increased the expression of FHL1, p53, and E-cadherin in BT549 cells. Furthermore, a miR-183-5p mimic reversed these effects of FHL1 overexpression, whereas FHL1 silencing caused opposite results to those observed in MDA-MB-231 cells; however, this was reversed by a miR-183-5p inhibitor. @*Conclusion@#Our study suggests that miR-183-5p promotes cell proliferation, metastasis, and angiogenesis by negatively regulating FHL1 in BC.
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Purpose@#Four and a half LIM protein 1 (FHL1) is involved in breast cancer (BC) development, but the regulatory mechanism involved remain unclear. In the present study, we examined the role of FHL1 in BC development. @*Methods@#The expression of FHL1, miR-183-5p, and miR-96-5p in BC tissues was analyzed using StarBase analysis. FHL1 expression in BC tissues, a normal human breast epithelial cell line, and BC cell lines was detected using quantitative reverse transcription polymerase chain reaction (qRT-PCR). The relationship between FHL1 and miR-183-5p/miR-96-5p was analyzed via Pearson's rank correlation, TargetScan, and a dual-luciferase reporter assay. BT549 and MDA-MB-231 cells were transfected with either FHL1 and miR-183-5p mimics, or siFHL1 and a miR-183-5p inhibitor, respectively. The viability, colony number, migration, invasion, and tube length of BT549 and MDA-MB-231 cells were examined using cell counting kit-8, colony formation, wound-healing, Transwell, and tube formation assays, respectively. The levels of FHL1, vascular endothelial growth factor (VEGF), p53, E-cadherin, N-cadherin, and vimentin were quantified using western blotting and qRT-PCR. @*Results@#FHL1 expression was downregulated in BC tissues and cells, whereas miR-183-5p and miR-96-5p were upregulated in BC tissues (negative correlation with FHL1 expression).FHL1 overexpression inhibited the viability, colony number, migration, and invasion of BC cells and the expression of VEGF, N-cadherin, and vimentin, and increased the expression of FHL1, p53, and E-cadherin in BT549 cells. Furthermore, a miR-183-5p mimic reversed these effects of FHL1 overexpression, whereas FHL1 silencing caused opposite results to those observed in MDA-MB-231 cells; however, this was reversed by a miR-183-5p inhibitor. @*Conclusion@#Our study suggests that miR-183-5p promotes cell proliferation, metastasis, and angiogenesis by negatively regulating FHL1 in BC.
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OBJECTIVE@#To study the clinical effect of calsurf, a domestic exogenous pulmonary surfactant, in the treatment of severe neonatal infectious pneumonia.@*METHODS@#A total of 208 neonates with severe infectious pneumonia who hospitalized in 5 hospitals of China were enrolled. According to their parents' wishes on admission, these neonates were administered with conventional treatment (control group; n=81) and calsurf treatment + conventional treatment (calsurf treatment group, n=127). The two groups were compared in terms of the degree of oxygen dependence on admission, blood gas parameters before and after treatment, lung ultrasound results, duration of mechanical ventilation, length of hospital stay, hospital costs, complications and prognosis.@*RESULTS@#Compared with the control group on admission, the calsurf treatment group had significantly higher inhaled oxygen concentration and partial pressure of carbon dioxide and significantly lower arterial partial pressure of oxygen and oxygenation index (P<0.01). After 1 hour of treatment, both groups had significant improvements in the above indices (P<0.05), and the improvements were more significant in the calsurf treatment group (P<0.05). After 4-6 hours of calsurf administration, there was a significant reduction in the degree of pulmonary consolidation. The calsurf treatment group had significantly shorter duration of mechanical ventilation and length of hospital stay than the control group, while there was no significant difference in the incidence rate of complications between the two groups. The neonates of both groups had a good prognosis.@*CONCLUSIONS@#In neonates with severe infectious pneumonia, calsurf treatment can significantly improve oxygenation, reduce the degree of pulmonary consolidation, and shorten the duration of mechanical ventilation and length of hospital stay. Therefore, it should be considered in neonates with severe infectious pneumonia.
Subject(s)
Humans , Infant, Newborn , China , Pneumonia , Prospective Studies , Pulmonary Surfactants , Respiration, ArtificialABSTRACT
Alzheimer's disease (AD) is a typical neurodegenerative disease, which is clinically manifested as amnesia, loss of language ability and self-care ability, and so on. So far, the cause of the disease has still been unclear and the course of the disease is irreversible, and there has been no cure for the disease yet. Hence, early prognosis of AD is important for the development of new drugs and measures to slow the progression of the disease. Mild cognitive impairment (MCI) is a state between AD and healthy controls (HC). Studies have shown that patients with MCI are more likely to develop AD than those without MCI. Therefore, accurate screening of MCI patients has become one of the research hotspots of early prognosis of AD. With the rapid development of neuroimaging techniques and deep learning, more and more researchers employ deep learning methods to analyze brain neuroimaging images, such as magnetic resonance imaging (MRI), for early prognosis of AD. Hence, in this paper, a three-dimensional multi-slice classifiers ensemble based on convolutional neural network (CNN) and ensemble learning for early prognosis of AD has been proposed. Compared with the CNN classification model based on a single slice, the proposed classifiers ensemble based on multiple two-dimensional slices from three dimensions could use more effective information contained in MRI to improve classification accuracy and stability in a parallel computing mode.
Subject(s)
Humans , Alzheimer Disease , Diagnosis , Brain , Diagnostic Imaging , Cognitive Dysfunction , Deep Learning , Neural Networks, Computer , Neuroimaging , PrognosisABSTRACT
In recent years, researchers have introduced various methods in many domains into medical image processing so that its effectiveness and efficiency can be improved to some extent. The applications of generative adversarial networks (GAN) in medical image processing are evolving very fast. In this paper, the state of the art in this area has been reviewed. Firstly, the basic concepts of the GAN were introduced. And then, from the perspectives of the medical image denoising, detection, segmentation, synthesis, reconstruction and classification, the applications of the GAN were summarized. Finally, prospects for further research in this area were presented.
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Objective To investigate the effect of neurally adjusted ventilator assist(NAVA) and synchronized intermittent mandatory ventilation(SIMV) on respiratory function in premature infants with respiratory distress syndrome.Methods A total of 54 preterm infants who were diagnosed neonatal respira-tory distress syndrome after birth and needed invasion mechanical ventilation in our hospital from Oct.2014 to Dec.2016 were given SIMV for 4 hours and NAVA mode ventilation for 4 hours,with a total of 4 cycles.The peak inspiratory pressure(PIP),tidal volume(TV),Compliance,respiratory rate(RR),Edi peak,Edi min, FiO2and mean airway pressure(MAP) were monitored every 30 minutes, and pressure of carbon dioxide (PaCO2)were monitored every 2 hours in different modes.Results The mean values of PIP[(19.5 ± 3.1) cmH2O,1 cmH2O=0.098 kPa],RR[(51.4 ± 7.9)breaths/min],Edi peak[(5.1 ± 3.2)μV],FiO2[(38.2 ± 12.9)%],MAP[(12.0 ± 0.8)cmH2O],PaCO2[(41.2 ± 9.3)mmHg,1 mmHg=0.133 kPa] and Edi min[(1.2 ± 1.4)μV] in NAVA mode were significantly lower than those in SIMV mode[(22.9 ± 3.4) cmH2O,(56.9 ± 8.3)breaths/min,(7.9 ± 4.9)μV,(39.9 ± 14.1)%,(13.2 ± 0.7)cmH2O,(47.1 ± 10.4)mmHg,(2.0 ± 1.7)μV,respectively](P<0.05).But the mean values of TV,Compliance in SIMV mode[(6.2 ± 1.0)ml/kg,(0.25 ± 0.33)ml/cmH2O,respectively] were significantly lower than those in the NAVA mode[(7.2 ± 0.9)ml/kg,(0.37 ± 0.21)ml/cmH2O,respectively](P<0.05).The downward trend of PIP,RR,Edi peak,FiO2,Edi min,MAP and upward trend of TV,Compliance were found during the first circle from NAVA mode to SIMV mode.The decrease and increase of above ventilator parameters were more obvious in NAVA mode compared with SIMV mode.Conclusion The respiratory muscle load is reduced, TV increases,and pulmonary compliance improves during NAVA ventilation.NAVA is better than SIMV in improving respiratory function of premature infants with respiratory distress syndrome. NAVA has lung protective effect.
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The traditional Chinese medicine (Tripterygium wilfordiiHook.f.,TWH) has been clinically used to treat primary and secondary renal diseases and proteinuria for nearly 40 years.However,there is a rare literature about the effect of triptolide (the main active ingredient of TWH) on the expression of oxidative carbonyl protein (OCP) in diabetic nephropathy (DN).This study aimed to provide experimental evidence for triptolide treatment on DN through its effect on the expression of OCP,in order to investigate the effects of triptolide on the expression of OCP in rats with DN.Sixty SD rats were randomly divided into five groups:control group,high-dose triptolide (Th) group,low-dose triptolide (T1) group,DN model group,and positive control (benazepril) group.The DN model was established using streptozotocin.Urinary protein excretion,fasting blood glucose (FBG),superoxide dismutase (SOD) in renal homogenate,malondialdehyde (MDA) in renal homogenate and renal nitrotyrosine by immunohistochemistry,and the expression of OCP by oxyblotimmune blotting were detected.In the DN model group,rat urinary protein excretion and renal MDA were significantly increased,while renal SOD significantly decreased and nitrotyrosine expression was obviously upregulated in the kidney.After triptolide treatment,24-h urinary protein excretion (61.96±19.00 vs.18.32±4.78 mg/day,P<0.001),renal MDA (8.09±0.79 vs.5.45±0.68 nmol/L,P<0.001),and nitrotyrosine expression were decreased.Furthermore,renal OCP significantly decreased,while renal SOD (82.50±19.10 vs.124.00±20.52 U/L,P<0.001) was elevated.This study revealed that triptolide can down-regulate the expression of OCP in the renal cortex of DN rats.
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Frailty syndrome is the core of the comprehensive geriatric assessment of the elderly, which affects the prognosis of elderly critical illness patients and becomes the hotspot of the current geriatric medical research of elderly patients. In critically ill elderly patients, the incidence rate of frailty syndrome is 21%-59%. Frailty syndrome is an independent risk factor in elderly patients with complications, short-term and long-term mortality. Moreover frailty is always accompanied by poor state and affects the health quality of these patients. In the field of critical care medicine in our country, the study of the frailty syndrome is still in its infancy. This article focuses on the research progress of frailty syndrome, and the assessment of the frailty critical illness elderly patients is helpful for the clinical doctors to determine the prognosis and treatment decision.
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Frailty syndrome is the core of the comprehensive geriatric assessment of the elderly, which affects the prognosis of elderly critical illness patients and becomes the hotspot of the current geriatric medical research of elderly patients. In critically ill elderly patients, the incidence rate of frailty syndrome is 21%-59%. Frailty syndrome is an independent risk factor in elderly patients with complications, short-term and long-term mortality. Moreover frailty is always accompanied by poor state and affects the health quality of these patients. In the field of critical care medicine in our country, the study of the frailty syndrome is still in its infancy. This article focuses on the research progress of frailty syndrome, and the assessment of the frailty critical illness elderly patients is helpful for the clinical doctors to determine the prognosis and treatment decision.
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Objective To investigate the dynamic changes and influencing factors of peripheral blood white blood cells (WBC), differential counts (DCs) and platelet (PLT) count in preterm infants to understand the changing characteristics of these blood parameters in preterm infants of different postnatal age, gestational age, and birth weight.Methods Totally 2 849 preterm infants admitted to the Department of Neonatology of Northwest Women's and Children's Hospital from November 30, 2011 to November 30, 2014 were retrospectively analyzed except for those diagnosed with infectious diseases, hematological system diseases, or immunologic diseases.All of the subjects were divided into seven groups based on their postnatal age, three groups based on gestational age and three groups based on birth weight, or male and female groups, respectively.Peripheral blood samples were obtained for determination of WBC, DCs and PLT.Statistical analysis was performed with oneway analysis of variance, t-test and Spearman linear correlation analysis.Results WBC, neutrophil (Ne), lymphocyte (Ly), monocyte (Mo), eosinophil (Eo), basophil (Ba) and PLT counts were significantly different among the seven groups of preterm babies of different postnatal age (F=172.00, 364.90, 34.88, 14.22, 80.82, 168.10 and 86.64, respectively, all P < 0.01).WBC was found to be at the peak value within one day after birth [(18.40±6.87)× 109/L], followed by remarkable decrease in day > 2-≤ 5 [(10.62±4.68)× 109/L], further gradual decrease thereafter, and then being stable in day > 14-≤ 21 and > 21 ≤≤ 30 [(10.54±3.09)× 109/L and (10.27 ± 3.70) × 109/L, respectively].PLT counts showed no significant change within one day after birth and in day > 1-≤ 2 [(240.56± 63.54)× 109/L and (240.85 ± 71.47) × 109/L, respectively], then began to increase in day > 2-≤ 5 [(249.21 ±80.55)× 109/L], peaked in day > 7-≤ 14 [(339.11 ± 121.84)× 109/L], and decreased gently and became stable finally.The changing trends of Ne and Ly were cross and inverted in day > 5-≤ 7.WBC, Ne, Ly, Mo, Eo, Ba and PLT counts of the preterm infants were all correlated with the postnatal age shown by Spearman linear correlation analysis (r=-0.46,-0.60, 0.18,-0.07, 0.33,-0.47 and 0.29, respectively, all P < 0.01).With the increase of gestational age, WBC, Ne, Mo, and PLT counts increased, but Ly and Eo counts decreased.And all of the above showed significant difference (F=81.00, 124.49, 13.34, 18.35, 5.35 and 4.11, respectively, all P < 0.05).While, the WBC, Ne, Mo, Ba and PLT counts showed positive relationship with the increase of birth weight (F=122.12, 133.09, 39.38, 13.77 and 21.24, respectively, all P < 0.05).WBC, Ne and PLT counts of female infants were higher than those of male babies (t=l 6.35, 16.72 and 13.19, respectively, all P < 0.05).Conclusions The peripheral WBC, DCs and PLT counts of preterm infants change dynamically with postnatal age with the remarkable variations on day >2-≤ 5 after birth and stable after 14 days of age.WBC, DCs and PLT counts might all be influenced by gestational age, birth weight and gender to some cxtend.
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<p><b>OBJECTIVE</b>To compare the effect and hemodynamics of sevoflurane(SEV) and propofol (PRO) in combined anesthesia induction with remifentanil for tracheal intubation fibreoptic bronchoscope (FOB).</p><p><b>METHODS</b>Twenty-four patients without difficult airway undergoing elective surgery with tracheal intubation general anesthesia were randomly divided into SEV and PRO group. FOB intubation was performed with sevoflurane or propofol administration combined with remifentanil induction. Blood pressure (BP), heart rate (HR), SPO2 and Narcotrend index (NI) were monitored to evaluate the anesthetic depth during the induction. The time to loss of consciousness (LOC), intubation time, intubation score, anesthetic dosage and adverse effects were recorded.</p><p><b>RESULTS</b>No significant difference was found between the two groups in the time to LOC, intubation time, intubation score, remifentanil dosage. Intubation was performed successfully in both groups. BP and HR of both groups decreased after the induction and did not increase after the intubation, with variation within the normal range. No significant difference in BP and HR was found between the two groups. NI of both groups decreased after the induction and during intubation. NI of SEV group 2 min after intubation was higher than that of PRO group. There was no significant difference in NI between the two groups at the other time points. No significant adverse effects or recall of the intubation procedure were reported.</p><p><b>CONCLUSION</b>Anesthesia induction FOB intubation with sevoflurane and propofol, both in combination with remifentanil, can be applied in surgical patients without contraindications to general anesthesia, and both methods can provide fast induction and good intubation condition with stable hemodynamics.</p>
Subject(s)
Adult , Aged , Humans , Middle Aged , Anesthesia , Methods , Anesthetics, Inhalation , Therapeutic Uses , Anesthetics, Intravenous , Therapeutic Uses , Bronchoscopes , Hemodynamics , Intubation, Intratracheal , Methods , Methyl Ethers , Therapeutic Uses , Piperidines , Therapeutic Uses , Propofol , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of intrathecal ouabain and tizanidine injection for treatment of neuropathic pain in rats.</p><p><b>METHODS</b>Male SD rats weighing 250-300 g were randomly divided into 5 groups (n = 6), namely the control group, ouabain group, tizanidine group, combined ouabain and tizanidine injection group, and the antagonist group. Intrathecal catheter was implanted 7 days before spinal nerve ligation to establish the neuropathic pain model. Mechanical withdrawal threshold (MWT) before and after intrathecal administration of the agents was recorded in the rats. Isobolographic analysis was performed to evaluate the interactions between the agents.</p><p><b>RESULTS</b>Intrathecal injection of ouabain (0.25-5 microg) or tizanidine (0.5-5 microg) alone produced dose-dependent analgesic effect against the neuropathic pain (P < 0.05). Isobolographic analysis revealed a synergistic interaction between ouabain and tizanidine. Intrathecal pretreatment with atropine (5 microg) or yohimbine (20 microg) antagonized the effects of ouabain and tizanidine administered alone or in combination (P < 0.05).</p><p><b>CONCLUSION</b>Intathecal injection of ouabain or tizanidine produces dose-dependent analgesic effects against neuropathic pain, and their synergistic effect after combined injection probably involves the cholinergic transmission and alpha2 receptor.</p>
Subject(s)
Animals , Rats , Analgesics , Clonidine , Injections, Spinal , Ouabain , Pain , Drug Therapy , Random Allocation , Rats, Sprague-Dawley , Spinal Nerves , Wounds and InjuriesABSTRACT
<p><b>OBJECTIVE</b>To examine the effect of ulinastatin (UTI) on the inflammatory responses induced by oesophagectomy.</p><p><b>METHODS</b>Forty patients with esophageal cancer (without serious hypertension, heart disease, or respiratory function impairment, including 34 men and 6 women aged 46 to 70 years) scheduled for oesophagectomy via left thoracotomy were randomly divided into control group (n=20) and UTI group (n=20). Anesthesia induction and perioperative management followed the same protocols in the two groups, and in UTI group, patients received 5000 U/kg UTI while those in the control group were given the same volume of saline. Before operation (T(1)), 10 min after recovery of two-lung ventilation (T(2)), and 24 h (T(3)) and 48 h (T(4)) after operation, the venous blood sample was taken from the internal jugular vein and the plasma was separated and stored at -70 degrees C for later analysis of IL-6 and IL-8 with enzyme-linked immunosorbent assay (ELISA). The bronchoalveoar lavage fluid (BAFL) was also collected at T(1) and T(2) for IL-6 and IL-8 detection.</p><p><b>RESULTS</b>IL-6, IL-8 levels in the plasma and BALF collected at T(2)-T(4) increased significantly as compared with those in samples collected at T(1), and their peak concentration inplasma and BALF samples were similar. IL-6 and IL-8 levels in the UTI group were significantly lower than those in the control group during the time points of T(2)-T(4).</p><p><b>CONCLUSION</b>Inflammatory responses occur during and after oesophagectomy, which can be inhibited with UTI.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Esophageal Neoplasms , General Surgery , Esophagectomy , Glycoproteins , Therapeutic Uses , Interleukin-6 , Blood , Interleukin-8 , Blood , Pneumonia , Blood , Postoperative Complications , Blood , Treatment Outcome , Trypsin Inhibitors , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To observe the effect of esmolol application before and during operation on propofol dose required for anesthesia induction and maintenance.</p><p><b>METHODS</b>Forty patients (ASA physical status I or II) undergoing general anesthesia for thyroidectomy were randomized equally into esmolol and control groups. Patients in esmolol group received a loading dose of esmolol at 0.5 mg/kg in 30 ml normal saline over a period of 5 min followed by an intravenous infusion of esmolol at 50 microg.kg(-1).min(-1) until the end of surgery, while patients in the control group were given normal saline in the same manner, in addition to anesthesia with protofol. Perioperative hemodynamic parameters and BIS were measured, and the duration of anesthesia, operation and recovery time from anesthesia were recorded.</p><p><b>RESULTS</b>There were significant differences between the two groups in propofol dose required for anesthesia induction and recovery time from anesthesia, but not in maintenance propofol dose. Patients in esmolol group had significantly lower HR and BIS during tracheal intubation than those in the control group , and no significant differences were found in HR, BP and BIS during operation between the two groups. The hemodynamic parameters during extubation showed less fluctuation in esmolol group.</p><p><b>CONCLUSION</b>Perioperative esmolol administration during anesthesia reduces propofol dose required for anesthesia induction and recovery time from anesthesia, and decreases HR and BIS variation during tracheal intubation and hemodynamic response during extubation without affecting the maintenance propofol dose.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Anesthesia , Methods , Blood Pressure , Dose-Response Relationship, Drug , Electroencephalography , Heart Rate , Preoperative Period , Propanolamines , Pharmacology , Propofol , Pharmacology , ThyroidectomyABSTRACT
AIM: To predict MHC class Ⅰ binding peptides by using neural network ensembles. METHODS: As a combination of neural networks, neural network ensemble (NNE) was here used to improve the predictive performance. Based on a database of 628 nonamers and their classified binding capacities, the generalized NNEs were used to classify peptides respectively with non, low, moderate and high binding capacities to MHC class I molecule encoded by gene HLA-A*0201. The predictive power of NNE was further evaluated by running generalized NNE on a set of actual T-cell epitopes. RESULTS: The generalized NNEs achieved an average predictive hit rate of 0.8 for the above classifications. In addition, NNE was also efficient in the prediction of the potential T-cell epitopes, and about 84% of the actual T-cell epitopes were among the potentially antigenic peptides with high and moderate affinities. CONCLUSION: The NNEs can be applied in the prediction of MHC class Ⅰ binding peptides, and moreover, after proper modifications, they can be conveniently extended to cover peptides with any length and thus suitable for the prediction of peptides binding to other MHC class Ⅰ or even class Ⅱ molecules.