Value of neutrophil-lymphocyte count ratio in diagnosing bloodstream infection / 基础医学与临床

Objective To explore the diagnostic value of five infection markers in bloodstream infection.Methods Randomly selected 110 bloodstream infection patients with positive blood cultures and 30 bacterial infection patients with negative blood cultures.Blood was simultaneously drawn with blood cultures;the complete blood count and C-reactive protein (CRP) levels were measured.The white blood cell count (WBC),neutrophil count (NEU),lymphocyte count (LMY),CRP level and neutrophil-lymphocyte count ratio (NLCR) were compared between the two groups.Results The levels of WBC,NEU,NLCR and CRP in bloodstream infection group were significantly higher than those in control group (P＜0.05),while LYM was significantly lower than that in control group (P＜ 0.05).Among these five infection markers,the area under the receiver operating characteristic curve (ROC-AUC) was the highest for NLCR (0.808) and LMY (0.756);when the cutoff value for NLCR was ＞9.33,sensitivity was 63.6％,specificity was 93.3％;and the cutoff value for LYM was ≤0.97,sensitivity was 58.2％,specificity was 86.7％.Furthermore,the NLCR of patients with gram-negative bloodstream infection was higher than those in patients with gram-positive bloodstream infection.NLCR showed important clinical significance in distinguishing strains of different bloodstream infections.Conclusions NLCR is the better predictors than routine parameters in diagnosing bloodstream infection.

Comparison between shikani optical stylet and Mc coy laryngoscope on elder patients with intratracheal intubation anesthesia / 中国内镜杂志

Objective To compare shikani optical stylet and Mc coy laryngoscope on elder patients with intratracheal intubation anesthesia.Methods 112 cases of elder patients with intratracheal intubation anesthesia were enrolled as study objects, all patients were divided into shikani optical stylet group (52 cases), Mc coy laryngoscope group (60 cases) according to different intubation way. Then detect the hemodynamic parameters, stress-related indicators, EEG relevant indicators of the two groups.Results One time success rate and total success rate in Shikani visual laryngoscope group was higher than Mc Coy visual laryngoscope group, while many times intubation rate was lower (P < 0.05); T1, T2 MAP, HR levels were lower in Shikani optical stylet group than Mc Coy laryngoscope group patients (P < 0.05); Plasma levels of epinephrine, norepinephrine, and glucose on T1, T2 in Shikani optical stylet group was lower than that in Mc Coy laryngoscope group (P < 0.05); T1, T2 BIS, ECoG grading, αβ% values in Shikani optical stylet group was lower than that in Mc coy laryngoscope group (P < 0.05).Conclusions Elderly patients with intratracheal intubation anesthesia received shikani optical stylet can enhance the success rate of intubation and effectively stabilize patients circulatory system, reduce excessive physical stress caused by various system dysfunction, which shows positive significance.

Effect of sedation with regional anesthesia with dexmedetomidine on postoperative cognitive function in elderly patients with diabetes mellitus / 中华麻醉学杂志

Objective To evaluate the effect of sedation with regional anesthesia with dexmedeto-midine on postoperative cognitive function in elderly patients with diabetes mellitus. Methods A total of 180 elderly patients of either sex with diabetes foot, aged 65-80 yr, weighing 45-90 kg, of American So-ciety of Anesthesiologists physical status ⅡorⅢ, with preoperative Mini-Mental State Examination score>24, undergoing elective débridement, were divided into 2 groups(n=90 each)using a random number table: sedation with dexmedetomidine group(group D)and routine sedation control group(group C). Lumbar plexus block and sciatic nerve block were performed, after the reliable efficacy was achieved, dexmedetomidine was intravenously infused in a dose of 0.5 μg∕kg for 10 min followed by an infusion of 0.5 μg·kg-1·h-1until the end of surgery. Midazolam 0.02-0.04 mg∕kg was intravenously injected and mid-azolam 1 mg was injected intermittently during operation in group C. Ramsay sedation scores were main-tained between 2 and 4. At 30 min before surgery(T1), 1 h after the beginning of surgery(T2), at the end of surgery(T3), 6 h after the end of surgery(T4), and 24 h after the end of surgery(T5), venous blood samples were collected for determination of the level of blood glucose and plasma cortisol(Cor)con-centrations. Mini-Mental State Examination scores were assessed at 1 day before surgery and 1 and 3 days after surgery, and the occurrence of postoperative cognitive dysfunction was recorded in a short time period after operation. Results Compared with the baseline at T1, the level of blood glucose at T2-5and plasma Cor concentrations at T3,4were significantly increased in group C, and plasma Cor concentrations were sig-nificantly increased at T3,4(P<0.05), and no significant change was found in the level of blood glucose at T2-5in group D(P>0.05). Compared with group C, the level of blood glucose at T3-5and plasma Cor con-centrations at T3,4were significantly decreased, Mini-Mental State Examination scores were increased at 1 and 3 days after operation, and the incidence of postoperative cognitive dysfunction in a short time period after operation was decreased in group D(P<0.05). Conclusion Sedation with regional anesthesia with dexmedetomidine can improve postoperative cognitive function in elderly patients with diabetes mellitus.

Role of NO signal in ABA-induced phenolic acids accumulation in Salvia miltiorrhiza hairy roots / 生物工程学报

To investigate roles of nitric oxide (NO) signal in accumulations of phenolic acids in abscisic.acid (ABA)-induced Salvia miltiorrhiza hairy roots, S. miltiorrhiza hairy roots were treated with different concentrations of sodium nitroprusside (SNP)-an exogenous NO donor, for 6 days, and contents of phenolic acids in the hairy roots are determined. Then with treatment of ABA and NO scavenger (2-(4-carboxy-2-phenyl)-4,4,5,5-tetramethylimidazoline-1- oxyl-3-oxide, c-PTIO) or NO synthase inhibitor (NG-nitro-L-arginine methyl ester, L-NAME), contents of phenolic acids and expression levels of three key genes involved in phenolic acids biosynthesis were detected. Phenolic acids production in S. miltiorrhiza hairy roots was most significantly improved by 100 µmoL/L SNP. Contents of RA and salvianolic acid B increased by 3 and 4 folds. ABA significantly improved transcript levels of PAL (phenylalanine ammonia lyase), TAT (tyrosine aminotransferase) and RAS (rosmarinic acid synthase), and increased phenolic acids accumulations. However, with treatments of ABA+c-PTIO or ABA+L-NAME, accumulations of phenolic acids and expression levels of the three key genes were significantly inhibited. Both NO and ABA can increase accumulations of phenolic acids in S. miltiorrhiza hairy roots. NO signal probably mediates the ABA-induced phenolic acids production.

Effect of different withdrawal time of dexmedetomidine on the quality of general anesthesia recovery / 中国医师杂志

Objective To explore effect of different withdrawal time of dexmedetomidine (DEX) on the quality of general anesthesia recovery.Methods Eighty patients of ASA Ⅰ or Ⅱ undergoing lymph surgery were randomly assigned to four groups (n =20).Groups D1,D2 and D3 received DEX 0.5 μg/kg as bolus before induction,continued with 0.5 μg/(kg · h) by infusion until one hour,30 min before the end of operation and the end of operation,respectively.Group C received equal volume of normal saline.Mean artery pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) were observed during and after operation.Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time,observer's assessment of alertness/sedation score (OAA/S),restlessness score (RS),and visual analogue scales (VAS) were observed after operation.Results For MAP and HR in Groups D2 and D3,there were no statistically significant difference during extubation compared to those at preoperation,but at the same time point,they were lower than those in group C (P ＜ 0.05).For groups C and D1,MAP and HR at extubation and 5 min after extubation were higher than those at preoperation (P ＜0.05).Spontaneous respiration recovery time,eyes open time,extubation time,orientation recovery time in group D3 were significantly longer than those in Group C (P ＜ 0.05),while there were no statistically significantly difference between groups D1,D2,and group C.OAA/S in group D3 was significantly lower than that in group C (P ＜ 0.05) at extubation.Incidence of restlessness,VAS,and cases given analgesic 2 hours after operation in groups D2 and D3 were significantly lower than those in groups C and D1.Compared to those in group C,dosages of propofol and remifentanil in groups D2 and D3 were significantly lower.Conclusions Dexmedetomidine administered of 0.5 μg/kg before induction,continued with infusion of 0.5 μg/(kg · h) until 30 min before the end of operation,may improve emergence,without influencing the awakening time of patients,and prolong the duration time of analgesia which comfort the patients.

The effect of event-related potentials N400 in rehabilitation for patients with post-stroke aphasia / 中国基层医药

Objective To explore the siqnificance of event related potential(ERP) N400 on stroke patients with aphasia and provide theoretical basis for clinical operations.Methods 29 stroke patients with aphasia(aphasia group) and 58 stroke patients without aphasia(control group) were selected,which were examined with N400.The latency and amplitude of N400 were compared between the two groups.Results The difference waves' latency and amplitude of aphasia group were longer and higher than those of control group.The difference had statistical significance (all P ＜ 0.05).Conclusion N400 is a significant marker for the language disturbance of aphasia patients.

Clinical study of different dosage of Ketamine Combined with Propofol on painless Induced Abortion / 中国基层医药

Objective To explore a reasonable and secure anesthesia induction in painless induced abortion.Methods 120 patients of painless induced abortion were randomly divided into six groups,control group was injected with Propofol 3.5mg/kg through vein,besides given Propofol 3.5mg/kg,other 5 groups were injected with ketamine 0.1mg/kg、0.2mg/kg、0.3mg/kg、0.4mg/kg、0.5mg/kg through vein respectively.The parameter of hemodynamics,effect of analgesia,time of unconsciousness,recovery time of consciousness,recovery time of orientation,incidence of respiratory depression,side effect,time of discharge from hospital were observed.Results The recorded time and incidence of side effect have statistical significance between group of ketamine 0.5mg/kg and group of ketamine 0.3mg/ks(P<0.05);effect of analgesia have statistical significance between group of ketamine 0.3mg/kg、0.4mg/kg、0.5mg/kg and control group.Conclusion Ketamine 0.3mg/kg combined with Propofol is an ideal choice of painless induced abortion.

Electroencephalogram diagnosis and biofeedback treatment for the child with attention deficit hyperactivity disorder / 中国组织工程研究

BACKGROUND: The concern over the use of electroencephalogram (EEG)diagnosis and biofeedback training as a viable option for children with attention deficit hyperactivity disorder(ADHD) has grown gradually.OBJECTIVE: To evaluate the diagnostic accuracy and therapeutic efficacy of A620 EEG system to ADHD children.DESIGN: Prospective observation and comparative study on ADHD children.SETTING: Psychological department of a municipal hospital.PARTICIPANTS: From October 2003 to May 2004, 113 outpatient children in Psychology Hyperactivity Department of the Central Hospital of Anshan City were selected. Inclusion criteria: 6 to 14-year-old outpatient children in Hyperactivity Department. Exclusion criteria: nervous system organic diseases, pervasive developmental disorder(PDD), mental retardation, epilepsy, psychotic disorder, acoustical and visual abnormalities,etc. Of all the ADHD children, 88 were male and 25 were female, with the mean age of(10 ± 3) years.METHODS: A620 EEG system was applied to examine the 113 participants. According to the Diagnostic Criteria for ADHD in Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ), published by American Psychiatry Association, ADHD children were diagnosed and then the EEG diagnostic accuracy and specificity were calculated. The System was also used for biofeedback treatment on 27 ADHD children. Fluctuation of EEG θ/β value was measured both before and after treatment, and the change of hyperactivity index was investigated by Conners Parent Symptom Questionnaire as well.MAIN OUTCOME MEASURES: EEG θ/β value, Conners index of hyperactivity (CIH).RESULTS: The diagnostic sensitivity of EEG on ADHD was 83.58%, and the specificity of it was 82.61%; EEB θ/β value of post-treatment was 8.26 ±4.05, which decreased significantly compared with pre-treatment value (12.38 ± 7.96) ( t = 2. 39, P ＜ 0.05); CIH was also dramatically declined from(24. 73 ± 10. 96) (pre-treatment) to( 12.05 ± 8.63)(post-treatment) ( t= 4.72, P ＜ 0. 01 ).CONCLUSION: EEG can be used as an accessory method in ADHD diagnosis due to its high sensitivity and specificity. Abnormalities of brainwave and hyperactivities of ADHD patients can be greatly ameliorated by EEGbiofeedback treatment.

Progress in stem cell research / 中国药理学通报

Stem cells exist not only in the developing mammalian embryo but also in certain areas of various adult tissues. In embryo, they can take part in the development of tissues and the whole organism while in adult, they are thought to be involved in cell metabolism. With the development of research in embryo and nervous system, the field of stem cells has become a hot point in scientific world. A brief summary is made on stem cell biology and its potential medical importance.