Advances in methods and applications of electroencephalogram microstate analysis / 生物医学工程学杂志

Electroencephalogram (EEG) is characterized by high temporal resolution, and various EEG analysis methods have developed rapidly in recent years. The EEG microstate analysis method can be used to study the changes of the brain in the millisecond scale, and can also present the distribution of EEG signals in the topological level, thus reflecting the discontinuous and nonlinear characteristics of the whole brain. After more than 30 years of enrichment and improvement, EEG microstate analysis has penetrated into many research fields related to brain science. In this paper, the basic principles of EEG microstate analysis methods are summarized, and the changes of characteristic parameters of microstates, the relationship between microstates and brain functional networks as well as the main advances in the application of microstate feature extraction and classification in brain diseases and brain cognition are systematically described, hoping to provide some references for researchers in this field.

Research on the influence of mixed emotional factors on false memory based on brain functional network / 生物医学工程学杂志

Analyzing the influence of mixed emotional factors on false memory through brain function network is helpful to further explore the nature of brain memory. In this study, Deese-Roediger-Mc-Dermott (DRM) paradigm electroencephalogram (EEG) experiment was designed with mixed emotional memory materials, and different kinds of music were used to induce positive, calm and negative emotions of three groups of subjects. For the obtained false memory EEG signals, standardized low resolution brain electromagnetic tomography algorithm (sLORETA) was applied in the source localization, and then the functional network of cerebral cortex was built and analyzed. The results show that the positive group has the most false memories [(83.3 ± 6.8)%], the prefrontal lobe and left temporal lobe are activated, and the degree of activation and the density of brain network are significantly larger than those of the calm group and the negative group. In the calm group, the posterior prefrontal lobe and temporal lobe are activated, and the collectivization degree and the information transmission rate of brain network are larger than those of the positive and negative groups. The negative group has the least false memories [(73.3 ± 2.2)%], and the prefrontal lobe and right temporal lobe are activated. The brain network is the sparsest in the negative group, the degree of centralization is significantly larger than that of the calm group, but the collectivization degree and the information transmission rate of brain network are smaller than the positive group. The results show that the brain is stimulated by positive emotions, so more brain resources are used to memorize and associate words, which increases false memory. The activity of the brain is inhibited by negative emotions, which hinders the brain's memory and association of words and reduces false memory.

Research on the effect of background music on spatial cognitive working memory based on cortical brain network / 生物医学工程学杂志

Background music has been increasingly affecting people's lives. The research on the influence of background music on working memory has become a hot topic in brain science. In this paper, an improved electroencephalography (EEG) experiment based on n-back paradigm was designed. Fifteen university students without musical training were randomly selected to participate in the experiment, and their behavioral data and the EEG data were collected synchronously in order to explore the influence of different types of background music on spatial positioning cognition working memory. The exact low-resolution brain tomography algorithm (eLORETA) was applied to localize the EEG sources and the cross-correlation method was used to construct the cortical brain function networks based on the EEG source signals. Then the characteristics of the networks under different conditions were analyzed and compared to study the effects of background music on people's working memory. The results showed that the difference of peak periods after stimulated by different types of background music were mainly distributed in the signals of occipital lobe and temporal lobe ( < 0.05). The analysis results showed that the brain connectivity under the condition with background music were stronger than those under the condition without music. The connectivities in the right occipital and temporal lobes under the condition of rock music were significantly higher than those under the condition of classical music. The node degrees, the betweenness centrality and the clustering coefficients under the condition without music were lower than those under the condition with background music. The node degrees and clustering coefficients under the condition of classical music were lower than those under the condition of rock music. It indicates that music stimulation increases the brain activity and has an impact on the working memory, and the effect of rock music is more remarkable than that of classical music. The behavioral data showed that the response accuracy in the state of no music, classical music and rock music were 86.09% ± 0.090%, 80.96% ± 0.960% and 79.36% ± 0.360%, respectively. We conclude that background music has a negative impact on the working memory, for it takes up the cognitive resources and reduces the cognitive ability of spatial location.

Rac1 Modulates Excitatory Synaptic Transmission in Mouse Retinal Ganglion Cells / 神经科学通报·英文版

Ras-related C3 botulinum toxin substrate 1 (Rac1), a member of the Rho GTPase family which plays important roles in dendritic spine morphology and plasticity, is a key regulator of cytoskeletal reorganization in dendrites and spines. Here, we investigated whether and how Rac1 modulates synaptic transmission in mouse retinal ganglion cells (RGCs) using selective conditional knockout of Rac1 (Rac1-cKO). Rac1-cKO significantly reduced the frequency of AMPA receptor-mediated miniature excitatory postsynaptic currents, while glycine/GABA receptor-mediated miniature inhibitory postsynaptic currents were not affected. Although the total GluA1 protein level was increased in Rac1-cKO mice, its expression in the membrane component was unchanged. Rac1-cKO did not affect spine-like branch density in single dendrites, but significantly reduced the dendritic complexity, which resulted in a decrease in the total number of dendritic spine-like branches. These results suggest that Rac1 selectively affects excitatory synaptic transmission in RGCs by modulating dendritic complexity.

Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome: A Prospective, Open-Labeled, Randomized Controlled Trial / 中华医学杂志(英文版)

<p><b>Background</b>Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.</p><p><b>Methods</b>This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.</p><p><b>Results</b>A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E'; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E' to the late diastolic mitral annular velocity (E'/A'; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E' (E/E'; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E' (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E'/A' (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E' (r = 0.472; P = 0.003) and E'/A' (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E' (r = -0.590; P < 0.001), E/E' (r = 0.454; P = 0.004), and E'/A' (r = -0.377; P = 0.018).</p><p><b>Conclusions</b>Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.</p><p><b>Chinese Clinical Trial Register</b>ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.</p>

Clinical Application Status and Thoughts of "Preventive Treatment of Diseases"Based on Literature / 中国中医药信息杂志

Objective To analyze the clinical application status and existing problems of TCM "preventive treatment of diseases"; To propose corresponding countermeasures. Methods Contrast observation literature about application of TCM "preventive treatment of diseases" in CNKI, Wanfang Database and VIP from 1stJanuary of 2013 to 31stDecember of 2017 was retrieved by computers. Prevention and treatment of people, intervention methods, evaluation criteria, frequency of use, etc. in the literature were analyzed. Results Totally 203 articles were included, involving 37 104 cases. The prevention and treatment of diseases were mostly caused by common chronic diseases and their complications. The prevention and treatment of "the undiseased" involved sub-healthy (28.08%) and healthy (2.46%) people. Intervention methods included medicine treatment, TCM treatment, health management, diet, sports rehabilitation, psychological rehabilitation, etc., and medicine treatment was the main method. The evaluation criteria mostly adopted disease efficacy evaluation criteria. The constituent indicators mainly included syndrome symptom indicators, biological indicators, scale evaluation indicators, and outcome indicators. The most common were syndrome/symptoms/signs (77.66%). Conclusion The clinical application of TCM "preventive treatment of diseases"is widely used. At present, problems, such as few research reports on healthy people, diverse intervention methods but lack of evidence-based evidence, evaluation indicators the same as disease evaluation index system, and lagging effect evaluation standard still exist.

Alpha-wave Cerebral Cortex Functional Networks of Magnetic Stimulation on Acupoints of Different Meridians / 中国康复理论与实践

@#Objective To study the coordination mechanism of brain induced by stimulating on acupoints of different meridians by means of constructing cerebral cortex functional networks reflecting actual brain functional connections. Methods A 128-lead electroencephalogram (EEG) recording and analysis system was used to collect the EEG signals of 14 healthy subjects (eight males and six females) aged 21 to 25 in resting state and magnetic stimulation on the acupuncture points of Guangming (GB37) and Neiguan (PC6) located in different meridians from October to November, 2017. Then EEG sources were localized by group independent component analysis and standard low-resolution brain electromagnetic tomography, and the statistical relationships of EEG components were calculated. Finally, alpha-wave cerebral cortex functional networks were constructed and analyzed based on complex network theory. Results The connections of brain regions associated with movement, vision increased in the stimulation of Guangming acupoint. The brain regions associated with movement, attention and working memory in the stimulation of the Neiguan acupoint were reduced in the network. Some common brain areas were activated and some changes of functional connections were similar. Conclusion The changes in the topological structure of brain networks are basically consistent with the efficacy of the acupuncture point during magnetic stimulation on Guangming and Neiguan of different meridians, however, it causes some similar changes in functional connectivity connections of some brain regions.

Improving Asymptomatic Left Ventricular Diastolic Dysfunction in Postmenopausal Hypertensive Women with Metabolic Syndrome: A Prospective, Open-Labeled, Randomized Controlled Trial / 中华医学杂志(英文版)

<p><b>Background</b>Postmenopausal women with metabolic syndrome (MetS) have increased cardiovascular morbidity and left ventricular diastolic dysfunction (LVDD). The various protective effects of astragalus membranaceus (AM) have been described in previous studies. Therefore, this study aimed to evaluate the effects of different doses of AM on diastolic function in postmenopausal hypertensive women with MetS.</p><p><b>Methods</b>This was a prospective, randomized controlled study. The postmenopausal hypertensive patients with MetS were enrolled from Lanzhou University Second Hospital from March 2014 to April 2015. Patients were divided into three groups: control group (received conventional medical treatment), AM Group 1 (received AM capsules at 5 g/d additionally), and AM Group 2 (received AM capsules at 10 g/d additionally). Echocardiographic and clinical characteristics were evaluated before and 12 months after treatment. Quantitative data were analyzed using unpaired t-test, analysis of variance, and multiple linear regression analysis.</p><p><b>Results</b>A total of 154 patients were subjected to final analysis. In the AM Group 2, significant improvements were noted in diastolic function 12 months after treatment than those of the control group, including the early diastolic mitral annular velocity (E'; 0.065 ± 0.007 m/s vs. 0.061 ± 0.008 m/s, P = 0.014), the ratio of the early diastolic mitral peak flow velocity to the late diastolic mitral peak flow velocity (E/A; 0.81 ± 0.05 vs. 0.80 ± 0.06, P = 0.012), the ratio of E' to the late diastolic mitral annular velocity (E'/A'; 0.56 ± 0.12 vs. 0.51 ± 0.13, P = 0.048), and the ratio of the early diastolic mitral peak flow velocity (E) to E' (E/E'; 10.70 ± 1.30 vs. 11.37 ± 1.73, P = 0.031). After treatment, E/E' (10.70 ± 1.30 vs. 11.24 ± 1.56, P = 0.021), deceleration time (DT; 261.49 ± 44.41 ms vs. 268.74 ± 53.87 ms, P = 0.046), and E'/A' (0.56 ± 0.12 vs. 0.52 ± 0.13, P = 0.019) values improved more significantly than those of AM Group 2 before treatment. Besides, waist circumference was positively correlated with E' (r = 0.472; P = 0.003) and E'/A' (r = 0.321; P = 0.047). In addition, the waist-to-hip ratio was a significant predictor of DT (r = 0.276; P = 0.041), E' (r = -0.590; P < 0.001), E/E' (r = 0.454; P = 0.004), and E'/A' (r = -0.377; P = 0.018).</p><p><b>Conclusions</b>Conventional medical plus AM therapy improved diastolic function. Moreover, WC and WHR might be risk factors for LVDD.</p><p><b>Chinese Clinical Trial Register</b>ChiCTR-TRC-11001747. http://www.chictr.org.cn/showprojen.aspx?proj=7798.</p>

Study on accuracy of information collection of anesthesia information management system / 医疗卫生装备

Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100％,95％ credibility interval from 86.87％ to 97.30％ and the BMDL higher than 85％;in PPS set he total data accuracy was 100％,95％ credibility interval was from 92.89％ to 100％ and the BMDL was also higher than 85％.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.

Study on accuracy of information collection of anesthesia information management system / 医疗卫生装备

Objective To explore the data accuracy acquired by the anesthesia information management system.Methods Totally 100 patients from two hospitals were selected randomly,whose anesthesia time was estimated more than 1 h.The vital signs data acquired by the system were compared with those by the monitor once every 5 min±30 s,and totally there were 12 times of comparison executed.SAS 9.2 software was used for statistical analysis.Results In FAS set the system had the total data accuracy being 100％,95％ credibility interval from 86.87％ to 97.30％ and the BMDL higher than 85％;in PPS set he total data accuracy was 100％,95％ credibility interval was from 92.89％ to 100％ and the BMDL was also higher than 85％.The system gained "Excellent" or "Good" grade in system response,stability,functional interface operability and the accuracy of special functions.Conclusion The system acquires and stores the vital signs data automatically and accurately,enhances anesthesia information in objectivity,authenticity and tractability,and has high values for enhancing anesthesia safety,medical safety and scientific research.

Comparison between propofol used alone and in combination with opioids for sedation during gastroscopy / 临床麻醉学杂志

Objective To study the effects of propofol used alone and in combined with opioids in gastroscopy,in order to select the more suitable anesthesia protocol.Methods A total of 285 pa-tients undergoing gastroscopy were selected in April ,201 5 in our hospital,including 105 males,180 females,ranging from 18 to 65 years old,weighing 40-90 kg,falling the category of ASA Ⅰ or Ⅱ. According to random number table,subjects were divided into four groups:dezocine group(group D, n =76),fentanyl group (group F,n =87),oxycodone group (group O,n = 71 )and control group (group C,n =5 1).Each group was implemented the corresponding anesthesia.SBP,DBP,HR,SpO 2 in baseline(T0 ),1(T1 ),3(T2 ),5(T3 )min after entering gastroscope were recorded.Choking cough, body movement,extra propofol,awakening time and inspecting time were observed.Results Among four groups,there was no statistical significance in age,gender,weight,blood pressure,heart rate and oxygen saturation and other general information.There were more cases given extra propofol in group C than in the other three groups (P <0.01 ).While for the experimental groups,there were more cases needing extra propofol in group O than in group D and group F (P < 0.01 ).The incidences of body movement and choking cough in group C were higher than those in the other three groups (P <0.01 ).Compared with the group C,dosage of propofol ,awakening time in the three groups,especially in group D,were much lower (P < 0.01 ).Conclusion Propofol in combination with opioids for sedation during painless gastroscopy can alleviate adverse reaction caused by propofol used alone.The more suitable anesthesia protocol is propofol with dezocine.

Effects of Mongolia Astragali Radix in protecting early cardiac and nephritic functions of patients of hypertension with metabolic syndrome / 中国中药杂志

To explore the effect of Mongolia Astragali Radix produced in Longxi of Gansu province in protecting cardiac and nephritic functions of patients of essential hypertension(EH) with metabolic syndrome(MetS). A total of two hundred and twenty-six EH patients with MetS aged above 18 were selected. Patients were randomly divided to control group(adopted conventional medical treatment), Astragali Radix group 1(added Astragali Radix capsules 10 g•d⁻¹ besides conventional medical treatment) and Astragali Radix group 2(added Astragali Radix capsules 5 g•d⁻¹ besides conventional medical treatment). Cardiac anatomy structure, cardiac systolic function and diastolic function were measured by M-mode echocardiography, two-dimensional echocardiography, Doppler echocardiographic determination and tissue Doppler imaging. The level of microalbuminuria(MAU) was evaluated by radioimmunoassay. In addition, the estimated glomerular filtration rate(eGFR) was calculated by modification of diet in renal disease (MDRD) formulas. The changes of relevant indicators for cardiac and nephritic functions before and after treatment were compared during the 12-month follow-up. The study protocol was registered at the website of Chinese clinical trial register and approved by the ethics committee of second hospital of Lanzhou university. Each patient was required to sign an informed consent. SPSS software was used for statistical analysis. According to the result, compare with before treatment, the three groups show no difference in efficacy of metablic indicators. Left ventricular end-systolic volume (ESV) and left ventricular end-systolic dimension (LVESd) of all patients were improved after treatment. However, there was no significant difference among the three groups. After the addition of Astragali Radix, the mitral flow velocity(Vp) of patients was improved to some extent(P<0.05). However, there was no significant difference among the three groups. Astragali Radix had a significant effect in reducing the MAU(P<0.05). Moreover, the MAU level of patients in Astragali Radix group 1 decreased more significantly than the other groups(P<0.05). Compared with conventional therapy, Astragali Radix combined with conventional therapy could improve cardiac structure, left ventricular systolic function, left ventricular diastolic function, and reduce the MAU to a certain extent in EH patients with MetS. Moreover, the effects of high-dose Astragali Radix are better than that of the low-dose Astragali Radix. However, the effect of Astragali Radix on EH patients with MetS shall be further observed to confirm its efficacy.

Comparison of effects of ephedrine and phenylephrine on hemodynamics in patients undergoing surgery in prone position under general anesthesia / 中华麻醉学杂志

Objective To compare the effects of ephedrine and phenylephrine on hemodynamics in the patients undergoing surgery in prone position under general anesthesia.Methods Sixty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 20-60 yr, with body mass index of 18.5-2:5.0 kg/m2, scheduled for elective posterior lumbar interbody fusion under general anesthesia, were randomized to ephedrine group (group E, n =30) or phenylephrine group (group P, n =30).When hypotension [decrease in systolic blood pressure (SBP) ＞20％ of the baseline value, T0] occurred in supine position, SBP, diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), cardiac index (CI) and central venous pressure (CVP) were recorded, and ephedrine 0.1 mg/kg (group E) or phenylephrine 1 μg/kg (group P) was injected via the central veins.The parameters mentioned above were recorded within 10 min after administration (T1-T10).Results Both ephedrine and phenylephrine could maintain the parameters of hemodynamics at the normal level.Compared with the baseline values at T0 , SBP, DBP, MAP and HR at T1-T10 and CO and CI at T2-T10 were significantly increased, and no significant change was found in CVP at each time point after administration in group E, and SBP and MAP at T1-T6, DBP at T1-T5, CVP at T2 and T3, and CO and CI at T1-T3 were significantly increased, and HR was decreased at T2 and T3 in group P.Compared with group P, SBP was significantly decreased at T1, and increased at T2-T10, DBP and MAP were decreased at T1, and increased at T3-T10, HR was increased at T1-T10, CO and CI were increased at T2-T10, and CVP was decreased at T1-T3 in group E.Conclusion Compared with phenylephrine, although ephedrine provides no significant effect on hemodynamics clinically, it can increase cardiac output to some extent in the patients undergoing surgery in prone position under general anesthesia.

Effect of Astragali Radix in improving early renal damage in metabolic syndrome rats through ACE2/Mas pathway / 中国中药杂志

To study the expression of angiotensin converting enzyme 2 (ACE2) and angiotensin (Ang) 1-7 specific receptor Mas protain in renal blood vessels of metabolic syndrome ( MS) rats and its anti-oxidative effect. A total of 80 male SD rats were divided into four groups: the normal control group (NC, the same volume of normal saline), the MS group (high fat diet), the MS + Astragali Radix group (MS + HQ, 6 g x kg(-1) x d(-1) in gavage) and the MS + Valsartan group (MS + XST, 30 mg x kg(-1) x d(-1) in gavage). After four weeks of intervention, their general indexes, biochemical indexes and blood pressure were measured; plasma and renal tissue Ang II, malondialdehyde (MDA) and superoxide demutase (SOD) levels were measured with radioimmunoassay. The protein expressions of Mas receptor, AT1R, ACE and ACE2 were detected by western blot analysis. According to the result, compared with the NC group, the MS group and the MS + HQ group showed significant increases in systolic and diastolic pressures, body weight, fasting glucose, fasting insulin, triglycerides, free fatty acid and Ang II level of MS rats (P < 0.05). The MS + XST group showed notable decreases in systolic and diastolic pressures than that of the MS group. The MS group showed significant increases in the SOD activity and NO level and decrease in the MDA level after being intervened with Astragali Radix. ACE and AT1R protein expressions in renal tissues of the MS group were higher than that in the NC group, but with lower ACE2 and -Mas receptor expressions (all P < 0.05). Compared with the MS group, the MS + HQ group showed significant increase in Mas receptor expression in renal tissues, whereas the MS + XST group showed notable decrease in AT1R (all P < 0.05). In conclusion, Astragali Radix can increase the Mas receptor expressions in renal tissues, decrease ACE expression and change local Ang II, MDA, NO and SOD in kidneys, so as to protect early damages in renal tissues.

The performance evaluation of G test on patients with invasive pulmonary fungal infections complicated with chronic obstructive pulmonary disease / 国际检验医学杂志

Objective To evaluate the value of (1 ,3)‐β‐D‐glucan(G test) in the diagnosis of invasive pulmonary fungal infection (IPFI)in patients with chronic obstructive pulmonary disease (COPD) .Methods 96 COPD patients with high risk of IPFI were en‐rolled in the study ,and were divided into IPFI group and non‐IPFI group .The G test were performed on those people while the tra‐ditional methods sputum smear and fungal culture were also performed .The (1 ,3)‐β‐D‐glucan concentrations of IPFI group and non‐IPFI group were compared ,and then the areas under receiver operating characteristic curve (ROC) were calculated .The sensi‐tivity ,specificity ,positive predictive value ,negative predictive value ,and the area under ROC of the two methods (G test and tradi‐tional methods) were compared .Results The sensitivity ,specificity ,positive predictive value ,negative predictive value of G test were 89 .5% ,89 .6% ,68 .0% ,97 .2% ,respectively ,when 20 pg/mL was the critical value .Areas under curve were 0 .942 for G test ,and 0 .790 for traditional method .Conclusion The detection of (1 ,3)‐β‐D‐glucan might be faster and with higher positive rate than traditional method ,and could be used for the early diagnosis of IPFI ,provide reference for the treatment .

Composing Factors, Evolution and Countermeasures for 621 Cases of Medical Disputes in A Top Level Hospital / 中国医学伦理学

Objective:Total 621 cases of medical disputes occurred during 2000 to 2013 were analyzed retro-spectively, to investigate the dispute factors and analysis of improvement, to promote doctor-patient relationship. Methods:621cases of medical disputes from 2000 to 2013, on a case by case attributes are classified, analyzed two year interval comparison, find the dispute factors in evolution.Results:Through the analysis of 621 cases of disputes over property, complications of the disease cause dispute case first, economic reasons, the second medical defect.Conclusions:Analysis of the two year interval comparison shows:how to strengthen the hospital scientific management, innovative service mode, the medical system implemented is the important link of reducing medical disputes.

The effects of dexmedetomidine as a pre-anesthesia medication in rapid sequence induction / 临床麻醉学杂志

Objective To investigate the effects of dexmedetomidine on hemodynamics and tra-cheal intubation facility in general anesthetized patients.Methods Forty gynecological patients of se-lective operation under general anesthesia were randomly arranged into 2 groups:group D and group C.With high flow mask oxygen inhalation(5 L/min),dexmedetomidine was intravenously pumped in-to the patients in group D at 0.6μg/kg in 10 minutes while in group C saline were given instead.Both groups were then proceeded with rapid sequence induction (RSI)immediately.The values of MAP, HR,PaO2 and PaCO2 were recorded every minute from pumping start till 15 minutes,the bucking, intubation time and glottis exposure were evaluated as well.Results No significant differences were found in intubation time or glottis exposure between these two groups.After tracheal intubation group D showed higher MAP value than group C at 14,15 minutes,and a lower HR value (P <0.05).Even no significant differences were found in values of SpO2 and PaO2 ,the group D showed less bucking than the group C (P<0.05).Conclusion Dexmedetomidine administration at 0.6μg/kg in RSI can diminish the variation in hemodynamics and facilitate the tracheal intubation by less buc-king,but no affect the oxygen reserve.

Effect of sildenafil on expression of tumor necrosis factor-alpha in lung tissues of rats with pulmonary hypertension / 中华麻醉学杂志

Objective To evaluate the effect of sildenafil on the expression of tumor necrosis factor-alpha (TNF-α) in lung tissues of rats with pulmonary hypertension.Methods Twenty-four male Sprague-Dawley rats,aged 8 weeks,weighing 180-220 g,were randomly divided into 3 groups (n =8 each) using a random number table:control group (group C),pulmonary hypertension group (group PH),and sildenafil group (group S).Sildenafil 50 mg/kg was injected through a gastric tube into stomach once a day for 35 consecutive days starting from 1 day after lelf pneumonectomy in group S.Pulmonary hypertension was induced by left pneumonectomy and subcutaneous monocrotaline injected at 7 days after operation in PH and S groups.At 35 days after operation,mean pulmonary arterial pressure (mPAP),relative medial thickness of pulmonary artery (RMT),right ventricular systolic pressure (RVSP),and muscularization of small pulmonary arteries were measured in the lung.The ratio of the right ventricular weight to the sum of the weights of the left ventricle and septum (RV/(LV + S)) was calculated.The expression of TNF-α mRNA and protein was determined using RT-PCR and Western blot analysis,respectively.Results Compared with group C,mPAP,RVSP,muscularization of small pulmonary arteries,RMT and RV/(LV + S) ratio were significantly increased,and the expression of TNF-α mRNA and protein was upregulated in group PH,and RVSP,muscularization of small pulmonary arteries and RV/(LV + S) ratio were increased in group S.Compared with group PH,mPAP,RVSP,muscularization of small pulmonary arteries,RMT and RV/(LV + S) ratio were significantly decreased,and the expression of TNF-α mRNA and protein was downregulated in group S.Conclusion Sildenafil can down-regulate the expression of TNF-α in lung tissues of rats with pulmonary hypertension,inhibit reconstruction of pulmonary artery,and decrease the pulmonary arterial pressure.

Comparison of pressor responses to ephedrine during general anesthesia with different drugs / 中华麻醉学杂志

Objective To compare the pressor responses to ephedrine during general anesthesia with different drugs.Methods Sixty ASA physical status Ⅰ or Ⅱ patients,scheduled for elective gastrointestinal tumor resection under general anesthesia,aged 20-64 yr,weighing 45-90 kg,were included in this study.The patients were randomized to receive dexmedetomidine + remifentanil + sevoflurane (group Ⅰ,n =20),propofol + remifentanil + sevoflurane (group Ⅱ,n =20),or dexmedetomidine + propofol + remifentanil + sevoflurane (group Ⅲ,n =20) to maintain the depth of anesthesia.Ephedrine 0.1 mg/kg was injected intravenously when the systolic blood pressure (SBP) was decreased to about 90 mm Hg during anesthesia.Blood pressure was monitored and recorded at 1-min intervals for 10 min after the injection.The onset time (TSBP,TDBP,TMAP) for ephedrine to raise the SBP,diastolic blood pressure (DBP) and mean arterial pressure (MAP) and the maximal amplitude (△SBP,△DBP,△MAP) were also recorded.Results Compared with Ⅱ group,TSBP,TDBP and TMAP were significantly shortened,and △SBP,△DBP and △MAP were increased in Ⅰ and Ⅲ groups (P ＜ 0.05).Conclusion Compared with propofol + remifentanil + sevoflurane combined anesthesia,dexmedetomidine + remifentanil + sevoflurane combined anesthesia and dexmedetomidine + propofol + remifentanil + sevoflurane combined anesthesia augment the pressor responses to ephedrine in patients.

Effect of ulinastatin on renal function during perioperative period in infants undergoing open heart surgery under CPB / 中华麻醉学杂志

Objective To investigate the effect of ulinastatin on the renal function during perioperative period in infants undergoing open heart surgery under CPB.Methods Forty ASA Ⅱ infants (25 male, 15 female)aged 3-5 months weighing 5.3-6.8 kg undergoing open heart surgery under CPB were randomly divided into 2 groups (n = 20 each): control group (group C) and ulinastatin group (group U). Ulinastatin 20 000 U/kg in normal saline 20 ml was infused iv in 3 parts (1/3 was infused via CVP line when the catheter was successfully placed in the internal jugular vein; 1/3 at the beginning of CPB and 1/3 at aortic unclamping). Blood and urine samples were collected at 30 min before incision ( T1 ), 5 min before aortic clamping (T2 ), 5 min after aortic unclamping (T3 ), at the end of operation (T4) and 24 and 48 h after operation (T5, T6 ) for determination of serum urea nitrogen (BUN) and creatinine (Cr) and urinary N-acetyl-β-D-glucosaminidase (NAG) and β2-microglubin (β2-MG) levels. Results There was no significant difference in serum BUN and Cr concentrations between the two groups. The urinary β2-MG concentration and NAG activity were significantly increased at T2-6 as compared with baseline values at T1 in both groups. The urinary β2-MG concentration and NAG activity were significantly lower in group U than in group C at T3-5 . Conclusion Ulinastatin can protect the renal function during perioperative period in infants undergoing open heart surgery under CPB.