Investigation on knowledge, attitude and practice of edema in critically ill patients among ICU nurses / 中国实用护理杂志

Objective:To understand the knowledge, attitude and practice of edema in patients with critically illness of ICU nurses, and to analyze its influencing factors.Methods:After developing the Knowledge-Attitude-Practice Scale of Edema Status in Critically Ill Patients for ICU nurses by Delphi expert consultation method, the level of knowledge, attitude and practice of edema status of ICU nurses in six tertiary hospitals in Shanghai City was investigated by using convenience sampling method.Results:A total of 292 ICU nurses were investigated by questionnaire. The total scores of knowledge dimension, attitude dimension and practice dimension of critical patients with edema in ICU nurses were 38.27 ± 5.52, 58.33 ± 8.34 and 43.04 ± 8.05, respectively. Multiple stepwise regression analysis showed that age ( β=0.28, P<0.05) was the main factor affecting ICU nurses′ knowledge about edema state of critically ill patients; age( β=0.20, P<0.05) and education ( β=0.28, P<0.05) were the factors affecting ICU nurses' attitude towards edema state of critically ill patients; and years of nursing work ( β=0.28, P<0.05) was the factor affecting the practice of critically ill patients of ICU nurses. Conclusions:The level of knowledge and attitude towards edema in critically ill patients of ICU nurses is good, but the level of behavior is general. Nursing managers should strengthen the training related to edema for ICU nurses, further to form a standardized prevent-treatment plan and nursing process in order to actively improve the nursing practice of edema in critically ill patients.

Comparative evaluation of susceptibility testing methods for colistin and polymyxin B on isolates of Enterobacteriaceae / 中华检验医学杂志

Objective:To provide a promising and optimal laboratory susceptibility-testing method for the clinical usage of antibiotic (polymyxin), four susceptibility-testing methods were performed and the broth microdilution (BMD) was chosen as the gold standard.Methods:A total number of eighty-eight nonduplicate clinical Enterobacteriaceae specimes were collected from January to December of 2019 in the First Affiliated Hospital, Fujian Medical University. Among the clinical specimens, of which six strains were positive for mcr-1. The minimal inhibitory concentration (MIC) of polymyxin of the clinical specimens were examined by the following methods: (1) broth microdilution, (2) colistin broth disk elution, (3) Vitek-2?, (4)BD PhoenixTM,(5)commercial broth microdilution. With BMD as reference, essential agreement (EA), categorical agreement(CA), very major error(VME) and major error (ME) of polymyxins for different methods were analyzed. The Kappa-consistency testing, paired Chi-square testing and the Spearman-rank correlation testing were used to analyze the consistency between the four antimicrobial susceptibility testing methods and the gold standard.Results:Taking broth microdilution as reference, the EA of colistin broth disk elution, Vitek-2?, BD PhoenixTM, commercial broth microdilution were 94.32% (83/88), 92.05% (81/88), 90.90% (80/88), and 96.59%(85/88), respectively. The CA of all the four methods were 100% (88/88). No VME and ME were recorded for four methods. Moreover, the consistency between four susceptibility testing methods and the gold standard is acceptable (Kappa values=1, P<0.001, McNemar test P=1 and r>0.5, P<0.05). Conclusions:In the present work, four susceptibility testing methods all met the standards recommended jointly by the Clinical and Laboratory Standards Institute and European Committee on Antimicrobial Susceptibility Testing, of which the performance of the commercial broth microdilution and CBDE fared relatively well. Thus, these four methods could be routinely used in clinical microbiology laboratory of our hospital for colistin and polymyxin B susceptibility testing.

Cytogenetic analysis of an amniotic sample with X chromosome abnormality signaled by non-invasive prenatal testing / 中华医学遗传学杂志

OBJECTIVE@#To determine the chromosomal karyotype of a fetus with copy number variation (CNV) of the X chromosome signaled by non-invasive prenatal testing (NIPT).@*METHODS@#NIPT was performed on the peripheral blood sample taken from the pregnant women. Amniotic fluid and cord blood samples were subjected to conventional G banded karyotyping, and were further analyzed by high-throughput sequencing for chromosome microdeletion/microduplication. The results were then verified by fluorescence in situ hybridization (FISH) on metaphase cells.@*RESULTS@#The NIPT test of pregnant women suggested low risk for 21-trisomy, 18-trisomy, and 13-trisomy, whilst indicated the number of chromosome X to be low. The G banded karyotype of the amniotic fluid and cord blood cells was 46,XX. The result of high-throughput sequencing chromosome microdeletion/microduplication detection was seq[hg19](X)× 1, (Y)× 2. FISH showed a clear red signal at each end of a whole chromosome, and a green signal on the other chromosome, with a karyotype of 46,X,ish idic(Y) (q11.23) (SRY++, DXZ1+). C banding showed that there is a dense and a slightly loose centromere at both ends of the Y chromosome, and the parachromatin region was missing. The karyotype of amniotic fluid and cord blood cells was finally determined to be 46,X, pus idic(Y) (q11.23).@*CONCLUSION@#For chromosome anomalies suggested by auxiliary report of NIPT, conventional karyotyping combined with high-throughput sequencing for chromosome microdeletion/microduplication should be adopted for the prevention and reduction of the rate of chromosome microdeletion/microduplication syndromes.

Direction value of endovascular pressure differences in endovascular management of subclavian steal syndrome / 中华神经医学杂志

Objective To explore the direction value of endovascular pressure differences in endovascular management of subclavian steal syndrome (SSS).Methods Eleven SSS patients accepted endovascular management,admitted to our hospital from January 2016 to December 2017,were collected in this study.Before and after operation,pressure-sensing wire was used to measure endovascular pressure differences (mean distal stenosis pressure minus mean proximal pressure),digital substraction angiography (DSA) was used to assess the stenotic rate,transcranial doppler (TCD) was used to assess the steal degrees,and electronic sphygmomanometer was used to measure the systolic pressure differences between bilateral brachial arteries.The pressure differences before and after endovascular management were compared.Before operation,the relations of pressure differences with stenotic rate,steal degrees and systolic pressure differences between bilateral brachial arteries were analyzed.After operation,the relations of pressure differences with stealing and clinical symptom improvements were analyzed.The predictive values of pressure differences and residual stenosis in clinic success were compared.Results (1) After operation,the blood stealing disappeared and the clinical symptoms improved in 10 patients;although residual stenotic rate of one patient decreased obviously,blood stealing and clinical symptoms still existed after operation;the clinic success rate was 90.9％(10/11).(2) Pressure differences before surgery ([11.2±5.7] mmHg) were significantly higher as compared with those after the surgery ([2.5±5.3] mmHg,P＜0.05).(3) Before operation,pressure differences were significantly correlated with stenotic rate (r=0.757,P=0.007) and bilateral systolic pressure differences (r=0.701,P=0.016).Six patients had pressure differences of 6-9 mmHg,enjoying degree I and Ⅱ of stealing,and 5 patients had pressure differences ≥ 10 mmHg,enjoying degree Ⅲ of stealing.(4) After operation,pressure difference was 18 mmHg in one patient without clinic success,but pressure differences were ≤ 3 mmHg in 10 patients with clinic success.(5) Significant difference was noted between the two clinic success indexes (residual stenotic rate ≤ 30％ by DSA and pressure differences ≤ 3 mmHg,P＜0.05).Conclusion Endovascular pressure differences can reflect the hemodynamic changes before and after endovascular management;as compared with residual stenosis,it is better to predict the clinic success after operation;it is useful to guide the endovascular management in the SSS patients.

Clinical and laboratory analysis of a neonate with Down syndrome and a novel GATA1 gene mutation / 中华医学遗传学杂志

OBJECTIVE@#To analyze the clinical and molecular biological characteristics of a neonate with myeloid proliferation related to Down syndrome (DS).@*METHODS@#The neonate, who was suspected for Down syndrome, was analyzed in terms of clinical feature, peripheral blood cell morphology, fluorescence in situ hybridization (FISH), immunological classification and other laboratory tests. On hundred and fourteen leukemia-related genes were subjected to next-generation sequencing (NGS).@*RESULTS@#Laboratory test revealed obvious abnormal liver function and coagulation function, anemia, and extreme leukocytosis. Cell smear indicated significantly increased progenitor cells, which conformed to proliferation of megakaryocytes. FISH showed trisomy 21. By NGS, c.220+dupT, a novel mutation, was identified in exon 2 of the GATA1 gene, which encodes a N-terminal activation domain and has a frequency of 95.8%. No mutation was identified among the remaining 113 genes.@*CONCLUSION@#The neonate had DS and GATA1 gene mutation. High percentage of circulating blasts should be considered as transient myelodysplasia but not congenital leukemia.

CEP55 may be a potential therapeutic target for non-obstructive azoospermia with maturation arrest / 南方医科大学学报

OBJECTIVE@#To explore the effect of small interfering RNA (siRNA)-mediated CEP55 gene silencing on the proliferation of mouse spermatogonia.@*METHODS@#Six patients with azoospermia diagnosed to have maturation arrest (3 cases) or normal spermatogenesis (3 cases) based on testicular biopsy between January 1 and December 31, 2017 in our center were examined for differential proteins in the testicular tissue using isobaric tags for relative and absolute quantitation (iTRAQ), and CEP55 was found to differentially expressed between the two groups of patients. We constructed a CEP55 siRNA for transfection in mouse spermatogonia and examined the inhibitory effects on CEP55 expressions using Western blotting and qPCR. The effect of CEP55 gene silencing on the proliferation of mouse spermatogonia was evaluated with CCK8 assay.@*RESULTS@#In the testicular tissues from the 6 patients with azoospermia, iTRAQ combined with LC/MS/MS analysis identified over two hundred differentially expressed proteins, among which CEP55 showed the most significant differential expression between the patients with maturation arrest and those with normal spermatogenesis. The cell transfection experiment showed that compared with the cells transfected with the vehicle or the negative control sequence, the mouse spermatogonia transfected with CEP55 siRNA showed significantly lowered expressions of CEP55 mRNA and protein ( < 0.05) and significantly decreased proliferation rate as shown by CCK8 assay ( < 0.05).@*CONCLUSIONS@#CEP55 may play a key role in spermatogenesis and may serve as a potential therapeutic target for non-obstructive azoospermia with maturation arrest.

Causes of oocyte vitrification and its value in assisted reproductive technology / 南方医科大学学报

OBJECTIVE@#To explore the causes of oocyte vitrification and its application in assisted reproduction.@*METHODS@#We retrospectively analyzed the data of 26 patients with 27 cycles of oocyte vitrification cryopreservation undergoing intracytoplasmic sperm injection (ICSI) and embryo transfer between January, 2008 and October, 2018. The causes of oocyte vitrification and the outcomes of ICSI and clinical pregnancy were analyzed.@*RESULTS@#The causes of oocytes vitrification included mainly azoospermia or severe spermatogenesis disorder of the husband, failure to obtain sperms from the husband, failure of the husband to be present on the day of oocyte retrieval and acute diseases of the husband to not allow sperm collection. A total of 274 oocytes were frozen in 27 oocyte retrieval cycles, and 217 eggs were thawed in 19 cycles with a survival rate of 81.11% (176/217). The normal fertilization rate, cleavage rate and high-quality embryo rate was 74.81% (98/131), 89.80% (88/98) and 36.73% (36/98), respectively. Fifteen patients underwent embryo transfer, and the clinical pregnancy rate and live birth rate was 53.33% (8/15) and 33.33% (5/15), respectively. Compared with patients below 35 years of age, the patients aged above 35 years had significantly lower oocyte survival rate after thawing (82.76% 74.42%, =0.211), clinical pregnancy rate (77.78% 16.67%, =0.041) and live birth rate (55.56% 0, =0.044).@*CONCLUSIONS@#Oocytes vitrification can be used as a remedy for infertile couples who fail to provide sperms due to male factors on the day of oocyte retrieval. Vitrification of the oocytes does not significantly affect the fertilization rate or the clinical pregnancy rate. The survival rate of the thawed oocytes is related to the age of the wife, and an age younger than 35 years can be optimal for achieving favorable clinical pregnancy outcomes after oocyte vitrification.

A meta-analysis of Kangai injection combined with chemotherapy in treating colorectal cancer / 国际中医中药杂志

Objective To evaluate the therapeutic effect and safety of Kangai injection combined with Chemotherapy in treating Colorectal cancer. Methods The CNKI, Wanfang, CBM, VIP, Medline and Cochrane Library from inception to the August 17th 2017 were searched, and all the relevant journals, and the literature of RCTs were enrolled. The quality of RCTs was assessed by Jadad scores, meta-analyses were performed by Review Manager 5.3 software. Results 21 Chinese articles were enrolled, including three high quality article, and the Jadad average score is 2.7. 1 879 patients were included. The result of Meta-analyses showed that intervention could improve the quality of life [OR=3.29, 95% CI (2.53-4.27), P＜0.01]; improve the short-term effects [OR=1.79, 95% CI (1.36-2.37),P＜0.001]; reduce the gastrointestinal reactions [OR=0.36,95% CI (0.29-0.45), P＜0.01], reduce bone marrow suppression reaction [OR=0.35, 95% CI (0.27-0.44),P＜0.01]. reduce the peripheral neurotoxicity [OR=0.57, 95% CI (0.41-0.78), P＜0.01], improve the abnormal liver function [OR=0.0.41,95% CI (0.26-0.65), P＜0.01], and improve the abnormal renal function [OR=0.55,95% CI (0.31-0.98), P=0.04]. Conclusions The combination of Kangai injection and Chemotherapy in treating Colorectal cancer is better than only using chemotherapy. However, we need more high-quality RCTs to improve the research.

Effect of carotid artery stenting on cerebral blood flow and cerebrovascular reactivity in patients with internal carotid artery stenosis / 中华神经医学杂志

Objective To analyze the effect of carotid artery stenting (CAS) on cerebralblood flow and cerebrovascular reactivity in patients with severe carotid stenosis.Methods Twenty patients with unilateral severe internal carotid artery stenosis,conformed by carotid color ultrasonography or MR angiography in our hospital from August 2014 to December 2015,were chosen in our study.CAS was performed;relative cerebral blood flow (rCBF) detection and relative cerebrovascular reactivity (rCVR) assessment were performed by single photon emission computed tomography (SPECT) combined with carbon dioxide (CO2) inhalation within one week before surgery and 3 months after surgery.Four regions of interest (ROIs) in the bilateral middle cerebral artery (MCA) territory of internal carotid stenosis were selected for data analysis.The changes of rCBF and rCVR before and after CAS between the ipsilateral and contralateral ROIs of these patients were compared.Results In these 20 patients,80 ROIs from each patient were obtained.Preoperative ipsilateral rCBF averaged 0.883±0.075,and contralateral rCBF averaged 0.929±0.033;preoperative ipsilateral rCVR averaged 0.010±0.055,and contralateral rCBF averaged 0.124±0.053;postoperative ipsilateral rCBF and rCVR averaged 0.927±0.040 and 0.092±0.058,and contralateral rCBF averaged 0.938±0.038 and 0.127±0.054.Postoperative ipsilateral rCBF and rCVR were significantly improved as compared with preoperative ones (P＜0.05).Postoperative contralateral rCBF and rCVR were improved as compared with preoperative ones,without significant differences (P＞.05).Conclusions CAS can not only improve rCBF and rCVR of the MCA in the carotid artery stenosis,but also improve the contralateral side.

Correlation between degrees of extracranial cerebral artery stenosis and pressure ratio across stenosis / 中华神经医学杂志

Objective To observe the correlation between degrees ofextracranial cerebral artery stenosis and pressure ratio across stenosis.Methods The patients with ≥ 50％ stenosis,admitted to our hospital and conformed by DSA from September 2015 to February 2017,were collected in this study.Collateral circulation compensation was assessed by DSA.The distal stenosis pressure (Pd) and stenosis pressure (Pa) were measured by pressure wire system;the pressure ratio across stenosis was recorded.Correlations of pressure ratio with stenosis rate and collateral circulation compensation were analyzed by Spearman correlation.Results Thirty one stenotic extracranial cerebral arteries (9 of carotid stenosis,12 of vertebral artery stenosis and 10 of subclavian artery stenosis) in 28 patients were collected.There were no perioperative complications or adverse events.The vascular stenosis rate showed negative correlation with pressure ratio (r=-0.615,P=0.000).In the subgroups,pressure gradient was negatively correlated with carotid artery stenosis rate (r=-0.948,P=-0.000),vertebral artery stenosis rate (r=-0.757,P=0.004) and subclavian artery stenosis (r=-0.759,P=0.011).Pressure ratio and collateral circulation compensation showed negative correlated relation (r=-0.475,P=0.007).Conclusion The pressure ratio across stenosis gets worse impairment with increase of severity of stenosis,and the collateral circulation influences the pressure ratio.

Blind Sample Assessment of Sodium Saccharin in Drinks / 中国药师

Objective: To evaluate the testing level of the relevant items in food inspection agency laboratory objectively, analyze the existing problems and help them enhance the ability of detection.Methods: The blind sample assessment of sodium saccharin in drinks was organized and performed.The test samples at high and low concentrations were prepared and studied by the tests of homogeneity and stability.Those met the requirements of blind sample assessment were randomly distributed to 193 laboratories and the returned data were analyzed statistically.Results: Totally 182 valid data were collected.Among the reported results, those from 85 laboratories were satisfied in the low concentration group with the satisfaction rate of 87.6% , those from 12 laboratories were not satisfied, and no results were suspicious;as for the high concentration group, the above data was 67(78.8%), 12 and 6, respectively.The overall satisfaction rate was 83.5%.The results, especially the dissatisfied and suspicious data, were analyzed by the original records of each participating laboratory, the analysis focused on 8 aspects including detection method, instrument brand, control product variety, pretreatment method, recovery rate, column selection and the other influencing factors, and suggestions were given to every laboratory to improve its own situation.Conclusion: The statistical data reflect that our food testing laboratory has strong detection ability in the determination of saccharin sodium in beverages, and can provide powerful technical support for the regulatory authorities.

Application effect of WeChat intervention in patients with musculoskeletal injuries in emergency department / 重庆医学

Objective To explore the effect of WeChat intervention on mood ,coping style and satisfaction of the patients with musculoskeletal injury in emergency department .Methods Seventy-six patients with acute musculoskeletal injury in the emer-gency department of a grade 3A hospital in Zhengzhou City from September 2016 to March 2017 were selected and randomly divided into the control group and intervention group ,38 cases in each group .The control group was given the conventional guidance ,health education and telephone follow up ;while on this basis ,the intervention group received the musculoskeletal injury related information with WeChat sent by the emergency informatization research group ,the personalized guidance and answering the patient′s questions by network communication were performed .The mood ,coping style and patient satisfaction after 1 week intervention were com-pared between the two groups .Results The Brief Profile of Mood State score after 1 week intervention in the intervention group was (41 .55 ± 8 .40) points and the Grogan Patient Satisfaction Questionnaire score was (83 .45 ± 8 .07) ,which were lower than (46 .13 ± 9 .37) points and (94 .58 ± 9 .49) points ,the difference was statistically significant (P<0 .05);in the intervention group , the face-face coping ,avoidance coping and surrender coping were significantly improved (P<0 .05) .Conclusion After 1 weeks of in-tervention ,patients in the intervention group were better than those in the control group in mood ,medical coping and satisfac-tion ,It is a kind of intervention method worthy of popularization .

Consideration on Establishment of Physiochemical Quality Standard for Health Food / 中国药师

Under the enforcement background of the newly issued Food Safety Law and combined with the work on registration and record of health food , the article put forward the problems and challenges of health food regulation according to the physiochemical quality standard for health food .The paper provided methods and suggestions for the establishment of physical and chemical indices for health food , and discussed how to improve the compositions of physical and chemical testing indicators for health food and improve the specificity of the standard , which can provide basis and guarantee for the post-marketing supervision of health food .

Efficacy of thoracic paravertebral nerve block on radiofrequency ablation of liver tumor / 中国现代医生

Objective To investigate the safety and effectiveness of thoracic paravertebral nerve block on radiofrequency ablation of liver tumors. Methods A total of 40 patients underwent radiofrequency ablation of liver tumor, were ran-domly divided into target-controlled infusion group(group G,n=20)and paravertebral nerve block group (group P,n=20). The intraoperative vital signs, anesthesia effects,anesthesia work time, total operation time,postanesthesia care unit stay time, major adverse clinical events and postoperative VAS scores of two groups were recorded and compared. Results The anesthesia satisfactory rate of G group was 95% and P group was 100%. After anesthesia induction MAP,HR,SPO2 and R declined significantly in group G. Compared with group G,intraoperative vital signs were more stable in group P. Major adverse clinical events in group P were less than group G (P<0.05). The effecting time in group P was longer than group G. The postanesthesia care unit stay time was longer in group G than group P(P<0.05). The post-operative VAS scores in group P declined much more than those in group G before 24 hours postoperatively(P<0.05). Conclusion Thoracic paravertebral nerve block for anesthesia in liver tumors underwent radiofrequency ablation is safe and effective.

Genetic analysis and counseling for two fetal cases with large de novo Yq deletions / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To analyze the deletion region for two fetal cases with large Yq deletions in order to provide genetic counseling and prenatal diagnosis.</p><p><b>METHODS</b>For both cases, amniotic fluid samples were cultured and analyzed with G banding and fluorescence in situ hybridization (FISH). Multiplex polymerase chain reaction was also carried out to amplify 15 sequence tagged sites (STS) of azoospermia factor (AZF) on the Y chromosome.</p><p><b>RESULTS</b>For both samples, the karyotypes were determined as 46,X,del(Y)(pter→q11:). No heterochromatin was found in C band. The karyotypes of their fathers were 46,XY, and heterochromatin was found in C band. STS analyses suggested that only sY82, sY84 and sY86 in AZFa were amplifiable while the other 12 STS were negative in amniotic fluid for the first case, which indicated deletions of AZFb, AZFd and AZFc. No AZF deletion was found in its father. For the second case, all 15 STS were amplifiable in the amniotic fluid, suggesting no AZF deletion. No AZF deletion was found in its father too.</p><p><b>CONCLUSION</b>Conventional karyotyping combined with FISH and molecular genetics techniques can enable characterization of AZF microdeletions and facilitate genetic counseling and prenatal diagnosis.</p>

Tripterygium glycosides combined with Xiangdan injection in HSPN efficacy and influence of the clotting mechanism / 中国生化药物杂志

Objective To observe effects of tripterygium glycosides combined with Xiangdan injection in henoch schonlein purpura nephritis (HSPN)and influence of the clotting mechanism,providing reference for clinical diagnosis and treatment.Methods 76 cases of children with allergic purpura nephritis were randomly divided into control group(n=38)and observation group(n=38)according to the random number table.Control group was given Xiangdan injection treatment.Observation group was given Xiangdan injection treatment combined with tripterygium glycoside.12 weeks was considered as a course of treatment. Results After treatment,the total efficiency rate in treatment group(94.74%)was significantly higher than control group(68.42%),which was statistically different(P <0.05).Before treatment,prothrombin time(PT),fibrinogen(FIB),activated partial thromboplastin time(APPT),platelet(PLT)levels were not significantly different between two groups;FIB and PLT levels in the control group were significantly lower than before treatment(P<0.05 ),PT and APPT had no statistically significant difference before and after treatment.After treatment in observation group,FIB and PLT levels were significantly lower than before treatment(P<0.05 ),PT level was significantly higher compared with before treatment(P<0.05 ),APTT level had no difference before and after treatment.After treatment,PT in treatment group was significantly higher than the control group(P<0.05 ),PLT in treatment group were significantly lower than the control group (P <0.05 ),FIB and APTT had no statistical difference.There was no adverse reaction in two groups after treatment.Conclusion Tripterygium glycosides combined with Xiangdan injection treatment for HSPN has significant effect,which affect the children clotting mechanism to improve the PT,FIB,PLT levels.It is safe and valuable in clinical research.

Development and application of reference materials containing mixed degradation products of amoxicillin and ampicillin / 药学学报

Reference materials containing mixed degradation products of amoxicillin and ampicillin were developed after optimization of preparation processes. The target impurities were obtained by controlled stress testing, and each major component was identified with HPLC-MS and compared with single traceable reference standard each. The developed reference materials were applied to system suitability test for verifying HPLC system performed in accordance with set forth in China Pharmacopeia and identification of major impurities in samples based on retention and spectra information, which have advantages over the methods put forth in foreign pharmacopoeias. The development and application of the reference materials offer an effective way for rapid identification of impurities in chromatograms, and provide references for analyzing source of impurities and evaluation of drug quality.

Effects of continuous wound infusion of ropivacaine for postoperative analgesia on local inflammation / 中华麻醉学杂志

Objective To investigate the effects of continuous wound infusion of ropivacaine for postoperative analgesia on local inflammation.Methods Forty ASA Ⅰ or Ⅱ patients,aged 45-64 yr,weighing 45-80 kg,undergoing simple nephrectomy,were randomized into either continusous wound infusion of local anesthetic group ( group CWI ) or control group ( group C),with 20 cases each.Group CWI were treated with continuous wound infusion of 0.25％ ropivacaine for postoperative analgesia,while group C were infused with the same volume of normal saline.All patients received patient-controlled analgesia with intravenous morphine.At 6,12,24 and 48 h after operation,the accumulated consumption of morphine was documented,and the concentration of prostaglandinE2 (PGE2) of drainage was determined using ELISA.Results Compared with group C,the accumulated consumption of morphine was decreased,and the PGE2 concentration was decreased in group CWI at each time points.Conclusion The mechanism of postoperative analgesic effect of continuous wound infusion of ropivacaine is related to the suppression of local inflammation in wound sites.

Clinical analysis of 6 patients with internal carotid steal syndrome / 国际脑血管病杂志

Objective To investigate the clinical features of internal carotid steal syndrome. Methods The clinical manifestations, CT or MRI, digital subtraction angiography, and blood flow compensation in 6 patients with internal carotid steal syndrome were analyzed. Results Of the 6 patients, 2 had unilateral internal carotid artery stenosis, 4 had severe stenosis (in which 2 were on the left side, 1 was on the right side, and 1 was on both sides). The clinical manifestations of the patients with internal carotid steal syndrome were watershed infarction and transient ischemic attack. Four patients had posterior circulation ischemia and 2 had anterior circulation ischemia. Digital subtraction angiography demonstrated that collateral circulation was established in all the 6 patients. The anterior communicating artery, posterior communicating artery, and pial artery were the common compensatory vessels. Conclusions Internal carotid artery steal syndrome can be presented as anterior or posterior circulation ischemia, and the collateral circulation plays an important role in the compensation.