Efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing in pediatric patients with autism / 中华麻醉学杂志

Objective:To evaluate the efficacy of esketamine combined with propofol for colonic transendoscopic enteral tubing (TET) in pediatric patients with autism.Methods:Sixty pediatric patients with autism of both sexes, aged 3-12 yr, weighing 15-45 kg, of American Society of Anesthesiologists Physical Status classification Ⅰ or Ⅱ, who underwent painless transendoscopic enteral tubing (TET) from October 2022 to August 2023, were selected and divided into 2 groups ( n=30 each) by a random number table method: normal saline + propofol group (group NP) and esketamine + propofol group (group EP). In group NP, normal saline 10 ml was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. In group EP, esketamine 0.3 mg/kg (diluted to 10 ml in normal saline) was intravenously injected, and 30 s later propofol 2.0 mg/kg was given. TET was performed when the Modified Observer′s Assessment of Alertness/Sedation Scale score ≤2. Propofol 0.5-1.0 mg/kg was added if the sedation depth was not enough, and the Modified Observer′s Assessment of Alertness/Sedation Scale score was maintained ≤2 until the end of surgery. The degree of body movement during TET was observed and recorded. The injection pain during induction, total consumption of propofol, operation time, spontaneous emergence time, and completion of operation were recorded. Adverse reactions such as respiratory depression, nausea and vomiting, hypotension, bradycardia, and postoperative agitation were recorded during operation and in the emergence period. Results:Compared with group NP, the degree of intraoperative body movement was significantly lighter, the total consumption of propofol and incidence of injection pain and intraoperative hypotension were significantly lower, and no significant change was found in the spontaneous emergence time and incidence of adverse reactions during recovery in group EP ( P<0.05). Conclusions:Esketamine (0.3 mg/kg) combined with propofol (2.0 mg/kg) can be safely and effectively used for colonic TET in pediatric patients with autism, and esketamine does not increase the risk of adverse reactions during resuscitation in a resuscitation strategy without early awakening.

Surveys on the infrastructure construction of healthcare institutions in public health emergencies: data of Wuhan / 中华医院管理杂志

Objective:To analyze, with Wuhan as an example, the problems found in the infrastructure development of China′s healthcare institutions, and put forward optimization suggestions for future epidemic prevention and control.Methods:From May to June 2020, we surveyed with questionnaires 56 healthcare institutions in Wuhan, covering such aspects as basic information of the institutions, infectious disease infrastructure readiness, and the converted wards for COVID-19. Statistical descriptions were used to analyze data so acquired.Results:The number of beds in the infectious departments of healthcare institutions in Wuhan amounted to 1.64 per 10 000 people, yet the existing 1 873 beds and about 5 000 convertible beds failed to meet the medical needs against the outbreak of COVID-19. After the outbreak, a total of 19 084 convertible beds were set up, of which general hospitals accounted for 88%; the area occupied by each converted bed in traditional Chinese medicine hospitals, hospitals of traditional and Western medicine, and maternal and child hospitals (<30.0m 2) was lower than that in general hospitals and specialist hospitals (>40.0m 2). Conclusions:Healthcare institutions should scientifically allocate " peacetime-wartime adaptive" hospital beds, optimize both the number and efficiency of these beds, and prepare for the worst scenarios, so that the infrastructure can be built and maintained in strict accordance with standards, government departments can rationally arrange infectious disease prevention and control facilities and strengthen their planning in case of emergencies.

Exploration and practice of teaching reform and course construction of human parasitology / 中华医学教育探索杂志

In order to adapt to the needs of innovative medical personnel training,Zunyi Medical University conducted teaching reform and curriculum construction for human parasitology.Key teachers were trained by strengthening the construction of the teaching staff.Through the preparation of lessons,lectures,supervision and other measures,the teaching quality has been improved.Teaching reform was carried out by the introduction of humanities knowledge,scientific research training,and formative evaluation.Through the development of quality curriculum resources,standardized teaching archives,improved scientific research,and quality service for the society,the curriculum construction of human parasitology has been greatly improved.

Experience of digitized reform with teaching quality in human parasitology / 中华医学教育探索杂志

Teaching level is the core of teaching quality monitoring.Students' feedback to the quality ofteaching will help teachers to reflect and rectify the related factors of their teaching,so as to achieve the purpose of improving teaching quality.We have always insisted on doing this work.However,there are inconveniences in the "paper version" of the survey:complicated preparations and operations,inconvenient storage,and labor and material costs.Combined with the actual situation in our department,we are trying to reform and explore the digital survey for teaching quality ofhuman parasitology.Teachers will put the issue on the network,students can evaluate it at anytime,anywhere,and the platform automatically organize the information and quickly feed back to the teachers.The novel and effectiveway has been well received by students and teachers.

Changes in platelet activity during perioperative period in patients with diabetes mellitus / 中华麻醉学杂志

Objective To evaluate the changes in the platelet activity during the perioperative period in the patients with diabetes mellitus.Methods Twenty patients with type 2 diabetes mellitus (group DM) and 22 patients with no diabetes mellitus (group NDM) of both sexes,with body mass index of 20-30 kg/m2,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective spinal or hip joint surgery,were enrolled in the study.Blood samples were collected on admission to the operating room (T0),immediately after recovery from general anesthesia (T1) and at 24 h after surgery (T2).The expression of platelet P-selectin (CD62P) was measured by flow cytometry,and the positive rate was calculated.The platelet count (PLT) and mean platelet volume (MPV) were determined using an automatic blood cell analyzer.Results Compared with group NDM,the positive rate of CD62P cells at T0.1 and PLT at To were significantly increased (P＜0.05),and no significant change was found in MPV at each time point in group DM (P＞0.05).There was no significant difference in the positive rate of CD62P cells,PLT or MPV between each time point within each group (P＞0.05).Conclusion Platelets remain hyperactivity that is not further enhanced by diabetes mellitus during the perioperative period in the patients.

Epidemic characteristics of thelaziasis and specie identification of Thelazia callipaeda by 18S rRNA gene / 中华地方病学杂志

Objective To study epidemiological characteristics of thelazjasis, in Zunyi and surrounding areas, morphology and 18S rRNA gene sequence of Thelazia callipaeda. Methods The Thelazia callipaeda was collected from several hospitals, including affiliated Hospital of Zunyi Medical College and Zunyi Aerospace Hospital, in Zunyi region since 2011 to 2015. Clinical data of infected human thelaziasis, including the patients' gender, age, residence and pets such as cats or dogs, were analyzed to find out the factors influencing the incidence. Morphology characteristics of female and male Thelazia callipaeda were observed under microscope. 18S rRNA gene of Zunyi Thelazia callipaeda was amplified by PCR, and the evolutional relationship was analyzed through the software MEGA 7.01 based on neighbour-joining (NJ) method. Homology was campared with 18S rRNA gene from GenBank in National Center of Biotechnology. Results Totally 25 cases had been reported during the study, of which 22 cases had more details. Based on the cases, we found the thelaziasis was increasing year by year. For instance, 2 cases (9.1%) were reported in 2011, 1 case (4.5%) in 2012, 3 cases in 2013 (13.6%), 10 cases (45.5%) in 2014 and 6 cases (27.3%) in 2015 . During the five years , totally 15 cases were treated between August and November, when the human thelaziasis was in typical epidemic peaks. We analyzed characteristics of the total cases reported to date. Most of the cases occurred in rural areas (20 cases). Majority of patients lived in rural region. And most cases were between 30 to 60 years old, indicating no age limit, especially, there were two cases who were at the ages of 8.5 months and 77 years old, respectively. Moreover, more women suffered from the disease than that in men, of which, the case number was 16 in women and 6 in men, and there were 7 cases who had cats or dogs at home. Under light microscope, the edge of Thelazia callipaeda had serrated cuticle with transverse striations. And male worm had a sharp peak at the tail end of Thelazia callipaeda, which cured to the ventrite and had two copulatory spicules, long one and short one, respectively. While female worm had a blunt tail, containing numerous eggs and rounded first-stage larvaes in a single line in the distal area of the uterus, near the vulva. Sequences of Thelazia callipaeda 18S rRNA gene from Zunyi and Oita Japan (AB538282.1) were showed homology of 100%, and they were clustered in a same branch of Phylogenetic tree. Conclusions Human thelaziasis cases in Zunyi region are increasing each year, and most of the cases have occurred in rural areas. 18S rRNA gene has a high homology with sequence AB538282.1 in Thelazia callipaeda. Combining clinical data, analysis of epidemiological characteristics and the characteristics of 18S rRNA should be good for specie identification and epidemiological analysis.

Characterization of a Clonorchis sinensis antigen, calmodulin, and its relationship with liver fibrosis / 南方医科大学学报

<p><b>OBJECTIVE</b>To characterize the biological function of calmodulin (CaM) from Clonorchis sinensis (C. sinensis, Cs) and investigate its role in clonorchiasis-associated hepatic fibrosis.</p><p><b>METHODS</b>The full-length sequence of CsCaM gene was isolated from Cs cDNA library and its homologues were searched using BLASTx for comparison. Bioinformatics analysis was performed to compare the homologues and predict the physiochemical characteristics and functional domains. The gene was cloned in a prokaryotic plasmid and expressed in E. coli, and the recombinant protein was purified by affinity chromatography for immunizing rats to produce polyclonal antibodies, whose titer was determined using ELISA analysis. Immunoblotting analysis was carried out to determine of the purity and antibody recognition of CsCaM. Immunofluorescence assay was employed to analyze the tissue location of the protein. A rat model of liver fibrosis was established by introperitoneal injection of the recombinant protein.</p><p><b>RESULTS</b>The recombinant CsCaM protein obtained contained 150 amino acids with a theoretical molecular mass of 23.4 kD. CsCaM homologue had EF hand motifs. The recombinant pET-30a-CsCaM plasmid expressed in BL21 E. coli was about 23.4 kD. The total IgG antibody titer in the immunized mice reached the peak level (over 1: 51200) 2 to 4 weeks after the first injection. Immunohistochemistry showed that CsCaM located in the testis of adult C. sinensis. The rats receiving intraperitoneal injection of CsCaM showed severe liver inflammation with mild to moderate liver fibrosis.</p><p><b>CONCLUSION</b>The pro-inflammation and pro-fibrosis effects of CsCaM in rat liver suggest its involvement in clonorchiasis- associated hepatic fibrosis.</p>

A 2-Year Follow-up Study of Residual Hearing after Cochlear Implantation / 听力学及言语疾病杂志

Objective To investigate the effects of cochlear implantation on residual hearing and to evaluate the potential impact of long -term electrical stimulations on residual hearing .Methods 58 hearing impaired children with cochlear implants were included in this study .All subjects could cooperate with behavioral audiometry .Audio-metric evaluations were carried out pre -implantation and 3 ,12 ,24 months post -implantation respectively .Of 58 subjects ,43 were followed up more than 1 year and 17 were followed up more than 2 years .Results All 58 subjects showed significant differences (P0 .05) at 1 ,2 and 4 kHz .Of 17 subjects followed up more than 2 years ,there were significant differences (P<0 .05) between pre- and various return visits post-implantation .Post-implantation return visits ,there were significant differences between 3 months and 12 , 24 months at 0 .25 and 0 .5 kHz respectively ,not any significant differences on 1 ,2 and 4 kHz .There were no sig-nificant differences on each frequency between 12 months and 24 months post- implantation .Conclusion Residual hearing after cochlear implantation could decrease to some extent for various reasons .There were significant differ-ences between 3 and 12 months post-implantation at 0 .25 and 0 .5 kHz .Not any significant differences were ob-served between 12 months and 24 months post-implantation at each frequency .

Brain-derived neurotrophic factor gene-modified bone marrow mesenchymal stem cells in treatment of sciatic nerve injury / 中国组织工程研究

BACKGROUND: Peripheral nerve injuries are hoped to promote the regeneration of nerve repair by elevating brain-derived neurotrophic factor (BDNF) concentration in local injury regions. OBJECTIVE: To observe the recanalization of nerve fiber and motor function in sciatic nerve injury rats following BDNF gene-modified bone marrow mesenchymal stem cells (BMSCs). DESIGN, TIME AND SETTING: The randomized, controlled animal study was performed at the Fujian Institute of Neurology from May 2007 to May 2008. MATERIALS: Femur and tibia of F344 male rats aged 2 months were sterilely harvested to prepare BMSCs. BDNF gene-modified BMSCs were prepared using constructed chronic viral vector PNL-BDNF-IRES2-EGFP. METHODS: The right sciatic nerve injury models were made using 60 adult Sprague Dawley rats. All models were randomly assigned into phosphate buffer saline (PBS) group, BMSC group and BDNF gene-modified BMSC group. 2 ?L BPS, 2 ?L BMSC solution and 2 ?L BDNF modified BMSC solution were separately transfered into injury site of each group. MAIN OUTCOME MEASURES: The retrograde horseradish peroxidase tracing was practiced to observe neural cell number in the Lumbar 4 and 5 spinal cord anterior horn at 2 and 4 weeks after microinjection. Sciatic nerve function index was used to observe rat motor function of injured limbs. Fluorescence excitation and immunohistochemistry were employed to detect BMSC survival and BDNF expression. RESULTS: Cell number was more, and nerve function recovery was better in the Lumbar 4 and 5 spinal cord anterior horn in the BDNF gene-modified BMSC group than in the PBS and BMSC groups. BMSC survival was found in the injured sites in the BMSC and BDNF gene-modified BMSC groups. BDNF expression was significantly more in the BDNF gene-modified BMSC group than in the BMSC group. CONCLUSION: BDNF gene-modified BMSCs have promotion effects on the recanalization and functional recovery of nerve fiber following peripheral nerve injury.