The effect of BIS-guided propofol TCI in preventing adverse effect of carboprost tromethamine in puerperants undergoing caesarean section: a prospective, randomized controlled trial / 实用医学杂志

Objective To investigate whether BIS-guided (target-controlled infusion) propofol TCI can effectively prevent adverse effects of carboprost tromethamine in patients undergoing caesarean section.Methods Three hundred and fifty-four puerperants underwent spinal-epidural anesthesia were randomized into 3 groups:after fetal childbirth,in the control group,normal saline was infused at a rate of 10 ml/h.BIS 85 group,propofol with the initial target plasma concentrations of 0.8 μg/ml by TCI,adjusted TCI concentration and maintained BIS 80-90.BIS 75 group,propofol with the initial target plasma concentrations of 1.2 μg/ml by TCI,adjusted TCI concentration and maintained BIS 70-80,both until the end of operation.tThe rate of nausea,vomiting,diarrhea,chest congestion and headache were compared among 3 groups.Results Compared with the control group,the incidence of chest congestion was significantly reduced in BIS 85 group (P =0.004).The incidence of nausea,vomiting and chest congestion were significantly reduced in BIS 75 group (P ＜ 0.001,respectively).The puerperants in 2 BIS groups had no complaints of headache.Conclusion BIS-guided propofol TCI and maintaining BIS 70-80 can effectively prevent adverse effect of carboprost tromethamine in puerperants undergoing spinal-epidural anesthesia in caesarean section.

Current prevalence rate of congenital heart disease in 12 month-old and younger infants among four regions of Guangdong province / 中华心血管病杂志

<p><b>OBJECTIVE</b>To summarize prevalence rate and region distribution of congenital heart disease (CHD) in 12-month-old and younger infants among four regions of Guangdong province, China.</p><p><b>METHODS</b>Data from Guangdong CHD monitoring network including 34 monitoring units covering different geographic regions were analyzed. Professional training on screening and diagnosing CHD was provided to each work group member to improve the diagnosis level. CHD infants under or aged 12 months detected in the monitoring unit were included. CHD was diagnosed by fetus and infants echocardiography.</p><p><b>RESULTS</b>From July 2004 to December 2010, 383 281 perinatal were registered and 3263 cases of CHD were detected in the 34 member units of Guangdong CHD monitoring network [total prevalence rate of CHD: 0.851% (3263/383 281), male prevalence rate: 0.868% (1799/207 347), female prevalence rate:0.828% (1456/175 843)].Stillbirth CHD prevalence rate was significantly higher than livebirth CHD prevalence rate [10.627% (676/6361) vs. 0.686% (2587/376 920), P < 0.01]. The total prevalence of CHD was significantly higher in Pearl River Delta region [0.906% (2826/311 823)] than in other regions [0.611% (437/71 458), P < 0.01]. Ventricular septal defect [39.93% (1033/2587) in livebirth] was the most dominant CHD, followed by patent ductus arteriosus [29.84% (772/2587)] and secundum atrial septal defect [13.76% (356/2587)].</p><p><b>CONCLUSIONS</b>The present data indicate that the prevalence of CHD in Guangdong is at the medium-upper level of the country associated with high stillbirth rate. The dominant type of CHD is ventricular septal defect. CHD prevalence is higher in the Pearl River Delta region than in other regions.</p>

Study on the differences of risk factors regarding congenital heart defects between floating population and permanent residents in Guangdong / 中华流行病学杂志

<p><b>OBJECTIVE</b>To analyze the differences of risk factors on congenital heart defect (CHD)between floating population and permanent residents in Guangdong.</p><p><b>METHODS</b>A multicenter case-control study was carried out to investigate the risk factors of CHD in floating population and in permanent residents. Data was from 34 Guangdong CHD Monitoring Network centers during the year of 2004 to 2011. Exposed information related to the parents at pre-pregnancy and early pregnancy periods, was collected, using the same questionnaire survey methodology in the two populations. Possible risk factors were analyzed by univariate analysis and multivariate non-conditional logistic regression(ENTER method)methods. Risk factors were compared between the two populations.</p><p><b>RESULTS</b>Totally, 855 CHD cases and their controls from the floating population, as well as 1673 cases and their controls from the permanent residents were included in this study. Age of the children under study was defined from 28th week of gestation to 1 year old postnatal. In the floating population, specific risk factor for CHD appeared as:maternal passive smoking in early pregnancy, while the specific protective factor as high family income. However, the specific risk factors would include: having diseases as maternal diabetes mellitus or syphilis, living in a newly (within half a year) decorated house or with fetal macrosomia in the permanent residents. High education level showed as a risk factor in floating population, however contrarily, as protective factor to the permanent residents. Except for the factors related to having fever of the mother and infant with low birth weight, factors as having history of deliveries more than two, with maternal virus infection, exposure to chemical agent and negative bearing history etc., have higher OR values in floating population than in the permanent residents.</p><p><b>CONCLUSION</b>Significant differences of risk factors for CHD were noticed between floating population and the permanent residents, which have their individual specific risk factors. Most of the ORs appeared higher in floating population than in the permanent residents.</p>

Risk factors of congenital heart defects in fetal and infants born from 2004 to 2011 in Guangdong / 中华心血管病杂志

<p><b>OBJECTIVE</b>To analyze the risk factors of congenital heart defects (CHD) in fetal and infants born from 2004 to 2011 in Guangdong province.</p><p><b>METHODS</b>Babies with CHD aged from 28th week of gestation to 1 year old postnatal from July 1 2004 to December 31 2011 were registered in Guangdong CHD monitoring network with 34 participating units. Totally 2568 CHD cases were included, and 1: 1 matched with a normal control cohort by gender, living district and birth date (time span within 3 months).Exposed information of mother and father at pre-pregnancy and early pregnancy was collected. Post collinearity diagnostics analysis, univariate analysis results were included in a multivariate analysis model with forward stepwise conditional logistic regression.</p><p><b>RESULTS</b>Multivariate conditional logistic regression analysis showed that high risk factors for CHD included low birth weight infant (OR = 5.34, P < 0.01), macrosomia (OR = 1.67, P < 0.05), low per capita income (0-1200 yuan, OR = 1.68, P < 0.01), exposure to chemical agent at early pregnancy (OR = 19.72, P < 0.01), floating population (OR = 2.13, P < 0.01), abnormal reproductive history (OR = 3.18, P < 0.01), exposure to passive smoking (OR = 2.59, P < 0.01), suffering from fever (OR = 3.74, P < 0.01), equal to or more than twice parity (OR = 1.45, P < 0.01), living in a newly (within six months)-decorated-apartment (OR = 2.74, P < 0.01), suffering from virus infection (OR = 2.08, P < 0.01), rural residence (OR = 1.33, P < 0.01), living in an apartment within 50 meters of major traffic road (OR = 1.52, P < 0.01), syphilis infection at early pregnancy (OR = 13.06, P < 0.05) and father's drinking habit at pre-pregnancy (OR = 1.57, P < 0.05).</p><p><b>CONCLUSION</b>Numerous risk factors for CHD in fetal and infants of Guangdong province are indicated by our results, comprehensive intervention should be considered in pre-pregnancy and early pregnancy to reduce the risk of CHD.</p>

Study on the status and related socio-psychological factors of maternal depression among high-risk pregnancy women in Harbin city / 中华预防医学杂志

<p><b>OBJECTIVE</b>This study aimed to investigate the depression status among high-risk pregnancy women, and to analyze its relevant social and psychological factors.</p><p><b>METHODS</b>A total of 42 high-risk pregnancy women and 40 normal pregnancy women in a teaching hospital in Harbin city were followed up at time points of 32 - 36 weeks pregnancy, one week before labor, one week postpartum, and six weeks postpartum, respectively. During follow-up, the basic situation, social psychosocial factors of pregnancy women were collected and the depression of pregnancy women was measured by self-designed questionnaire and self-rating depression scale. The Edinburgh Postnatal Depression Scale (EPDS) was applied at timepoint of one week postpartum. Single factor analysis and the unconditional multivariate logistic regression were applied for analyzing the on the related social-psychosocial factors among high-risk pregnancy women.</p><p><b>RESULTS</b>The age of high-risk pregnancy women was (31.0±5.6), and the age of normal pregnancy women was (30.5±3.8) (t=0.169, P>0.05). The results showed that the depression rate in high-risk pregnancy women was 45.2% (19/42), which was 25.0% (10/40) in normal pregnancy women, the difference was significant (χ2=3.671, P=0.045). The depression rates at different time points were 30.9% (13/42), 42.9% (18/42), 23.8% (10/42), 26.2% (11/42) in high-risk pregnancy women respectively, and 25.0% (10/40), 15.0% (6/40), 20.0% (8/40), 17.5% (7/40) in the control group respectively, the difference of the depression rates among groups at one week before labor was significant (χ2=7.680, P<0.01), the difference among groups at 32-36 weeks pregnancy (χ2=0.133, P=0.80), at one week postpartum (χ2=0.174, P=0.79) and at six weeks postpartum (χ2=0.903, P=0.43) were not significant. At one week postpartum and six weeks postpartum periods, the EPDS depression rate were 12.5% (4/32), 30.4% (7/23) in case group respectively, 8.3% (3/36), 22.9% (8/35) in control group respectively, the difference were not significant (χ2=0.319, 0.416, P=0.573, 0.519). There were significantly associations between the depression mood of one week before labor and the depressive symptoms of six weeks postpartum in both groups (r=0.824, 0.677, both P values were <0.05). The risk factors for maternal depression among high-risk pregnancy women were not ready for production (OR=2.73, P<0.01) and fearing of childbirth safety (OR=2.89, P<0.01).</p><p><b>CONCLUSION</b>The depression date of high-risk pregnancy was high, especially at the time point one week before labor. Risk factors of maternal depression among high-risk pregnancy were "not ready for production" and "fear of childbirth safety".</p>

Association between heart rate and all-cause death and coronary event in the Chinese cohort: 16 years follow up results / 中华心血管病杂志

<p><b>OBJECTIVE</b>To evaluate the association between resting heart rate (HR) and all-cause death and coronary heart disease (CHD) events in the Chinese cohort.</p><p><b>METHODS</b>Data were obtained from the PRC-USA Cooperative Study on Cardiovascular and Cardiopulmonary Epidemiology. Baseline screen surveys were conducted in 1983 and 1984 from people aged 35 to 59 years living in urban or rural areas of Beijing and Guangzhou. Follow-up visits were performed for end point events of all-cause death and first CHD events every two years till 2005. Resting HR was determined from 5 consecutive intervals between R waves on the 12-lead electrocardiogram.</p><p><b>RESULTS</b>A total of 9856 (4805 males) people were included in the study and the mean follow up duration was 16.2 years. There were 1523 deaths, including 200 CHD events during the follow up period. Mean resting HR was 67.9 beat per minute (bpm) in men and 71.6 bpm in women respectively which had a trend to increase with aging. Cox Proportional Hazards model indicated the relative risk of all-cause death increased constantly with the increase of HR percentile after control of age, fasting glucose, serum cholesterol, serum triglyceride, body mass index, systolic blood pressure and diastolic blood pressure. With HR 60-89 bpm as control group, the relative risk and 95% confidence interval in group HR < 50 bpm, 50 - 59 bpm, 90 - 99 bpm and > or = 100 bpm were 0.76 (0.49 - 1.17), 0.87 (0.75 - 1.02), 1.33 (1.06 - 1.68), 1.48 (1.03 - 2.14) respectively. However there was no significant correlation between HR and CHD events in studied population.</p><p><b>CONCLUSION</b>The risk of total death increased significantly in people with HR > or = 90 bpm suggesting higher resting heart rate might be an independent risk factor for all-cause death in the Chinese population.</p>

Change trend of clinical characteristics of aortic dissection over 10 years / 中华心血管病杂志

<p><b>OBJECTIVE</b>To discuss the clinical epidemiology features and change trend of aortic dissection (AD).</p><p><b>METHODS</b>Retrospective analysis of consecutive 339 patients with AD over 10 years in Guangdong Cardiovascular Institution. Hospital records and prognosis were compared between two five-year periods.</p><p><b>RESULTS</b>339 cases with AD were hospitalized during the past 10 years. The mean age was 55.7 +/- 11.2. The male/female ratio was 4.75 to 1. Hypertension was present in 71.7% of all patients. Heavy smoking history was elicited in 52.2% of all the patients. Type I dissection were identified in 32.3% of all the cases, type II in 5.1%, and type III in 62.6%. In-hospital mortality of acute type A dissection was 35.3%, acute type B dissection 8.0%. In two five-year periods, the total number of cases increased by 165%, among which type I was the fastest, increased by 270%. Changes of mean age and male/female ratio were not significant. For acute AD, changes of prognosis in one year improved, but did not reach statistical significance.</p><p><b>CONCLUSIONS</b>This study provides insight into current regional profiles of AD. The number of hospitalized patients with AD is increasing dramatically. The mean age of the first-attack is much younger and the male ration is much higher than that reported by other regional researchers. Limited by sample size, one year prognosis of acute AD dissection improved, but did not reach statistical significance. These data support the urgent need for further improvement in prevention and treatment of AD.</p>

Cause analysis of failure to IOL implantation during cataract surgery / 眼科新进展

Objective　To study the causes of failure to IOL implantation during cataract surgery.Methods　We reviewed 540 eyes in which 23 eyes were failed to implant IOL during cataract surgery.Results　Detachment of suspended zonular ligament, rupture of posterior capsule and vitreous prolapse are the main factors influencing IOL implantation during cataract surgery.Conclusion　Improvement of surgical technique and reduction of complications are the key points for the IOL implantation successfully during cataract surgery.