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A 68-year-old male patient with malignant left lung tumor was treated with gefitinib(250 mg,po,qd)for 29 days.Liver function test results showed AST 310 U·L-1,ALT 493 U·L-1,AKP 100 U·L-1,TBil 18 μmol·L-1,GGT 60 U·L-1,INR 1.81.Several liver function indicators of the patient showed abnormal,which was consistent with the clinical manifestations of moderate liver injury.The liver function index of the patient improved after the doctor adopted the suggestion of clinical pharmacists to protect the liver.Clinical pharmacists made a comprehensive and dynamic assessment of the patient's condition,analyzed the correlation between the patient's liver injury and gefitinib,and judged that the patient's liver injury was likely caused by gefitinib.Clinical pharmacists analyzed the drug use of a blind trial patient,proposed the follow-up treatment plan,and discussed the blind trial drugs,which provided references for clinical safe and rational drug use and had important reference significance.
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ObjectiveThe transcriptome characteristics of different tissues of Codonopsis pilosula were analyzed to illustrate the genetic basis of the accumulation of active ingredients in the root of C. pilosula, and to provide theoretical basis for its high-quality production and cultivation. MethodDifferent tissues of C. pilosula at flowering stage were selected as experimental materials, and the contents of tangshenoside Ⅰ, lobetyolin and atractylenolide Ⅲ were detected by high performance liquid chromatography(HPLC). RNA-Seq was used to perform transcriptome sequencing of different tissues, and the differentially expressed genes were screened and analyzed by Gene Ontology(GO) and Kyoto Gene and Encyclopedia of Genes and Genomes(KEGG) enrichment analysis, in order to explore the characteristics of active compound distribution and the transcriptional profiles. ResultThe contents of polysaccharides and tangshenoside Ⅰ in the root of C. pilosula were significantly higher than those in other tissues. The transcriptional profiles of the root were significantly different from those of stem, leaf and flower. Cluster analysis, GO and KEGG enrichment analysis of differential gene expression showed that the differential expression genes were mainly enriched in flavonoid and phenylpropanoid biosynthesis, sucrose-starch metabolism, plant hormone signal transduction, plant-pathogen interaction, mitogen-activated protein kinase(MAPK) cascade signal transduction, Adenosine triphosphate(ATP)-binding cassette(ABC) transporter and other pathways. The expression of genes related to biosynthesis of phenylpropanoid compounds were significantly up-regulated in the roots and flowers, and ABC transporter proteins were mostly highly expressed in the flowers. The expression of key enzyme genes for polysaccharide synthesis, such as sucrose:sucrose 1-fructosyltransferase(1-SST) and fructan 1-exohydrolase(1-Feh), were significantly up-regulated in the roots, and a large number of stress-responsive genes closely related to the accumulation of secondary metabolites were significantly up-regulated in the roots. ConclusionThe active compound content and transcriptional profiles in C. pilosula roots were significantly different from those in stem, leaf, flower and other tissues, showing tissue specificity. Meanwhile, the genes related to stress response and biosynthesis of active compound, such as fructan and phenylpropanoid compounds, were up-regulated in roots of C. pilosula.
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Objective@# To analyze the correlation between third molar agenesis and craniofacial morphology by studying the location and number of congenital missing third molars and results of craniofacial cephalometric measurement. @*Methods@# A total of 123 patients were included, including 64 patients in the control group without congenital third molar absence and 59 patients in the absence group with at least one third molar absent. Cephalometric measurements included FMA, IMPA, AR-Go, GoGn-Sn, Co-A, Co-Gn, ANS-Me, Go-Me, SN-MP, Ar-Go-Me, SNA, SNB, ANB, Y-axis angle, Y-axis length, Ar-Go, Go-Me, MP-OP, FH-PP, FH-OP, a total of 18 bone tissue indicators, U1-SN, U1-L1, U1-NA, L1-NB, U1-APo and L1-APo, a total of 6 dental indicators, and UL-EP, LL-EP and nasolabial angle, a total of 3 soft tissue indicators. The correlation between congenital agenesis of third molars and craniofacial morphology was analyzed. @*Results@# The most common missing location of the third molar occured in the upper jaw and the most common number of missing teeth was one. In control group, Ar-Go-Me and SN-MP were larger (P<0.05), U1-SN, U1-NA, L1-NB, UL-EP and LL-EP were larger (P<0.05), and U1-L1 was smaller (P<0.01). There were no significant differences in Ar-Go and Go-Me between the two groups(P>0.05). @*Conclusion @#Patients with four third molars are more likely to have backward and downward rotation of the mandible and are more likely to develop into a convex facial type than patients with missing third molars, which has a higher correlation with hyperdivergent growth pattern and convex facial type.
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Objective@#To investigate craniofacial differences in individuals with hypodontia and explore the relationship between craniofacial features and the number of congenitally missing teeth. @*Methods@#A cross-sectional study was conducted among 261 Chinese patients (males, 124; females, 137; age, 7–24 years), divided into four groups (without hypodontia: no teeth missing, mild: one or two missing teeth, moderate: three to five missing teeth, severe: six or more missing teeth) according to the number of congenitally missing teeth. Differences in cephalometric measurements among the groups were analyzed. Further, multivariate linear regression and smooth curve fitting were performed to evaluate the relationship between the number of congenitally missing teeth and the cephalometric measurements. @*Results@#In patients with hypodontia, SNA, NA-AP, FH-NA, ANB, Wits, ANS-Me/N-Me, GoGn-SN, UL-EP, and LL-EP significantly decreased, while Pog-NB, AB-NP, N-ANS, and S-Go/N-Me significantly increased. In multivariate linear regression analysis, SNB, Pog-NB, and S-Go/N-Me were positively related to the number of congenitally missing teeth. In contrast, NA-AP, FH-NA, ANB, Wits, N-Me, ANS-Me, ANS-Me/N-Me, GoGn-SN, SGn-FH (Y-axis), UL-EP, and LL-EP were negatively related, with absolute values of regression coefficients ranging from 0.147 to 0.357. Further, NA-AP, Pog-NB, S-Go/N-Me, and GoGn-SN showed the same tendency in both sexes, whereas UL-EP and LL-EP were different. @*Conclusions@#Compared with controls, patients with hypodontia tend toward a Class III skeletal relationship, reduced lower anterior face height, flatter mandibular plane, and more retrusive lips. The number of congenitally missing teeth had a greater effect on certain characteristics of craniofacial morphology in males than in females.
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Granulomatous lobular mastitis (GLM) is a rare form of chronic inflammatory breast disease which may be sometimes difficult to distinguish from breast cancer. The cause of GLM is unknown, but may be associated with autoimmunity, abnormal hormone levels and infection. While GLM has no specific clinical manifestations, the diagnosis is principally established by histopathology. Therapeutic options for GLM range from observation to various medical treatments, such as steroids, immunosuppressants, and antibiotics, to surgical intervention. However, there are still many difficulties in the clinical diagnosis and treatment of GLM, and there is still no unified diagnosis and treatment consensus. So, we accomplished the present review through reviewing GLM-related domestic and foreign literature, aiming to provide the basis for rational clinical diagnosis and treatment.
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OBJECTIVES@#The aim of this study was to compare the anterior and posterior occlusal plane characteristics of patients with different temporomandibular joint osseous statuses.@*METHODS@#A total of 306 patients with initial cone beam CT (CBCT) and cephalograms were included. They were divided into three groups on the basis of their temporomandibular joint osseous status: bilateral normal (BN) group, indeterminate for osteoarthrosis (I) group, and osteoarthrosis (OA) group. The anterior and posterior occlusal planes (AOP and POP) of the different groups were compared. Then, the regression equation was established after adjusting for confounding factors, and a correlation analysis between the occlusion planes and other parameters was performed.@*RESULTS@#SNA, SNB, FMA, SN-MP, Ar-Go, and S-Go were correlated with the occlusal planes. Relative to the BN and I groups, the FH-OP of the OA group increased by 1.67° on the average, FH-POP increased by 1.42° on the average, and FH-AOP increased by 2.05° on the average.@*CONCLUSIONS@#The occlusal planes were steeper in the patients with temporomandibular osteoarthrosis than in the patients without it, and the mandible rotated downward and backward. The height of the mandibular ramus, the mandibular body length, and the posterior face height were small. In clinical practice, attention should be given to the potential risk of temporomandibular joint osteoarthrosis in such patients. In addition, SNB, FMA, SN-MP, Ar-Go, S-Go, and occlusal planes had moderate correlations.
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Humanos , Oclusão Dentária , Cefalometria , Mandíbula , Transtornos da Articulação Temporomandibular/diagnóstico por imagem , Articulação Temporomandibular/diagnóstico por imagem , Osteoartrite/diagnóstico por imagem , Côndilo MandibularRESUMO
In vitro studies have established the prevalent theory that the mitochondrial kinase PINK1 protects neurodegeneration by removing damaged mitochondria in Parkinson's disease (PD). However, difficulty in detecting endogenous PINK1 protein in rodent brains and cell lines has prevented the rigorous investigation of the in vivo role of PINK1. Here we report that PINK1 kinase form is selectively expressed in the human and monkey brains. CRISPR/Cas9-mediated deficiency of PINK1 causes similar neurodegeneration in the brains of fetal and adult monkeys as well as cultured monkey neurons without affecting mitochondrial protein expression and morphology. Importantly, PINK1 mutations in the primate brain and human cells reduce protein phosphorylation that is important for neuronal function and survival. Our findings suggest that PINK1 kinase activity rather than its mitochondrial function is essential for the neuronal survival in the primate brains and that its kinase dysfunction could be involved in the pathogenesis of PD.
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Metformin is the basic drug for type 2 diabetes mellitus. More and more studies have shown that metformin has anti-tumor effect, and its radiosensitization effect has been gradually found. Metformin can increase the radiosensitivity of tumor cells by improving hypoxia, increasing reactive oxygen species, inhibiting DNA damage repair, inducing cell cycle arrest and regulating immune microenvironment. However, several recently published randomized controlled trials have not confirmed that metformin can increase the efficacy of chemoradiotherapy. In this review, the mechanism and clinical results of metformin radiosensitization were summarized. The dose of metformin will be an important factor for basic and clinical research in the future.
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Objective:To explore the pathogenic characteristics of incision wound infections after breast cancer surgery and related influencing factors.Methods:Clinical files of 200 middle-aged and elderly patients who underwent breast-conserving surgery for breast cancer in the Affiliated Three Gorges Hospital from May 2016 to April 2021 were retrospectively analyzed.The results of pathogenic bacteria and drug sensitivity tests were examined, and the influencing factors of postoperative incision infections after breast cancer surgery were analyzed.Results:Among 200 middle-aged and elderly patients aged 55-75 years who underwent breast-conserving surgery for breast cancer, 13 patients(4.64%)developed postoperative incision infections, with 40 strains of pathogenic bacteria isolated, including 14 strains of gram-positive bacteria, 25 strains of gram-negative bacteria and 1 fungal strain.Univariate and multivariate logistic regression analysis showed that age( OR=3.40), duration of surgery( OR=2.50), albumin level( OR=2.83), underlying diseases( OR=4.23), preventive use of antibiotics( OR=3.14)and length of hospital stay( OR=2.33)were independent risk factors for postoperative incision infections in breast cancer patients(all P<0.05). Conclusions:Common pathogens of incision infections after breast-conserving surgery are Gram-negative bacteria.There are many factors affecting postoperative incision infections.Clinical measures need to be taken to reduce or prevent postoperative incision infections.
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Diabetes complications are the primary cause of disability and mortality in diabetic patients. As the center of cell energy metabolism, mitochondria dysfunction is closely related to the occurrence and development of various microvascular complications. This review focuses on common complications, including diabetic ulcers, diabetic nephropathy and diabetic retinopathy, and on the research progress of mitochondrial function and oxidative stress involving pathological mechanisms of diabetic microvascular complications. We also conclude and update the theoretical basis for targeting mitochondrial oxidative stress in the treatment of these diseases.
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Diabetic retinopathy(DR)is one of the common and severe ocular complications of diabetes mellitus, representing a leading cause of blindness among working-age people. Currently, the pathogenesis of DR is not been explained, and the treatment effect is quite limited in advanced stage. In recent years, it has been revealed in some studies that DR could produce a particularly remarkable performance in genomics, transcriptomics, epigenomics, proteomics and metabolomics. With the rapid development of high-throughput sequencing and detection technology, different omics techniques can explore the occurrence and development mechanism of DR from different omics levels. This paper introduces the research progress of DR in different omics techniques,as well as the new direction of integration analysis in multiomics with DR, and finally discusses the current existing problems and future prospects of omics technology. Therefore, the application of different omics techniques to explore the occurrence and development of DR on different levels contributes a novel idea to unraveling the pathophysiological mechanism of DR and identifying new biomarkers and therapeutic targets.
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Objective:To study the effect of Bushen Huatan prescription on helper T cell 17 (Th17)/T regulatory cells (Treg) balance of immune T cell subsets in the prevention and treatment of postmenopausal osteoporosis. Method:Sixty 6-month-old female SD rats were randomly divided into sham operation group, model group, estradiol valerate group (0.184 mg·kg<sup>-1</sup>) and Bushen Huatan prescription low, medium and high groups (4.7, 9.4, 18.8 g·kg<sup>-1</sup>) according to the random number table. All the groups except the sham operation group received ovariectomy to make postmenopausal osteoporosis model. Intragastric administration was started 1 week after operation, and the rats in model group and sham operation group received equal volume of normal saline, once a day for 12 weeks. Microcomputed tomography (Micro CT) was then used to detect bone mass and microstructure of rats, the contents of Forkhead box protein (Foxp3) and retinoic acid related nuclear orphan receptor (ROR<italic>γ</italic>t) in serum were detected by enzyme-linked immunosorbent assay (ELISA), the mRNA expression levels of Foxp3 and ROR<italic>γ</italic>t in bone tissues were detected by Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) and Western blot was used to detect the protein expression of Foxp3 and ROR<italic>γ</italic>t in bone tissues, the number of Th17 and Treg cells in each group was analyzed and compared by flow cytometry. Result:Compared with the sham operation group, the bone mass and trabeculae of the model group decreased (<italic>P</italic><0.01), the bone microstructure was destroyed, the concentration of Foxp3 in serum decreased, the concentration of ROR<italic>γ</italic>t increased (<italic>P</italic><0.01), the mRNA and protein expression levels of Foxp3 in bone tissues decreased, ROR<italic>γ</italic>t increased, the number of Treg cells in bone tissues decreased, number of Th17 cells increased (<italic>P</italic><0.01), and Th17/Treg ratio increased (<italic>P</italic><0.01) in model group. Compared with the model group, the bone mass in each treatment group increased (<italic>P</italic><0.05, <italic>P</italic><0.01), Foxp3 concentration in serum increased, ROR<italic>γ</italic>t concentration decreased (<italic>P</italic><0.01), the mRNA and protein expression levels of Foxp3 in bone tissues increased significantly (<italic>P</italic><0.05, <italic>P</italic><0.01), but no statistical difference was shown in mRNA expression between low dose group and the model group. In addition, the mRNA and protein expression of ROR<italic>γ</italic>t decreased (<italic>P</italic><0.05, <italic>P</italic><0.01), number of Treg cells increased, number of Th17 cells decreased (<italic>P</italic><0.05, <italic>P</italic><0.01), and Th17/Treg ratio decreased in treatment groups (<italic>P</italic><0.01). Conclusion:Bushen Huatan prescription can increase bone mass, improve bone microstructure, increase the number of Treg cells and decrease the number of Th17 cells in ovariectomized rats. It is concluded that Bushen Huatan prescription may play a role in preventing and treating postmenopausal osteoporosis by regulating Th17/Treg balance.
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Objective:To explore the effect of Bushen Huatan prescription on serum lipopolysaccharide (LPS) and Toll-like receptor 4 (TLR4)/ myeloid cell differentiation protein 88 (MyD88)/nuclear transcription factor-<italic>κ</italic>B (NF-<italic>κ</italic>B) signaling pathway in rats with ovariectomy-induced osteoporosis. Method:Sixty SPF 6-month-old female rats were randomly divided into sham operation group, model group, estradiol valerate group and Bushen Huatan prescription low, medium and high dose groups.One week after modeling by bilateral ovariectomy, 8 rats in each group were selected to receive intragastric administration.The estradiol valerate group was given 0.184 mg·kg<sup>-1</sup> by gavage, and Bushen Huatan prescription low, middle and high dose groups were given 4.7, 9.4 and 18.8 g·kg<sup>-1</sup> by gavage, sham operation group and model group were given 0.9% saline 4 mL by gavage respectively.After 12 weeks of intervention, the rats were sacrificed for detection.Serum LPS was detected by enzyme linked immunosorbent assay (ELISA), while protein expressions of TLR4, MyD88 and phosphorylated (p)-NF-<italic>κ</italic>B p65 in bone tissue were detected by Western blot, and the mRNA expressions of TLR4, MyD88, NF-<italic>κ</italic>B p65, IL-1<italic>β</italic>, and IL-6 in bone tissue were detected by quantitative real-time polymerase chain reaction(PCR). Result:Compared with sham operation group, the serum LPS level as well as protein expression of TLR4, MyD88, p-NF-<italic>κ</italic>B p65 and mRNA expression of TLR4, MyD88, NF-<italic>κ</italic>B p65, IL-1<italic>β</italic>, and IL-6 significantly increased in model group(<italic>P</italic><0.05).Compared with the model group, serum LPS level, protein expression of TLR4, MyD88, and p-NF-<italic>κ</italic>B p65, mRNA levels of TLR4, MyD88, and NF-<italic>κ</italic>B p65 in bone tissues as well as downstream inflammatory factors IL-1<italic>β</italic>, IL-6 mRNA expression decreased to different degrees in estradiol valerate group and Bushen Huatan prescription high dose group(<italic>P</italic><0.05). Conclusion:Bushen Huatan prescription can reduce serum LPS content, regulate mRNA and protein expression of TLR4, MyD88, NF-<italic>κ</italic>B p65 and p-NF-<italic>κ</italic>B p65 in TLR4/MyD88/NF-<italic>κ</italic>B pathway, and down-regulate mRNA levels of IL-1<italic>β</italic> and IL-6 in bone tissues to improve bone microstructure and inhibit the development of postmenopausal osteoporosis (PMOP).
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Computed tomography (CT) examination is the major measure for detecting and diagnosis of foreign bodies in human body. Although CT has high sensitivity in diagnosis of foreign body, some interference factors may still lead to missed diagnosis or misdiagnosis. Here we report a rare case that a bamboo stick accidentally pierced into the left chest of a young man who was drunk and unware of this hurt. The patient experienced cough, chest pain, fever, hemoptysis, and was misdiagnosed as primary and secondary tuberculosis based on chest CT examinations at a local hospital, although no tubercular bacillus detected by sputum smear. He subsequently received anti-tuberculous treatments in the following three years, but no improvement of his symptoms was observed. Until one month before his death, the bamboo stick was detected by spiral CT examination as well as three-dimensional image reconstruction at another hospital. Postmortem examination revealed pneumonia, pulmonary infarction, and abscess as the causes of his death. We analyze the potential reasons of misdiagnosis in this case, aiming to provide reference for the diagnosis and treatment of pulmonary inflammation associated with foreign body in the future.
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Humanos , Masculino , Abscesso , Erros de Diagnóstico , Pneumonia , Infarto Pulmonar , Tuberculose PulmonarRESUMO
Brain-computer interface (BCI) based on functional near-infrared spectroscopy (fNIRS) is a new-type human-computer interaction technique. To explore the separability of fNIRS signals in different motor imageries on the single limb, the study measured the fNIRS signals of 15 subjects (amateur football fans) during three different motor imageries of the right foot (passing, stopping and shooting). And the correlation coefficient of the HbO signal during different motor imageries was extracted as features for the input of a three-classification model based on support vector machines. The results found that the classification accuracy of the three motor imageries of the right foot was 78.89%±6.161%. The classification accuracy of the two-classification of motor imageries of the right foot, that is, passing and stopping, passing and shooting, and stopping and shooting was 85.17%±4.768%, 82.33%±6.011%, and 89.33%±6.713%, respectively. The results demonstrate that the fNIRS of different motor imageries of the single limb is separable, which is expected to add new control commands to fNIRS-BCI and also provide a new option for rehabilitation training and control peripherals for unilateral stroke patients. Besides, the study also confirms that the correlation coefficient can be used as an effective feature to classify different motor imageries.
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Humanos , Encéfalo , Diagnóstico por Imagem , Interfaces Cérebro-Computador , Pé , Imaginação , Movimento , Espectroscopia de Luz Próxima ao InfravermelhoRESUMO
Objective:To evaluate the efficacy and safety of traditional Chinese medicine (TCM) in the treatment of post stroke cognitive impairment (PSCI). Method:Seven databases, including CNKI, WanFang, VIP, CBM, PubMed, The Cochrane library and ClinicalTrials.gov, were electronically searched for relevant randomized controlled trials (RCTs) of TCM in the treatment of PSCI. The Cochrane risk of bias assessment tool was used to evaluate the methodological quality of the included studies, descriptive analysis was carried out on the included studies, and the Meta quantitative analysis was carried out with RevMan 5.3 software. Result:A total of 16 RCTs were included with 1 296 participants, and they were assigned to the intervention group (n=649) and the control group (n=647). The results showed that TCM combined with western medicine group and TCM group were better than western medicine group in improving the scores of Montreal Cognitive Assessment (MoCA), Mini-mental State Examination (MMSE), Barthel Index (BI), Activity of Daily Living (ADL), Chinese stroke scale (CSS) and National Institutes of Health stroke scale (NIHSS) of PSCI patients, and no serious adverse events were observed. Conclusion:TCM has potential advantages in improving the cognitive function of patients with PSCI, and it also has certain efficacy in improving the daily living ability and neurological impairment symptoms, and no serious adverse events have been observed. Due to the low quality of methodology included in the studies, in order to provide reliable basis for clinical decision-making, high-quality of RCTs are still needed to study the efficacy and safety of TCM for PSCI.
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Objective:To evaluate the accuracy of target-controlled infusion (TCI) of sufentanil at low concentration during combined intravenous and inhalational general anesthesia.Methods:Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients, aged 18-68 yr, with body mass index <35 kg/m 2, scheduled for elective laparoscopic surgery under combined intravenous and inhalational general anesthesia, were selected in the study.Anesthesia was induced with sufentanil TCI, propofol and rocuronium and maintained with sufentanil TCI combined with inhalation of sevoflurane.The patients were divided into 2 groups ( n=15 each) using the computer-generated sequence of random numbers method: 0.10 ng/ml group (groupⅠ) and 0.15 ng/ml group (groupⅡ). Arterial blood samples were collected from the radial artery for determination of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The bias, precision and wobble were calculated. Results:In Ⅰ and Ⅱ groups, the bias of sufentanil TCI was 17.0% and -3.0%, respectively, the precision was 22.4% and 20.3%, respectively, and the wobble was 23.0% and 21.7%, respectively.The pooled bias, precision and wobble were 6.0%, 22.0% and 22.0%, respectively.Conclusion:The accuracy of TCI of sufentanil at low concentration during combined intravenous and inhalational general anesthesia is within the clinically acceptable range, and the measured blood concentration of sufentanil is about 6% higher than the target concentration.
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Objective To predict the 5-year survival of patients with non-small cell lung cancer (NSCLC) by machine learning, and to improve the prediction efficiency and prediction accuracy. Methods The experiments were performed using NSCLC data from the SEER database. According to the imbalance of patient data, the Borderline-SMOTE method was used for data sampling. The perturbation-based feature selection (PFS) method and decision tree ( DT ) algorithm were used to screen the features and construct the postoperative survival prediction model . Results The patient data was balanced, and seven prognostic variables were screened, including primary site, stage group, surgical primary site, international classification of diseases, race and grade. Compared with LASSO, Tree-based, PFS-SVM and PFS-kNN models, the model constructed using PFS-DT has the best predictive effect. Conclusions The patient survival prediction model based on PFS-DT can effectively improve the accuracy of postoperative survival prediction in patients with NSCLC, and can provide a reference for doctors to provide treatment and improve prognosis.
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Objective To evaluate the accuracy of target-controlled infusion (TCI) of sufentanil at low concentration.Methods Sixty patients with American Society of Anesthesiologists physical status Ⅰ or Ⅱ,aged 18-68 yr,scheduled for elective surgery under general anesthesia,were included in this study.Anesthesia was induced and maintained with sufentanil TCI combined with propofol TCI,and muscle relaxation was maintained by intermittent injection of rocuronium as needed.The patients were divided into 3 groups (n=20 each) using the sealed envelope method:0.08 ng/ml group (group Ⅰ),0.10 ng/ml group (group Ⅱ) and 0.12 ng/ml group (group Ⅲ).Arterial blood samples were collected in 10 patients randomly selected from each group for measurement of plasma sufentanil concentrations by liquid chromatography-mass spectrometry/mass spectrometry.The accuracy of sufentanil TCI was evaluated by calculating bias (median performance error),precision (median absolute performance error) and wobble.Results In Ⅰ,Ⅱ and Ⅲ groups,the bias of sufentanil TCI was-6.1%,-10.2% and-5.0%,respectively,the precision was 19.4%,15.8% and 14.2%,respectively,and the wobble was 20.9%,11.0% and 10.8%,respectively.The pooled bias,precision and wobble were-7.1%,16.8% and 13.5% in Ⅰ,Ⅱ and Ⅲ groups,respectively.Conclusion The accuracy of sufentanil TCI at low concentration is considered acceptable in clinical anesthesia,and the measured plasma sufentanil concentration is approximately 7% lower than the target plasma sufentanil concentration in surgical patients.
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OBJECTIVES@#To study the epidemiological and pathological features of sudden death (SD) in Yunnan Province and to provide scientific evidence for prevention and forensic identification of sudden death.@*METHODS@#Totally 363 SD cases were collected from the autopsies between 2009 and 2017 in the Forensic Centre of Kunming Medical University. The related factors such as etiology, age, inducing factor, time interval between the onset of disease and death, morbidity season and pathological change were retrospectively analysed.@*RESULTS@#The incidence of SD in males was significantly higher than that of females. The peak age was ≥35-55 years. The mortality rate was relatively high within 6 h after the onset of disease. The season order with descending number of deaths was spring, summer, winter and autumn. The top ten causes of SD were coronary heart disease, sudden unexplained death (SUD), cerebral hemorrhage, acute hemorrhagic necrotic pancreatitis, aortic dissection rupture, cardiomyopathy, pneumonia, pulmonary thromboembolism, amniotic fluid embolism and allergy. Exercise, infusion, surgery, medication and minor injury were the most common predisposing factors of sudden coronary death. Consciousness disorder or coma, chest pain or chest tightness, and abdominal pain were the most common premortem symptoms of sudden coronary death.@*CONCLUSIONS@#The SD is more common in middle-aged males, which is the key population for the prevention of SD. For the forensic identification and prevention of SD, the attention on SUD should be paid.