Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · Aug 2018
[The relationship between non-alcoholic fatty liver disease and metabolic syndrome in patients with latent autoimmune diabetes in adults].
Objective: To investigate the relationship between non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome (MetS) in patients with latent autoimmune diabetes in adults (LADA). Methods: A total of 223 hospitalized patients were recruited between January 2007 and June 2009 in Department of Endocrinology and Metabolism of the Sixth People's Hospital Affiliated to Shanghai Jiaotong University. Finally, 142 patients with complete clinical data and without history of drinking were included in this study. ⋯ Binary regression analysis showed that NAFLD was an independent factor associated with MetS in the patients with LADA after correcting other confounding factors (P<0.001). Conclusions: Compared with the patients with LADA but without NAFLD, the prevalence of MetS was obviously higher, and had more serious metabolic disorder in the patients with LADA and NAFLD. The presence of NAFLD was an independent factor associated with MetS in the patients with LADA.
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Zhonghua yi xue za zhi · Jul 2018
[Study of the effects of hydromorphone on emergence agitation of children anesthetized by sevoflurane].
Objective: To observe the effect of hydromorphone on emergence agitation of children anesthetized by Sevoflurane. Methods: One hundred patients without any analgetic, aged 3 to 7 years, ASA Ⅰ-Ⅱ, undergoing strabismus surgery in Beijing Tongren Hospital from March, 2017 to December, 2017 were selected and they were randomly divided into two groups(n=50), H group and F group by random number table. After standardized tidal volume method induction by 8% sevoflurane and oxygen, suiltable laryngeal mask was inserted, and each patient was left spontaneously breathing anesthetized by 2.5%-3.0% sevoflurane. ⋯ The occurrence rates of swirl, glossocoma in H group were 0 and 10.0% while those of F group were all 6.0%, there were no significant differences between the two groups(P>0.05). Conclusions: Comparing with fentanyl, hydromorphone can prevent the occurrence rate of EA of the children anesthetized by sevoflurane equally, even decrease the occurrence rate of the severe EA more observably, and reduce postoperation pain more significantly with less occurrence rate of swirl or nausea. Glossocoma need be paid attention to when HM is administered.
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Zhonghua yi xue za zhi · Jul 2018
[Efficacy analysis of the endovascular treatment for 175 unruptured vertebrobasilar dissecting aneurysms].
Objective: To analyze the clinical characteristics, clinical effect and follow-up outcome of the different endovascular treatment techniques in the treatment of unruptured vertebrobasilar dissecting aneurysms (VBDAs). Methods: The clinical data of 160 consecutive patients (175VBDAs) from January 2012 to December 2016 in Beijing Tiantan hospital were retrospectively analyzed. All of the 175 aneurysms were treated with endovascular embolization, including 115 stent-assisted coils, 27 simple stents, 21 blood flow diverting devices, and 12 parent arteries occlusion. ⋯ Conclusions: The clinical manifestations of the unruptured VBDAs are complex, and the headache is the most common clinical symptom. Endovascular treatment for the treatment of unruptured VBDAs is safe and feasible. The principle of individualization should be followed during embolization.
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Zhonghua yi xue za zhi · Jul 2018
Randomized Controlled Trial[Effect of positive end-expiratory pressure on the cross-sectional area of the internal jugular vein and anatomic relationship between the internal jugular vein and the carotid artery in general anaesthesia of laryngeal mask airway].
Objective: To investigate the effect of positive end-expiratory pressure(PEEP) on the cross-sectional area (CSA) of the internal jugular vein (IJV) and anatomic relationship between the IJV and the common carotid artery (CCA) in general anaesthesia of laryngeal mask airway(LMA). Methods: Sixty American Society of Anesthesiologists (ASA) Ⅰ or Ⅱ grade patients undergoing elective operation received general anaesthesia using LMA from May to November 2017, aged 20-65, were included in this study and randomly divided into 4 groups: group P0 (PEEP: 0 cmH(2)O), group P5 (PEEP: 5 cmH(2)O), group P10 (PEEP: 10 cmH(2)O), group P15 (PEEP: 15 cmH(2)O). Following the induction of anesthesia, LMA was inserted, and mechanical ventilation was started while the right cervical vessels was imaged by ultrasonography after applying 4 different PEEPs in random order. ⋯ Conclusions: The application of PEEP effectively increases the CSA of IJV in general anaesthesia of LMA. At the same time, it also lead to higher overlap index between the IJV and CCA. Ten cmH(2)O PEEP provides the best balance between the increase of CSA and the stability of haemodynamics.
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Zhonghua yi xue za zhi · Jul 2018
[Relationship between intake volume of carbohydrates solution and gastric emptying time in termed parturients].
Objective: To investigate the relationship between intake volume of carbohydrates solution (CHO) and gastric emptying time in termed parturient, thus to optimize fasting time before anesthesia. Methods: This study was a prospective study. From May to July in 2016, a total of 100 termed parturients in Huangyan Hospital of Wenzhou Medical University, were divided into four groups equally by means of random number table: D1 (200 ml), D2 (300 ml), D3 (400 ml) and D4 (500 ml), based on the different intake volume of 12.5% CHO. ⋯ Gastric emptying times in D1, D2, D3 and D4 were (76.96±17.69), (96.52±20.14), (109.20±14.70) and (122.86±16.17) min respectively, the difference was significant (F=50.471, P<0.001). All parturients in D1, D2 and D3 group had been in the status of gastric emptying 120 min after oral CHO, and all parturients in D4 group had been in the status of gastric emptying either 150 min after oral CHO. Conclusion: Gastric emptying time will be within two hours when 400 ml or less oral CHO is taken by termed parturient, and it will be prolonged as intake volume increases.