Zhonghua yi xue za zhi
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Zhonghua yi xue za zhi · May 2019
[Value of intravoxel incoherent motion diffusion weighted imaging in evaluating the microstructure changes in white matter hyperintensities].
Objective: To investigate the value of intravoxel incoherent motion diffusion weighted imaging (IVIM DWI) in evaluating microstructure changes in elderly white matter hyperintensities (WMH) patients and to analyze the correlation between IVIM parameters and severity grading and cognitive scores. Methods: Sixty-two WMH patients in Zhejiang Hospital were collected from December 2014 to March 2018 and underwent conventional magnetic resonance (MR) plain scan and diffusion weighted imaging with different b values. The age was 60-92(74±10) years with 37 males, 25 females. ⋯ Only f in PWMH were positively associated with the MMSE scores (r=0.326 5,P<0.05). Conclusions: IVIM DWI can noninvasively assess the variation of microstructure diffusion and perfusion in WMH in one sequence,which may objectively reflect the severity of these lesions. This method has important clinical significance for better assessment and management of this disease.
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Zhonghua yi xue za zhi · May 2019
[Effects of different fluid resuscitation methods on hemorheology in pigs during burn shock stage].
Objective: To investigate the impact of different methods of fluid resuscitation on hemorheology during burn shock stage. Methods: Twenty four miniature swines were randomly divided into four groups with 6 in each group (succinylated gelatin group, hydroxyethyl starch group, Parkland group and allogeneic plasma group). Severe burn shock model was established by burning miniature swine with napalm. ⋯ Compared with pre-injury (17.3±1.3 s, 16.4±1.5 s), the levels of EFT in hydroxyethyl starch group (15.5±1.4 s) and Parkland group (13.4±1.2 s) decreased substantially at 48 h post-injury (both P<0.05). Compared with allogeneic plasma group, the level of EFT in succinylated gelatin group at 4 h post-injury (19.5±2.3 s) increased and decreased at 24 h post-injury (12.0±5.7 s) (both P<0.05). Conclusion: During swine burn shock stage, the hemorheological parameters of shock resuscitation with artificial colloid are more stable than those with Parkland formula resuscitation.
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Zhonghua yi xue za zhi · May 2019
Randomized Controlled Trial[Effect of Dexmedetomidine Combined with Propofol or Sevoflurane General Anesthesia on Stress and Postoperative Quality of Recovery(QoR-40) in Patients Undergoing Laparoscopic Surgery].
Objective: To explore the effects of dexmedetomidine combined with propofol or sevoflurane general anesthesia on stress and postoperative quality of recovery (QoR-40) in patients undergoing laparoscopic surgery. Methods: Two hundreds patients with laparoscopic gastrointestinal tumor resection (100 cases of gastric tumor and 100 cases of colon tumor) from March 2016 to January 2018 at Henan Cancer Hospital,were randomly divided into 4 groups(n=50): group SP (gastric neoplasm + propofol anaesthesia), group SS (gastric tumor + sevoflurane anaesthesia), group CP (colon tumor+ propofol anaesthesia), and group CS (colon tumor + sevoflurane anaesthesia). The four groups were all induced by dexmedetomidine, etomidate, sufentanil and cisatracurium. ⋯ At the same time, the time of regain consciousness was (9.2±1.2)min,which was also lower than CS group [(10.1±1.2)min,P<0.05]. The recovery quality scores of the SP and CP group were (164±11) and (168±11) after 24 hours, which were greater than that of the SS and CS group(146±10, 143±12, all P<0.05). Conclusion: Dexmedetomidine combined with propofol in laparoscopic surgery can effectively suppress intraoperative stress, reduce postoperative pain and agitation, and improve the quality of postoperative recovery.
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Zhonghua yi xue za zhi · May 2019
Randomized Controlled Trial[Effect of esmolol in septic shock patients with tachycardia: a randomized clinical trial].
Objective: To investigate the effect of esmolol in septic shock patients with tachycardia. Methods: A prospective randomized controlled trial was conducted. Screening septic shock patients that admitted to Department of General Intensive Care Unit of the First Affiliated Hospital of Zhengzhou University from June 2016 to August 2017. ⋯ Compared with control group, the esmolol group had a lower heart rate on day 1-7; but over all, there was no statistically significant difference in heart rate between the two groups (P>0.05). There was no significant difference in total does of norepinephrine, lactate level, inflammatory markers, APACHE Ⅱ, SOFA, length of hospital stay between the two groups (all P>0.05). Conclusion: Tachycardia significantly increases the risk of death in patients with septic shock, esmolol may decrease the mortality by controlling heart rate.