American journal of translational research
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Endobronchial ultrasound-guided sheath (EBUS-GS) and electromagnetic navigation bronchoscopy combined with EBUS (ENB-EBUS) are two diagnostic methods used to obtain lung tissue for biopsy of peripheral lung lesions. This study retrospectively summarized the case data of patients who underwent EBUS-GS or ENB-EBUS, both procedures performed at the respiratory endoscopy center of Tangdu Hospital, and the study compared the diagnostic efficacy and complications of the two methods. The study included 93 patients who underwent EBUS-GS and 26 who underwent ENB-EBUS. ⋯ An analysis of the complications showed that the incidence of complications in the EBUS-GS group was 8.4%, and the incidence of complications in the ENB-EBUS group was 3.8%, with no statistical difference (P>0.05). Both EBUS-GS and ENB-EBUS can be used for the diagnosis of peripheral pulmonary disease. However, the diagnostic rate of EBUS-GS is significantly higher than ENB-EBUS in cases with bronchial signs associated with the lesion, and the diagnostic rate of ENB-EBUS in cases with no bronchial signs was higher than that of EBUS-GS with no statistical difference.
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This study aimed to evaluate the efficacy and safety of remimazolam tosylate versus propofol in patients undergoing colonoscopy. In this multicentered, blinded, randomized, active-controlled, non-inferior phase III trial, 384 eligible patients who were about to undergo colonoscopy were randomized as a ratio of 1:1 into remimazolam and propofol group. Procedure success was assessed and defined as the completion of colonoscopy without administration of rescue sedative agent or more than 5 top-ups of trial drug in any 15 minute-period after initial administration of trial drug. ⋯ Besides, induction time of sedation was increased (P<0.001), while hypotension and respiratory depression was decreased in remimazolam group compared to propofol group; however, time to fully alert (P>0.05) or time to discharge (P>0.05) were unchanged. For safety assessment, total treatment-emergent adverse events were decreased in remimazolam group compared to propofol group (P<0.001); specifically, administration site pain (P<0.001), increased bilirubin (P=0.019), decreased respiratory rate (P<0.001) and decreased SpO2 (P<0.001) were less frequent in remimazolam group compared with propofol group. In conclusion, remimazolam tosylate is non-inferior in sedation efficacy while safer than propofol in patients undergoing colonoscopy.
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Concerns about the potential neurotoxicity of general anesthesia to the developing brain have been increasing in recent years. Animal studies have shown that neonatal exposure to general anesthesia causes both acute neurotoxicity and behavioral abnormalities later in life. ⋯ More importantly, we found that insulin administered through intranasal delivery prior to anesthesia prevented anesthesia-induced over-activation of neuronal apoptosis. This study provides experimental evidence for a potential effective, yet simple, method to prevent anesthesia-induced neurotoxicity in children, especially in infants.
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To investigate whether sublabial mucosa is more suitable for evaluation of microcirculation than commonly used sublingual mucosa in ICU patients, we enrolled 57 adults (47 critically ill patients and 10 volunteers) at convenience from Oct 2018 to Jan 2019. Videomicroscopy images at both sublingual mucosa and sublabial mucosa were acquired at the same time in each enrollee. Qualified images were recorded for later analysis. ⋯ This study indicates that point of care evaluation of microcirculation by POEM score shows good to excellent agreement between sublingual mucosa and sublabial mucosa. It is easier to acquire qualified videomicroscopy images at sublabial mucosa than at sublingual mucosa. Therefore, sublabial mucosa might be more suitable for bedside evaluation of microcirculation with handheld SDF device in ICU.
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This study was designed to assess the levels of human serum amyloid A (SAA) and C-reactive protein (CRP) in patients with coronavirus disease 2019 (COVID-19) to determine their prognostic value in predicting the severity of disease. Patients with COVID-19 who presented with acute respiratory distress syndrome (ARDS) shared distinct characteristics. For example, the patients were older, and had higher levels of inflammatory indicators [i.e., levels of CRP, SAA, procalcitonin (PCT), and interleukin-6; CRP-to-PCT ratio; SAA-to-CRP ratio; and neutrophil-to-lymphocyte ratio (NLR)], higher inflammatory cell counts (i.e., white blood cell count and neutrophil count), and lower lymphocyte counts compared with patients without ARDS. ⋯ For patients with elevated levels of SAA but not CRP, a mild condition was predicted. For patients with elevated levels of both SAA and CRP, and a high NLR, a severe infection was predicted, requiring medical attention. Therefore, CRP and SAA levels demonstrate a prognostic value for predicting the severity of COVID-19.