OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 p...OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were nondiabetic.Patients were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,respectively.The primary endpoint was in-hospital mortality.RESULTS Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,respectively.Compared with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not changed.Further-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic status.Adding FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic cohorts.CONCLUSIONS This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without diabetes.FPG might be useful to stratify patients with AMI.展开更多
The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in...The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.展开更多
Parkinson’s disease(PD)was first described as a neurological disease by Dr.James Parkinson in 1817 as a“shaking palsy”.Since that time,much more is known about the pathophysiology of PD yet the disease is still unc...Parkinson’s disease(PD)was first described as a neurological disease by Dr.James Parkinson in 1817 as a“shaking palsy”.Since that time,much more is known about the pathophysiology of PD yet the disease is still uncurable.The hallmark of the disease is often considered Lewy body neural inclusions in the substantia nigra pars compacta and other brain areas,although not all patients have these inclusions.The patients exhibit massive neuronal cell loss in the substantia nigra pars compacta,which is associated with the motor symptoms of tremor,bradykinesia,rigidity,and postural instability.PD is the second most common neurodegenerative disease after Alzheimer’s disease with a prevalence of around 1%of individuals over the age of 60.展开更多
Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare...Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed and initiated at the ED.展开更多
The global incidence rates of in-hospital cardiac arrest(IHCA)range from1.2 to 9.0 per1,000 hospitalized patients,as per the National Cardiac Arrest Database.[1] While IHCAs tend to exhibit superior 30-day survival ra...The global incidence rates of in-hospital cardiac arrest(IHCA)range from1.2 to 9.0 per1,000 hospitalized patients,as per the National Cardiac Arrest Database.[1] While IHCAs tend to exhibit superior 30-day survival rates relative to out-of-hospital cardiac arrests (OHCA) due to situational advantages,such as immediate access to medical personnel and treatments.展开更多
Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Pat...Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.展开更多
Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patient...Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.展开更多
Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer del...Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.展开更多
Method: In Cameroon limited data are available regarding the prevalence of enteric bacteria associated with table egg consuming infections. As such, a situational-based study was performed in patients with complains o...Method: In Cameroon limited data are available regarding the prevalence of enteric bacteria associated with table egg consuming infections. As such, a situational-based study was performed in patients with complains of stomach disorders after egg consumption. Data related to sociodemographic characteristics and other factors were collected using a structured based questionnaire. Stool culture of utmost importance in stomach disorders patients and serum were collected for typhoid serological test. Results: A total of 207 participants took part in the survey, Results indicated nontyphoidal Salmonella infections were highest in the 3 areas of study with Mfoundi (73.44%) having the highest level of infection compared to other bacterial infection. other enteric bacteria associated to this infection were E. coli serotype 157, Aeromonas, Citrobacter freundii, Enterobacter cloaca and typhi salmonella. Meanwhile salmonelosis caused by typhic salmonella had highest prevalence in the Lekie Division (13.11%) as a result of poor hygienic practices associated with the conservation and preparation of eggs, Stool culture was observed to detect more positive cases in the diagnosis of typhoid fever than Widal test, but with no statistically significant (p > 0.05) difference between the stool culture and Widal test in the 3 areas of study. Conclusion: this study revealed that egg consumers are pruned to enteric bacterial and salmonella infections depending on how and where egg is consumed.展开更多
Background: Pacemaker implantation is a very old activity which has revolutionized the cardiology practice throughout the world. This activity is effective at the Haute Correze Hospital Center since more than 20 years...Background: Pacemaker implantation is a very old activity which has revolutionized the cardiology practice throughout the world. This activity is effective at the Haute Correze Hospital Center since more than 20 years. Due to progress in this area, and the increasing request within this center located at the outskirts of town, we set out to evaluate our pacemaker activity in general and more specifically to assess the post-procedural complications in our series patients. Methodology: This was a retrospective longitudinal study. Data were recorded for period of 90 months from 27/05/2016 to 19/11/2023. This data collection was possible via a specific register completed by computerized patient data from the SillageTM software. All files of patients implanted with single or dual chamber pacemakers were included, generator replacements, upgrading procedures and addition of leads were excluded. The sampling was non-probabilistic, consecutive and non-exhaustive. Statistical analysis was carried out using the Excel 2019 spreadsheet and SPSS version 23 software. The quantitative variables were presented as mean ± standard deviation, the qualitative data as proportions. Results: A total of 303 first-time pacemaker’s implantations were carried out during the study period (rate of 40 per year). The average age in the population was 79.7 ± 9.4 years (44 - 99 years) with a male predominance of 63.7% (n = 193). Atrioventricular block (2nd and 3rd degree) was the main indication for pacemaker implantation in 42.9% of cases (n = 130). Patients were most often implanted with a dual-chamber pacemaker (57.7%, n = 175). The approach was most often cephalic in 72.6% of cases (n = 220), followed by the subclavian access in 27.4% of cases (n = 84). The average fluoroscopy time was 7.9 min ± 2.4 (1 - 43). The average irradiation dose in gray/cm2 was 12.4 ± 9.3 (0.22 - 117.5). The average length of hospitalization was 7 ± 4 (2 - 26) days. The overall complication rate at one year was 12.9% (n = 39). These complications are distributed as follows: Leads dislodgement in 8.2% (n = 25), hematoma 3.6% (n = 11) all without clinical consequences, pneumothorax 0.7% (n = 2), both cases of pneumothorax did not require specific care, infection (superficial) in 0.3% (n = 1). Leads dislodgement occurred after a median time of 18 days (IQR: 3 - 36). The earliest dislodgement was observed on D0 and the latest on D207. No serious complications were recorded. The average atrial threshold at implantation/first control/last follow-up was 0.7/1.3/0.8 V, respectively. The average ventricular threshold at implantation/first control/last follow-up was 0.5/1.08/0.87 V, respectively. The average atrial detection at implantation/first control/last follow-up was 3.2/2.3/ 2.05 mv, respectively. The average ventricular detection at implantation/first control/last follow-up was 10.3/11.03/10.8 mv. The average atrial impedance at implantation/first control/last follow-up was 610/457/457 ohms. The average ventricular impedance at implantation/first control/last follow-up was 754/547/563 ohms. Conclusion: Pacemaker implantation is safe at the Haute Correze Hospital Center with a relatively low rate of complications, in this case an almost zero major infection and no serious hematoma. The peripheral hospital should remain a focal point of this activity in order to respond more quickly to the needs of the populations.展开更多
BACKGROUND Sepsis,which is characterized by acute systemic inflammation and is associated with high rates of morbidity and mortality,presents a significant challenge in health care.Some scholars have found that the se...BACKGROUND Sepsis,which is characterized by acute systemic inflammation and is associated with high rates of morbidity and mortality,presents a significant challenge in health care.Some scholars have found that the sequential organ failure assessment(SOFA)and quick SOFA scores are not ideal for predicting severe sepsis and mortality.Microbial culture takes a long time(2-3 d)and provides no information for early diagnosis and treatment.Therefore,new diagnostic methods for sepsis need to be explored.AIM To assess cytokine levels in the plasma of sepsis patients and identify potential biomarkers for diagnosing sepsis.METHODS Ten sepsis patients admitted to the emergency department within 24 h of onset were enrolled as the observation group,whereas ten noninfected patients served as the control group.Of the 10 noninfected patients,9 hypertension combined with cerebral infarction,1 patients with vertiginous syndrome.Plasma Cytokines were measured using the Bio-Plex Pro^(TM)Human Chemokine Panel 40-plex.Differentially expressed cytokines in plasma of sepsis and nonsepsis patients were analyzed using Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses.RESULTS Interleukin(IL)-16,granulocyte-macrophage granulocyte-macrophage colony-stimulating factor(GM-CSF),CX3CL1,CXCL9,CXCL16,CCL25,and CCL23 plasma levels were significantly increased in sepsis patients.GO analysis revealed that these cytokines were mainly associated with cellular structures such as intermediates,nuclear plaques,adhesion plaques,lateral plasma membranes,and cell matrix junctions.These genes were involved in various molecular functions,such as cytokine activity,receptor ligand activity,and signal receptor activator activity,contributing to various biological functions,such as leukocyte chemotaxis,migration,and chemotaxis.KEGG analysis indicated involvement in cytokine cytokine receptor interactions,chemokine signaling pathways,virus–protein interactions with cytokines and cytokine receptors,and the tumor necrosis factor signaling pathway.CONCLUSION Elevated serum levels of IL-16,GM-CSF,CX3CL1,CXCL9,CXCL16,CCL25,and CCL23 in sepsis patients suggest their potential as diagnostic biomarkers for sepsis.展开更多
When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on...When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on patient safety.This review seeks to analyze the factors contributing to patient falls in hospitals.The main goal is to enhance our understanding of the reasons behind these falls,enabling hospitals to devise more effective prevention strategies.This study reviewed literature published from 2013 to 2022,using the Arksey and O’Malley methodology for a scoping review.The research literature was searched from seven databases,namely,PubMed,ScienceDirect,Wiley Library,Garuda,Global Index Medicus,Emerald Insight,and Google Scholar.The inclusion criteria comprised both qualitative and quantitative primary and secondary data studies centered on hospitalized patients.Out of the 893 studies analyzed,23 met the criteria and were included in this review.Although there is not an abundance of relevant literature,this review identified several factors associated with falls in hospitals.These encompass environmental,patient,staff,and medical factors.This study offers valuable insights for hospitals and medical personnel aiming to enhance fall prevention practices.Effective prevention efforts should prioritize early identification of patient risk factors,enhancement of the care environment,thorough training for care staff,and vigilant supervision of high-risk patients.By comprehending the factors that contribute to patient falls,hospitals can bolster patient safety and mitigate the adverse effects of falls within the health-care setting.展开更多
Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study ...Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.展开更多
Since the D-band center theory was proposed,it has been widely used in the fields of surface chemistry by almost all researchers,due to its easy understanding,convenient operation and relative accuracy.However,with th...Since the D-band center theory was proposed,it has been widely used in the fields of surface chemistry by almost all researchers,due to its easy understanding,convenient operation and relative accuracy.However,with the continuous development of material systems and modification strategies,researchers have gradually found that D-band center theory is usually effective for large metal particle systems,but for small metal particle systems or semiconductors,such as single atom systems,the opposite conclusion to the D-band center theory is often obtained.To solve the issue above,here we propose a bonding and anti-bonding orbitals stable electron intensity difference(BASED)theory for surface chemistry.The newly-proposed BASED theory can not only successfully explain the abnormal phenomena of D-band center theory,but also exhibits a higher accuracy for prediction of adsorption energy and bond length of intermediates on active sites.Importantly,a new phenomenon of the spin transition state in the adsorption process is observed based on the BASED theory,where the active center atom usually yields an unstable high spin transition state to enhance its adsorption capability in the adsorption process of intermediates when their distance is about 2.5Å.In short,the BASED theory can be considered as a general principle to understand catalytic mechanism of intermediates on surfaces.展开更多
Objective: By the end of 2021, the aging rate of China’s population is 18.9%, and the prevalence rate of chronic diseases in the elderly population is increasing year by year, and chronic diseases have become the mai...Objective: By the end of 2021, the aging rate of China’s population is 18.9%, and the prevalence rate of chronic diseases in the elderly population is increasing year by year, and chronic diseases have become the main causes of death and health threats of Chinese residents. Therefore, how to manage this huge group well is crucial. This paper analyzes the value of health education in the process of health management for patients with chronic diseases. Methods: 102 patients with chronic diseases treated from January 2021 to December 2021 were divided into control group and experimental group by random number table method. The control group was given routine health management while the experimental group was given health education based on the control group, and the implementation effect was analyzed. Results: After management, the scores of chronic disease knowledge in the experimental group were significantly higher than those in the control group, and the dimensions of ESCA were higher than those in the control group, and P < 0.05;Conclusion: The implementation of health education in the process of chronic disease health management is helpful to improve patients’ self-care ability and better control disease progression.展开更多
The classical Pauli particle(CPP) serves as a slow manifold, substituting the conventional guiding center dynamics. Based on the CPP, we utilize the averaged vector field(AVF) method in the computations of drift orbit...The classical Pauli particle(CPP) serves as a slow manifold, substituting the conventional guiding center dynamics. Based on the CPP, we utilize the averaged vector field(AVF) method in the computations of drift orbits. Demonstrating significantly higher efficiency, this advanced method is capable of accomplishing the simulation in less than one-third of the time of directly computing the guiding center motion. In contrast to the CPP-based Boris algorithm, this approach inherits the advantages of the AVF method, yielding stable trajectories even achieved with a tenfold time step and reducing the energy error by two orders of magnitude. By comparing these two CPP algorithms with the traditional RK4 method, the numerical results indicate a remarkable performance in terms of both the computational efficiency and error elimination. Moreover, we verify the properties of slow manifold integrators and successfully observe the bounce on both sides of the limiting slow manifold with deliberately chosen perturbed initial conditions. To evaluate the practical value of the methods, we conduct simulations in non-axisymmetric perturbation magnetic fields as part of the experiments,demonstrating that our CPP-based AVF method can handle simulations under complex magnetic field configurations with high accuracy, which the CPP-based Boris algorithm lacks. Through numerical experiments, we demonstrate that the CPP can replace guiding center dynamics in using energy-preserving algorithms for computations, providing a new, efficient, as well as stable approach for applying structure-preserving algorithms in plasma simulations.展开更多
Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical imp...Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.展开更多
Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare...Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.展开更多
Coal-type source rocks include both coal and terrigenous marine source rocks.By studying the distribution of secondary depressions,uplifts,as well as the characteristics of peat formation and accumulation in the north...Coal-type source rocks include both coal and terrigenous marine source rocks.By studying the distribution of secondary depressions,uplifts,as well as the characteristics of peat formation and accumulation in the northern marginal sea basin of the South China Sea,and combining them with coal formation characteristics observed in other basins,five genetic theories on the relationship between peat accumulation and dispersed organic matter accumulation are proposed.The northern marginal sea basin of the South China Sea is characterized by“disadvantageous coals formation and favorable terrigenous marine source rocks formation.”This paper provides a distribution map of coal seams and terrigenous marine source rocks in the Qiongdongnan Basin and determines their distribution patterns.Research shows that the migration of sedimentary facies in the basins and inner depressions led to the formation and migration of the peat accumulation centers.In addition,the vertical migration of the peat accumulation centers led to planar migration,which is actually a type of coupling relationship.Previous research results have revealed that the formation of coal-type source rock is multi-phased.The marginal sea basin is composed of several fault-depression basins,with each basin developing a second order of depression and uplift.There is no unified basin center or depositional center to be found.As a result,the concentration centers of coal-forming materials also vary greatly.Based on the distribution characteristics of coal-type source rocks in different basins within the marginal sea basins of the South China Sea,the research results have practical significance and provide guidance for exploring coal-type oil and gas reservoirs in this area.展开更多
BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing ...BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing frequency of international exchanges and collaborations,the threat of imported malaria persists in China.Consequently,the prevention and control of imported malaria have become a primary focus for our country to maintain its malaria elimination status.CASE SUMMARY Herein,we present a case report of a 53-year-old Chinese man who worked in Africa for nearly two years.He was diagnosed with malaria in the Democratic Republic of the Congo between November 19 and November 23,2022.After receiving effective treatment with oral antimalarial drugs,his condition improved,allowing him to return to China.He was later admitted to our hospital on January 12,2023,during the coronavirus disease 2019 pandemic in Huangshi,China.Through a thorough evaluation of the patient's symptoms,clinical signs,imaging and laboratory test results,and epidemiological data,he was rapidly diagnosed with severe cerebral malaria.The patient underwent successful treatment through a series of intensive care unit interventions.CONCLUSION The successful treatment of this imported case of severe cerebral malaria provides a valuable reference for managing patients with similar malaria infections and has significant clinical implications.展开更多
基金supported by CAMS Innovation Fund for Medical Sciences (CIFMS: 2021-I2M-1008)Beijing Municipal Health Commission-Capital Health Development Research Project (20201–4032)+1 种基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS: 2020I2M-C&T-B-056)the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China (2011BAI11B02)
文摘OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were nondiabetic.Patients were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,respectively.The primary endpoint was in-hospital mortality.RESULTS Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,respectively.Compared with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not changed.Further-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic status.Adding FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic cohorts.CONCLUSIONS This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without diabetes.FPG might be useful to stratify patients with AMI.
文摘The current study aimed to compare the effects between remimazolam and propofol on hemodynamic stability during the induction of general anesthesia in elderly patients.We used propofol at a rate of 60 mg/(kg·h)in the propofol group(group P)or remimazolam at a rate of 6 mg/(kg·h)in the remimazolam group(group R)for the induction.A processed electroencephalogram was used to determine whether the induction was successful and when to stop the infusion of the study drug.We measured when patients entered the operating room(T_(0)),when the induction was successful(T_(1)),and when before(T_(2))and 5 min after successful endotracheal intubation(T_(3)).We found that mean arterial pressure(MAP)was lower at T_(1–3),compared with T_(0) in both groups,but higher at T_(2) in the group R,whileΔMAP_(T0–T2) andΔMAP_(max) were smaller in the group R(ΔMAP_(T0–T2):the difference between MAP at time point T_(0) and T_(2),ΔMAP_(max):the difference between MAP at time point T_(0) and the lowest value from T_(0) to T_(3)).Cardiac index and stroke volume index did not differ between groups,whereas systemic vascular resistance index was higher at T_(1–3) in the group R.These findings show that remimazolam,compared with propofol,better maintains hemodynamic stability during the induction,which may be attributed to its ability to better maintain systemic vascular resistance levels.
基金supported by the Israel Science Foundation(ISF grant 1994/21 and 3252/21)Zuckerman(Zuckerman STEM leadership program)(to SS).
文摘Parkinson’s disease(PD)was first described as a neurological disease by Dr.James Parkinson in 1817 as a“shaking palsy”.Since that time,much more is known about the pathophysiology of PD yet the disease is still uncurable.The hallmark of the disease is often considered Lewy body neural inclusions in the substantia nigra pars compacta and other brain areas,although not all patients have these inclusions.The patients exhibit massive neuronal cell loss in the substantia nigra pars compacta,which is associated with the motor symptoms of tremor,bradykinesia,rigidity,and postural instability.PD is the second most common neurodegenerative disease after Alzheimer’s disease with a prevalence of around 1%of individuals over the age of 60.
文摘Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ED)serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed and initiated at the ED.
基金supported by a grant from the Chonnam National University Hospital Biomedical Research Institute (BCRI-24006)。
文摘The global incidence rates of in-hospital cardiac arrest(IHCA)range from1.2 to 9.0 per1,000 hospitalized patients,as per the National Cardiac Arrest Database.[1] While IHCAs tend to exhibit superior 30-day survival rates relative to out-of-hospital cardiac arrests (OHCA) due to situational advantages,such as immediate access to medical personnel and treatments.
文摘Sepsis is a lethal condition characterized by multiple organ dysfunction due to disrupted host responses to severe infections.[1]Aff ected patients often have a Sequential Organ Failure Assessment(SOFA)score≥2.[2]Patients with a SOFA score<2 and at least one of the following were considered as“suspected sepsis”:(1)quick SOFA(qSOFA)score≥2;(2)SOFA score=1;or(3)National Early Warning Score(NEWS)4-6.[3]Compared with studies on fluid resuscitation in sepsis patients,there are few studies on fluid management in patients with suspected sepsis.Therefore,we conducted a retrospective cohort study to evaluate the relationship between fluid management and disease progression in suspected sepsis patients.
文摘Cardiovascular diseases(CVD)are the leading cause of death in the world and one of the most common diseases in the elderly,with high prevalence and poor prognosis,which seriously affect the health of the elder patients.One report showed that global deaths from CVD increased from 12.4 million in 1990 to 19.8 million in 2022,reflecting the global population growth and aging,as well as the impact of metabolic,environmental,and behavioral risks.[1]With the progress of aging population,the burden of CVD in the elderly in China has increased year by year,and factors including multiple complications,organ function decline,and high complication rate have made the interventional treatment of CVD in the elderly one of the difficulties and focuses in the field of cardiology in China.
文摘Background: Leprosy is known to cause disability that leads to severe outcomes like stigma, discrimination, mental health problems and participation restriction. Furthermore, in cases of infectious leprosy, longer delays increase the risk for the spread of the disease. Despite being preventable and curable, a significant proportion of new leprosy patients (39%) in 2019 had grade 2 (Described as Visible disability) at the time of diagnosis signifying late presentation. The aim of this study was to describe patient journeys from first symptoms suggestive of leprosy to a diagnosis and individual and community level factors associated with health seeking behavior of leprosy patients. Methods: This was a cross-sectional explorative study implemented in Kasese, Mayuge and Yumbe districts .A structured questionnaire was used to collect quantitative data. Qualitative assessment included patients, family members, health workers, voluntary health teams and the district health team. Descriptive statistics were presented in terms of percentages, frequency tables, pie Charts and graphs for easy interpretation and discussion. Results: The results indicate that 53% of the respondents identified as female. The median age of the respondents being 34 years, with a range of 1 to 76 years (Mean: 44.7, Mode: 65, Standard-Deviation: 19.6, Kurtosis: 0.6). The most common first symptom noticed by respondents was skin lesions (65%) followed by deformities (18%) (P value = 0.05%) occurring mostly in the feet (P-value = 0.48). Majority (52%) of the patients had taken more than 24 months (SD 18.72 OR 2.75) for a diagnosis to be made with a maximum delay of over 60 months. The most common cause of delay in seeking health care was lack of knowledge on leprosy (P value=Conclusions: There was a delay of 2 years in seeking health care for the majority of the patients. Key barriers to early diagnosis were lack of knowledge and infrastructure. Community sensitization and strengthening capacity building are needed to achieve early diagnosis of leprosy and proper management.
文摘Method: In Cameroon limited data are available regarding the prevalence of enteric bacteria associated with table egg consuming infections. As such, a situational-based study was performed in patients with complains of stomach disorders after egg consumption. Data related to sociodemographic characteristics and other factors were collected using a structured based questionnaire. Stool culture of utmost importance in stomach disorders patients and serum were collected for typhoid serological test. Results: A total of 207 participants took part in the survey, Results indicated nontyphoidal Salmonella infections were highest in the 3 areas of study with Mfoundi (73.44%) having the highest level of infection compared to other bacterial infection. other enteric bacteria associated to this infection were E. coli serotype 157, Aeromonas, Citrobacter freundii, Enterobacter cloaca and typhi salmonella. Meanwhile salmonelosis caused by typhic salmonella had highest prevalence in the Lekie Division (13.11%) as a result of poor hygienic practices associated with the conservation and preparation of eggs, Stool culture was observed to detect more positive cases in the diagnosis of typhoid fever than Widal test, but with no statistically significant (p > 0.05) difference between the stool culture and Widal test in the 3 areas of study. Conclusion: this study revealed that egg consumers are pruned to enteric bacterial and salmonella infections depending on how and where egg is consumed.
文摘Background: Pacemaker implantation is a very old activity which has revolutionized the cardiology practice throughout the world. This activity is effective at the Haute Correze Hospital Center since more than 20 years. Due to progress in this area, and the increasing request within this center located at the outskirts of town, we set out to evaluate our pacemaker activity in general and more specifically to assess the post-procedural complications in our series patients. Methodology: This was a retrospective longitudinal study. Data were recorded for period of 90 months from 27/05/2016 to 19/11/2023. This data collection was possible via a specific register completed by computerized patient data from the SillageTM software. All files of patients implanted with single or dual chamber pacemakers were included, generator replacements, upgrading procedures and addition of leads were excluded. The sampling was non-probabilistic, consecutive and non-exhaustive. Statistical analysis was carried out using the Excel 2019 spreadsheet and SPSS version 23 software. The quantitative variables were presented as mean ± standard deviation, the qualitative data as proportions. Results: A total of 303 first-time pacemaker’s implantations were carried out during the study period (rate of 40 per year). The average age in the population was 79.7 ± 9.4 years (44 - 99 years) with a male predominance of 63.7% (n = 193). Atrioventricular block (2nd and 3rd degree) was the main indication for pacemaker implantation in 42.9% of cases (n = 130). Patients were most often implanted with a dual-chamber pacemaker (57.7%, n = 175). The approach was most often cephalic in 72.6% of cases (n = 220), followed by the subclavian access in 27.4% of cases (n = 84). The average fluoroscopy time was 7.9 min ± 2.4 (1 - 43). The average irradiation dose in gray/cm2 was 12.4 ± 9.3 (0.22 - 117.5). The average length of hospitalization was 7 ± 4 (2 - 26) days. The overall complication rate at one year was 12.9% (n = 39). These complications are distributed as follows: Leads dislodgement in 8.2% (n = 25), hematoma 3.6% (n = 11) all without clinical consequences, pneumothorax 0.7% (n = 2), both cases of pneumothorax did not require specific care, infection (superficial) in 0.3% (n = 1). Leads dislodgement occurred after a median time of 18 days (IQR: 3 - 36). The earliest dislodgement was observed on D0 and the latest on D207. No serious complications were recorded. The average atrial threshold at implantation/first control/last follow-up was 0.7/1.3/0.8 V, respectively. The average ventricular threshold at implantation/first control/last follow-up was 0.5/1.08/0.87 V, respectively. The average atrial detection at implantation/first control/last follow-up was 3.2/2.3/ 2.05 mv, respectively. The average ventricular detection at implantation/first control/last follow-up was 10.3/11.03/10.8 mv. The average atrial impedance at implantation/first control/last follow-up was 610/457/457 ohms. The average ventricular impedance at implantation/first control/last follow-up was 754/547/563 ohms. Conclusion: Pacemaker implantation is safe at the Haute Correze Hospital Center with a relatively low rate of complications, in this case an almost zero major infection and no serious hematoma. The peripheral hospital should remain a focal point of this activity in order to respond more quickly to the needs of the populations.
基金Supported by The Project of Hengyang Science and Technology Bureau,No.202222035602.
文摘BACKGROUND Sepsis,which is characterized by acute systemic inflammation and is associated with high rates of morbidity and mortality,presents a significant challenge in health care.Some scholars have found that the sequential organ failure assessment(SOFA)and quick SOFA scores are not ideal for predicting severe sepsis and mortality.Microbial culture takes a long time(2-3 d)and provides no information for early diagnosis and treatment.Therefore,new diagnostic methods for sepsis need to be explored.AIM To assess cytokine levels in the plasma of sepsis patients and identify potential biomarkers for diagnosing sepsis.METHODS Ten sepsis patients admitted to the emergency department within 24 h of onset were enrolled as the observation group,whereas ten noninfected patients served as the control group.Of the 10 noninfected patients,9 hypertension combined with cerebral infarction,1 patients with vertiginous syndrome.Plasma Cytokines were measured using the Bio-Plex Pro^(TM)Human Chemokine Panel 40-plex.Differentially expressed cytokines in plasma of sepsis and nonsepsis patients were analyzed using Gene Ontology(GO)functional enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway analyses.RESULTS Interleukin(IL)-16,granulocyte-macrophage granulocyte-macrophage colony-stimulating factor(GM-CSF),CX3CL1,CXCL9,CXCL16,CCL25,and CCL23 plasma levels were significantly increased in sepsis patients.GO analysis revealed that these cytokines were mainly associated with cellular structures such as intermediates,nuclear plaques,adhesion plaques,lateral plasma membranes,and cell matrix junctions.These genes were involved in various molecular functions,such as cytokine activity,receptor ligand activity,and signal receptor activator activity,contributing to various biological functions,such as leukocyte chemotaxis,migration,and chemotaxis.KEGG analysis indicated involvement in cytokine cytokine receptor interactions,chemokine signaling pathways,virus–protein interactions with cytokines and cytokine receptors,and the tumor necrosis factor signaling pathway.CONCLUSION Elevated serum levels of IL-16,GM-CSF,CX3CL1,CXCL9,CXCL16,CCL25,and CCL23 in sepsis patients suggest their potential as diagnostic biomarkers for sepsis.
文摘When a patient falls within a hospital setting,there is a significant increase in the risk of severe injury or health complications.Recognizing factors associated with such falls is crucial to mitigate their impact on patient safety.This review seeks to analyze the factors contributing to patient falls in hospitals.The main goal is to enhance our understanding of the reasons behind these falls,enabling hospitals to devise more effective prevention strategies.This study reviewed literature published from 2013 to 2022,using the Arksey and O’Malley methodology for a scoping review.The research literature was searched from seven databases,namely,PubMed,ScienceDirect,Wiley Library,Garuda,Global Index Medicus,Emerald Insight,and Google Scholar.The inclusion criteria comprised both qualitative and quantitative primary and secondary data studies centered on hospitalized patients.Out of the 893 studies analyzed,23 met the criteria and were included in this review.Although there is not an abundance of relevant literature,this review identified several factors associated with falls in hospitals.These encompass environmental,patient,staff,and medical factors.This study offers valuable insights for hospitals and medical personnel aiming to enhance fall prevention practices.Effective prevention efforts should prioritize early identification of patient risk factors,enhancement of the care environment,thorough training for care staff,and vigilant supervision of high-risk patients.By comprehending the factors that contribute to patient falls,hospitals can bolster patient safety and mitigate the adverse effects of falls within the health-care setting.
文摘Introduction The main objective of any healthcare establishment must be to ensure the quality of patient care and customer satisfaction. It is necessary to regularly assess patient satisfaction. The aim of this study was to assess the level of satisfaction of customers aged over 18 years attending the emergency department of the health center. Methodology This was a descriptive and analytical cross-sectional study of patients aged 18 years and over, who attended the Samu Municipal emergency department between 02 and 30 May 2023. The satisfaction index was determined using the adapted 2009 SAPHORA-MCO questionnaire and the Likert satisfaction scale. Results A total of 400 patients were surveyed. The average age was 35 years, with a standard deviation of 14.7. Of those surveyed, 51% were women, 87% were educated, 50% lived in Grand Yoff and 59.5% were unemployed. Satisfaction levels linked to perception of the cost of care (72%), waiting time (64.3%), information given to patients (69.1%) and pain management (74 .5%) are fair. On the other hand, the levels of satisfaction linked to administrative procedures (82.5%), staff attitudes towards patients (84%), staff availability (86.4%), patient privacy (89.2%), general atmosphere (87.2%), staff competence (87.3%), and the effectiveness of care (89.4%) were satisfactory. The average waiting time was 38 minutes. However, 32% of patients waited less than 30 minutes and 92% less than an hour. The satisfaction index linked to administration and reception was 72.9% and 79.85%, respectively. The satisfaction index linked to the administration and technical quality of care is equal to 85.8% and 83.7%, respectively. The overall satisfaction index is equal to 80.6%;the level of satisfaction of users of the health structure is satisfactory. Conclusion Patient satisfaction is an essential part of quality care. Patient satisfaction must be based on effective communication from the healthcare team and the creation of a patient-caregiver relationship.
文摘Since the D-band center theory was proposed,it has been widely used in the fields of surface chemistry by almost all researchers,due to its easy understanding,convenient operation and relative accuracy.However,with the continuous development of material systems and modification strategies,researchers have gradually found that D-band center theory is usually effective for large metal particle systems,but for small metal particle systems or semiconductors,such as single atom systems,the opposite conclusion to the D-band center theory is often obtained.To solve the issue above,here we propose a bonding and anti-bonding orbitals stable electron intensity difference(BASED)theory for surface chemistry.The newly-proposed BASED theory can not only successfully explain the abnormal phenomena of D-band center theory,but also exhibits a higher accuracy for prediction of adsorption energy and bond length of intermediates on active sites.Importantly,a new phenomenon of the spin transition state in the adsorption process is observed based on the BASED theory,where the active center atom usually yields an unstable high spin transition state to enhance its adsorption capability in the adsorption process of intermediates when their distance is about 2.5Å.In short,the BASED theory can be considered as a general principle to understand catalytic mechanism of intermediates on surfaces.
文摘Objective: By the end of 2021, the aging rate of China’s population is 18.9%, and the prevalence rate of chronic diseases in the elderly population is increasing year by year, and chronic diseases have become the main causes of death and health threats of Chinese residents. Therefore, how to manage this huge group well is crucial. This paper analyzes the value of health education in the process of health management for patients with chronic diseases. Methods: 102 patients with chronic diseases treated from January 2021 to December 2021 were divided into control group and experimental group by random number table method. The control group was given routine health management while the experimental group was given health education based on the control group, and the implementation effect was analyzed. Results: After management, the scores of chronic disease knowledge in the experimental group were significantly higher than those in the control group, and the dimensions of ESCA were higher than those in the control group, and P < 0.05;Conclusion: The implementation of health education in the process of chronic disease health management is helpful to improve patients’ self-care ability and better control disease progression.
基金supported by National Natural Science Foundation of China (Nos. 11975068 and 11925501)the National Key R&D Program of China (No. 2022YFE03090000)the Fundamental Research Funds for the Central Universities (No. DUT22ZD215)。
文摘The classical Pauli particle(CPP) serves as a slow manifold, substituting the conventional guiding center dynamics. Based on the CPP, we utilize the averaged vector field(AVF) method in the computations of drift orbits. Demonstrating significantly higher efficiency, this advanced method is capable of accomplishing the simulation in less than one-third of the time of directly computing the guiding center motion. In contrast to the CPP-based Boris algorithm, this approach inherits the advantages of the AVF method, yielding stable trajectories even achieved with a tenfold time step and reducing the energy error by two orders of magnitude. By comparing these two CPP algorithms with the traditional RK4 method, the numerical results indicate a remarkable performance in terms of both the computational efficiency and error elimination. Moreover, we verify the properties of slow manifold integrators and successfully observe the bounce on both sides of the limiting slow manifold with deliberately chosen perturbed initial conditions. To evaluate the practical value of the methods, we conduct simulations in non-axisymmetric perturbation magnetic fields as part of the experiments,demonstrating that our CPP-based AVF method can handle simulations under complex magnetic field configurations with high accuracy, which the CPP-based Boris algorithm lacks. Through numerical experiments, we demonstrate that the CPP can replace guiding center dynamics in using energy-preserving algorithms for computations, providing a new, efficient, as well as stable approach for applying structure-preserving algorithms in plasma simulations.
文摘Background: Deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.
文摘Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.
基金The National Natural Science Foundation of China under contract Nos 42072188,42272205 and 41872172。
文摘Coal-type source rocks include both coal and terrigenous marine source rocks.By studying the distribution of secondary depressions,uplifts,as well as the characteristics of peat formation and accumulation in the northern marginal sea basin of the South China Sea,and combining them with coal formation characteristics observed in other basins,five genetic theories on the relationship between peat accumulation and dispersed organic matter accumulation are proposed.The northern marginal sea basin of the South China Sea is characterized by“disadvantageous coals formation and favorable terrigenous marine source rocks formation.”This paper provides a distribution map of coal seams and terrigenous marine source rocks in the Qiongdongnan Basin and determines their distribution patterns.Research shows that the migration of sedimentary facies in the basins and inner depressions led to the formation and migration of the peat accumulation centers.In addition,the vertical migration of the peat accumulation centers led to planar migration,which is actually a type of coupling relationship.Previous research results have revealed that the formation of coal-type source rock is multi-phased.The marginal sea basin is composed of several fault-depression basins,with each basin developing a second order of depression and uplift.There is no unified basin center or depositional center to be found.As a result,the concentration centers of coal-forming materials also vary greatly.Based on the distribution characteristics of coal-type source rocks in different basins within the marginal sea basins of the South China Sea,the research results have practical significance and provide guidance for exploring coal-type oil and gas reservoirs in this area.
基金Local Special Projects in Major Health of Hubei Provincial Science and Technology Department,No.2022BCE054Key Scientific Research Projects of Hubei Polytechnic University,No.23xjz08AHubei polytechnic University Huangshi Daye Lake hightech Zone University Science Park joint open fund project,No.23xjz04AK.
文摘BACKGROUND On June 30,2021,China received certification from the World Health Organization for malaria elimination.However,this certification does not signify the absence of malaria within China.Due to the increasing frequency of international exchanges and collaborations,the threat of imported malaria persists in China.Consequently,the prevention and control of imported malaria have become a primary focus for our country to maintain its malaria elimination status.CASE SUMMARY Herein,we present a case report of a 53-year-old Chinese man who worked in Africa for nearly two years.He was diagnosed with malaria in the Democratic Republic of the Congo between November 19 and November 23,2022.After receiving effective treatment with oral antimalarial drugs,his condition improved,allowing him to return to China.He was later admitted to our hospital on January 12,2023,during the coronavirus disease 2019 pandemic in Huangshi,China.Through a thorough evaluation of the patient's symptoms,clinical signs,imaging and laboratory test results,and epidemiological data,he was rapidly diagnosed with severe cerebral malaria.The patient underwent successful treatment through a series of intensive care unit interventions.CONCLUSION The successful treatment of this imported case of severe cerebral malaria provides a valuable reference for managing patients with similar malaria infections and has significant clinical implications.