Advanced Emergency Medicine (E-Journal)
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Comparison of Neostigmine-Atropine Administration Methods for Hemodynamic Parameters in Patients Undergoing Elective Surgery: A Randomized Control Trial
Get PDFObjective: The aim of this study is to compare the hemodynamic effects of neostigmine-atropine in the reversal of muscle relaxants when administered either sequentially or simultaneously. Methods: Patients undergoing noncardiac surgery were recruited and randomly allocated to either a sequential or a simultaneous administration of neostigmine (0.04 mg kg−1) and atropine (0.02 mg kg−1) at the end of surgery. Sequential group (SEQ group): Neostigmine and 1/3 dose of atropine were administered first minute, followed by another 2/3 dose of atropine 3 minutes later. Simultaneous group (SIM group): Neostigmine and atropine mixture was finished in 4 minutes. The primary outcome was the area under the curve (AUC) of the heart rate difference within 15 minutes of administration. The secondary outcome was the heart rate at each time point and the heart rate difference. Results: The AUC of heart rate difference within 15 minutes after administration in the SEQ group was 13.05±9.57 versus 43.56±10.54 in the SIM group (P<0.05). SIM group had a significantly lower heart rate when compared to SEQ group at 9, 10, 11, 12, 13, 14, and 15 minutes after administration (P<0.05). Heart rate difference was significantly smaller at 9, 10, 11, 12, 13, 14, and 15 minutes after administration in the SEQ group (P<0.05). Conclusion: Sequential administration, when atropine was administered later, induced smaller heart rate variability. Atropine and neostigmine should be administered in this order: neostigmine combined with small doses of atropine was administered first, followed by the remaining atropine
Investigation and Analysis of the Relationship Between Gastric Disorders and Gluten Disorders Among Residents of Yushe County, Shanxi.
Get PDFCeliac disease, wheat and gluten allergies, and non-celiac gluten sensitivity are the three types of conditions belonging to gluten-re-lated disorders. While already a popularly known issue in developed countries, both medical professionals and the general populace in China lack basic knowledge of gluten-related disorders. However, previous studies have found that gluten-related disorders are possibly pervasive in China. This study targets the rural areas of Yushe, Shanxi, where wheat-based foods are the main staple. It confrms the relationship be-tween gastric disease occurrences and nut-and-grain allergies through a logistic regression model, with wheat and gluten being the most dominant foods in the local diet under this category. Therefore, gluten disorders may actually have the greatest impact on gastric diseases in villagers. Well-designed prospective studies are needed to establish the causality between gluten-related disorder and gastric disease
Treatment of Acute Proximal Interphalangeal Joint Palmar Plate Injury by Bone Channel Suture
Get PDFObjective: Objective: To explore the surgical efect of suture through bone canal in the treatment of reconstruction of acute prox-imal interphalangeal joint metacarpal anchorage. Methods From July 2018 to August 2021, we retrospectively analyzed 9 cases of avulsion of metacarpal plate near interphalangeal joint, including 7 males and 2 females, aged 17-40 years, with an average of 34 years. There were 4 cases of index fnger, 3 cases of middle fnger and 2 cases of ring fnger. Early fexion and extension exercises were performed after opera-tion. The last follow-up included the range of motion of the proximal interphalangeal joint and joint pain. Results All patients were followed up (4-12 months) after operation.According to the TAM method, 7 cases were excellent and 2 cases were good. Conclusion Transosseous su-ture for acute proximal interphalangeal joint metacarpal reconstruction has the advantages of simple operation, safety, frm fxation and rapid postoperative recovery
Clinical Application of Transrectal Ultrasound Guided Prostate Biopsy
Get PDFObjective: To analyze the clinical application of transrectal ultrasound guided prostate biopsy. Method: 100 suspected prostate cancer patients admitted to our hospital from January 2019 to January 2021 were selected and underwent transrectal ultrasound guided prostate biopsy. Based on the pathological results of the surgery, the disease detection rate (such as benign prostatic hyperplasia, prostatic intraepithelial tumor, prostate cancer, atypical adenomatous hyperplasia, etc.), visual analogue scale (VAS) scores, and Complication rate (hematuria, urinary retention, fever, vasovagal reflex, etc.), diagnostic efficacy (sensitivity, specificity, diagnostic coincidence rate, misdiagnosis rate, missed diagnosis rate, negative predictive value, positive predictive value). Result: According to the surgical and pathological results, there were 33 cases of benign prostatic hyperplasia, 11 cases of prostatic intraepithelial tumors, 7 cases of prostate cancer, and 17 cases of atypical adenomatous hyperplasia. The patients undergoing transrectal ultrasound guided prostate biopsy included 33 cases of benign prostatic hyperplasia, 11 cases of prostatic intraepithelial tumors, 7 cases of prostate cancer, and 7 cases of atypical adenomatous hyperplasia, with a disease detection rate of 98% (98/100); The patient's VAS score is (2.13 ± 0.45) points, and the incidence of complications is 3% (3/100); The sensitivity of transrectal ultrasound guided prostate biopsy was 92.50% (30/33), specificity was 90.47% (57/63), diagnostic accuracy was 94% (94/100), misdiagnosis rate was 3.17% (2/63), missed diagnosis rate was 9.09% (3/33), negative predictive value was 95% (67/70), and positive predictive value was 92.85% (26/28). Conclusion Transrectal ultrasound-guided prostate biopsy for prostate cancer has high diagnostic accuracy, low incidence of complications such as hematuria and urinary retention, light pain and high application value
Clinical Efficacy of Posterior Nasal Neurotomy in the Treatment of Allergic Rhinitis
Get PDFObjective: To analyze the clinical efficacy of posterior nasal neurotomy in the treatment of allergic rhinitis. Method: 100 patients with allergic rhinitis who received treatment at Shaanxi Provincial People's Hospital from January 2021 to January 2022 were selected as the study subjects. According to different treatment methods, patients were divided into an experimental group and a control group. There were 50 patients in each group, of which the control group was treated with drug therapy, including nasal spray of Siqing Bio rational Sea Salt Water (twice a day), nasal Fluticasone propionate nasal spray (once a day), and oral lupatadine fumarate tablets (10mg each time, once a day). The experimental group of patients underwent posterior nasal neurotomy combined with medication for treatment. After obtaining the patient's consent, track the VAS, RQLQ, and SNOT-20 scores of the patient before treatment, 3 months after treatment, and 6 months after treatment. Observe the postoperative complications in the experimental group and investigate the occurrence of adverse reactions to drugs in both groups of patients. Results: The main effect differences between VAS, RQLQ, and SNOT-20 scoring groups and time points were statistically significant (P The RQLQ and SNOT-20 scores were lower than before treatment (P<0.05). At the same time, the scores of the experimental group compared with the control group were lower than those of the control group. The experimental group will lose their sense of smell and experience complications such as atrophic rhinitis within two weeks after surgery. During drug treatment, there was no statistically significant difference in the total incidence of adverse reactions between the two groups of drugs. Conclusion: Posterior rhinotomy can alleviate clinical symptoms and further improve the quality of life of patients with allergic rhinitis. The short-term treatment effect is good, and no serious complications have occurred
A Comparative Analysis of the Diagnostic Value of Shoulder MRI Plain Scan and MR Shoulder Arthrography for Rotator Cuff Injury
Get PDFObjective: To analyze the diagnostic value of MRI plain scan and MR shoulder arthrography on rotator cuff injury. Methods: Sixty patients with suspected rotator cuff injury admitted to Yunnan South Central Hospital in Yunnan Province from October 2022 to March 2023 were selected, and all patients were scanned with MR conventional serial scan and MR arthrography, and the arthroscopic findings were used as the gold standard to compare the diagnostic results of the two methods on rotator cuff injury, the diagnostic value, the diagnostic value of different tear types, and the diagnostic value in oblique sagittal position for different parts of the display rate. Results: Arthroscopic findings were positive in 45 cases and negative in 15 cases; MR arthrography scans were positive in 42 cases and negative in 18 cases; MR conventional serial scans were positive in 39 cases and negative in 21 cases ; MR arthrography sensitivity was 88.89%, specificity 86.67%, accuracy 70.00%, positive predictive value 95.24% and 72.22% negative predictive value, while MR conventional serial scan was 84.44%, 93.33% specificity, 65.00% accuracy, 97.44% positive predictive value and 66.67% negative predictive value, with no statistically significant difference between the two methods (all P > 0.05); arthroscopy diagnosed 5 outer layer tears, 32 inner layer tears and 8 tendon MR arthrography diagnosed 6 outer layer tears, 33 inner layer tears and 6 intra-tendon tears, with an accuracy rate of 88.89% (40/45); MR conventional serial scan diagnosed 6 outer layer tears, 33 inner layer tears and 6 intra-tendon tears, with an accuracy rate of 84.44% (38/45). The difference in accuracy between the two groups was not 
Comparative Analysis of Laparoscopy Through Single Umbilical Hole and Traditional Laparoscopy
Get PDFObjective: To explore the standardized application effect of laparoscopy in gynecological clinical medical treatment. Methods: The experiment was carried out in patients admitted to gynecology department in a hospital in China from October 2021 to October 2022. 30 patients were selected as the research subject by random sampling, and 30 patients were divided into two experimental groups by using the digital random table. They were the experimental group and the control group. There were 15 patients in both experimental groups. The control group was treated by conventional Laparoscopy, The experimental group was treated with single hole Laparoscopy via umbilical cord. Result: Through experimental research, the surgical time of patients in the experimental group was longer than that of the control group, but the postoperative exhaust time and surgical water loss scores of patients in this experimental group were better than those in the conventional group, and P<0.05; The probability of postoperative complications in the experimental group patients will be significantly lower than that in the control group patients, P<0.05. Conclusion: Compared with traditional Laparoscopy, transumbilical single hole Laparoscopy has a better diagnosis and treatment effect, which can further alleviate the pain of patients and enable them to recover as soon as possible
Bioinformation Analysis of Key Genes and Pathways of Acute Myocardial Infarction to Predict Potential Medicine
Get PDFThis study was aimed to retrieval differentially expressed genes and biological signaling pathways of Acute Myocardial Infarction (AMI) based on integrated bioinformatics analysis[1]. Using Gene Expression Omnibus (GEO) dataset was used to download mRNA expression profile GSE66360 containing 50 healthy cohorts and 49 patients experiencing Acute Myocardial Infarction to study the the potential mechanism and predict medicine target in Acute Myocardial Infarction (AMI). The consistently differentially expressed genes(DEGs) were identified,and functional annotation and pathway analysis of these genes were excavated with GO, KEGG and Reactome. The protein-protein interaction network(PPI) of DEGs was created with Cytoscape and STRING to screen the hub genes including TNF, IL1B, FN1, CD4, PLEK, JUN, TLR4, FOS, LRRK2, TLR2. On the ground of discovered information, the potential drugs were calculated. The functional genes enrich mainly in Cytokine-cytokine receptor interaction, osteoclast differentiation, neutrophil degranulation and signaling by interleukins and so on. This study digs the pathological process of AMI and may aid in learning the deeper molecular mechanism of AMI and predict potential drugs of this disease
The Effect of Hypertriglyceridemia on the Development of Acute Pancreatitis and the Extent of Its Pathological Damage
Get PDFThis paper investigates the effect of hypertriglyceridemia on the development of acute pancreatitis and the extent of its pathological damage. It was found that hypertriglyceridemia has a significant correlation with the development of acute pancreatitis, and it may trigger acute pancreatitis by increasing blood viscosity and affecting microcirculation, leading to a decrease in pancreatic blood flow, which puts the pancreatic cells in a state of ischaemia and hypoxia. At the same time, hypertriglyceridemia can also affect the lipid metabolism and immune function of the pancreas, aggravating the progression of the disease and pathological damage. The influence of hypertriglyceridemia on the course of acute pancreatitis and the degree of pathological damage was confirmed through the analysis of specific clinical cases. On this basis, the possible mechanisms of hypertriglyceridemia on the degree of pathological damage in acute pancreatitis were explored, and possible mechanisms were proposed to affect the blood supply to the pancreas, to disrupt the balance of lipid metabolism in the pancreas, to affect the function of the immune system, and to directly affect the accumulation of pancreatic fluids and digestion
Relationship Between ANCA-Associated Vasculitis and Infection: A Review
Get PDFANCA-associated vasculitis (AAV) is an autoimmune disease with multiorgan involvement of the entire body. And infection has been paid more and more attention in the course of treatment. As far as the current research is concerned, infection participates in the pathogenesis of AAV, interferes with the treatment of AAV, and affects the prognosis of AAV. This paper focuses on the role of pathogen infections in AAV pathogenesis. This review also elaborates on the types and prognosis of secondary infections in AAV patients. According to the current study, maintaining an appropriate BMI and vaccination is beneficial to the prevention of infection and the prognosis of AAV patients