Ultrasound-guided axillary vein (AxV) cannulation has been described as an effective alternative to internal jugular vein cannulation in adult cardiac surgical patients. However, the learning curve for this technique has not yet been addressed. This study aimed to determine the number of cases required to achieve proficiency in performing AxV cannulation among novice anesthesiologists.This prospective study included the first 60 patients who underwent ultrasound-guided AxV cannulation performed by a single third-year resident who was trained in adult cardiac anesthesia. This study investigated the number of cases required to gain technical proficiency by applying cumulative sum analysis on the learning curve (LC-CUSUM) of ultrasound-guided AxV cannulation.Based on the assessment of the CUSUM plots, a descending inflection point for decreasing the overall procedural time for AxV cannulation was observed after patient 29. Regarding the procedural outcomes, comparing the early-experience group with the late-experience group (29 vs 31 cases), the former group had longer operating time (1526 s vs 1120 s, p < 0.001) and identification time (110 s vs 92 s, p < 0.001) and lower first-attempt success rate (8, 27.6% vs 30, 96.8%, p < 0.001) than the latter group.CUSUM demonstrated that at least 29 successful cases are required to achieve an expertized manipulation in ultrasound-guided AxV cannulation for inexperienced novices. The learning curve for ultrasound-guided AxV cannulation was observed in 29 cases. After adequate training, the overall procedural time and the first-attempt success rate, and puncture-related complications for AxV cannulation improved with increased experience.
Objective
To investigate the correlation between allergic rhinitis and bronchial asthma in children.
Methods
Fifty children with allergic rhinitis complicated with bronchial asthma who were followed up in Clinic of Foshan Women and Children’s Hospital from May 2015 to May 2017 were selected as experimental group; 50 children only with allergic rhinitis in the same period were selected as control group A; 50 children only with bronchial asthma in the same period were selected as control group B. Serum total IgE, serum allergen types and specific IgE (sIgE) were detected by allergen screening, and levels of total IgE and sIgE were compared among the three groups.
Results
①The positive rate of serum sIgE in experimental group and control group B was significantly higher than that in control group A (P 0.05).
Conclusions
Pediatric allergic rhinitis and most bronchial asthma in children belong to IgE-mediated type I allergic reaction. The main inhaled allergens in Foshan area are mites, house dust, mold, cat hair dander and dog hair dander. Mite is the most important inhaled allergen in this area. Early prevention and treatment should be implemented in clinical for children with allergic rhinitis and bronchial asthma.
Key words:
Pediatric allergic rhinitis; Bronchial asthma; Correlation
Abstract Background Epulis has a tumor‐like appearance but is considered to be a massive reactive lesion rather than a true neoplasia. Limited information about the pathogenesis of epulis is available. The purpose of our study was to identify potential signaling pathways in fibrous epulis through transcriptome profiling. Methods Differentially expressed genes (DEGs) between fibrous epulis lesions and normal gingival tissues were detected using RNA sequencing (RNAseq). The expression levels of eighteen genes were validated using quantitative real‐time PCR (qRT‐PCR). Results RNAseq identified 533 upregulated genes and 732 downregulated genes. The top 10 upregulated genes were IL11 , OSM , MMP3 , KRT75 , MMP1 , IL6 , IL1B , IL24 , SP7 , and ADGRG3 . The top 10 downregulated genes were BCHE , TYR , DCT , KRT222 , RP11‐507K12.1 , COL6A5 , PMP2 , GFRA1 , SCN7A , and CDH19 . KEGG pathway analysis further indicated that the DEGs were enriched in “Pathways in cancer” and the “Ras signaling pathway”. quantitative real‐time PCR verified that the expression levels of SOS1 , HRAS , PIK3CA , AKT3 , IKBKA , IKBKB , NFKB1 , BCL2 , BCL2L1 , XIAP , BIRC2 , and BIRC3 were increased significantly. Conclusions The current transcriptomic profiling study reveals that in fibrous epulis, RAS‐PI3K‐AKT‐NF‐κB pathway transcriptionally regulates the expression of BCL2 family and IAP family genes, leading to increased proliferation and apoptosis inhibition.
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