Objective
To investigate the rewarming effect of groin-mediated forced-air warming system in patients with hypothermia after cardiopulmonary bypass.
Methods
A total of 100 hypothermia patients after cardiopulmonary bypass were divided into observation group and control group with 50 cases each by random digits table method. Patients in control group received pelma-mediated forced-air warming system, observation group carried out groin-mediated forced-air warming system. The levels of bladder temperature, axillary temperature and lactate concentration were monitored at 10 min (T10), 30 min (T30), 60 min (T60), 90 min (T90) after rewarming in two groups, rewarming time and drainage volume at 90 min after rewarming between two groups was also compared.
Results
Bladder temperature in observation group were (34.44±0.98), (35.44±1.12), (36.71±1.16), (37.60±1.45) ℃ at T10, T30, T60, T90, axillary temperature were (34.30±1.85), (35.31±1.36), (36.38±1.57), (37.28±1.72) ℃, bladder temperature and axillary temperature in control group were (34.18±1.56), (36.91±1.61), (37.70±1.29), (37.40±1.10) ℃ and (34.45±1.03), (36.30±1.25), (37.70±1.23), (37.19±1.31) ℃, respectively. There was no significant difference in bladder temperature and axillary temperature at T10 and T90 (P>0.05), however, the bladder temperature and axillary temperature was significantly decreased in observation group compared to control group at T30 and T60 (t value was 5.309, 4.073, P 0.05), however, the lactate concentration was significantly decreased in observation group compared to control group at T60 and T90 (t value was 7.276, 8.640, P<0.01), in addition, there were crossover effect of time and grouping factor in lactate concentration (F value was 36.034, P<0.01). Drainage volume at 90 min after rewarming were (95.44±15.24) ml in observation group, (106.08±25.56) ml in control group, the difference was significant between two groups (t value was 2.528, P<0.05).
Conclusions
Groin-mediated forced-air warming system can effectively and uniformly rewarming the body temperature of patients with hypothermia after cardiopulmonary bypass and served as a potential rewarming strategy.
Key words:
Cardiopulmonary bypass; Forced-air rewarming; Bladder temperature; Axillary temperature
Introduction Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson’s disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. Methods and analysis 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years. Patients with PD who meet the criteria for STN DBS surgery will be allocated to either the early stimulation group or the late stimulation group based on the duration of their motor complications. The primary outcome will be changes in quality of life from baseline to 4 years, measured using the 39-item Parkinson’s Disease Questionnaire Summary Index. The secondary outcomes include changes in motor function measured using Movement Disorder Society-revised Unified Parkinson’s Disease Rating Scale (MDS-UPDRS) Part III, self-reported experiences of daily living measured using MDS-UPDRS Part I B and Part II, good ’on' time recorded by the patients using a diary and safety profile of both groups. Ethics and dissemination The study received ethical approval from the Medical Ethical Committee of the First Affiliated Hospital, Sun Yat-sen University. The results of this study will be published in peer-reviewed journals and presented at international conferences. Trial registration number NCT01922388 ; Pre-results.
To determine the prevalence of beta-fibrinogen gene -455G/A, -148C/T polymorphisms in Chinese Han population and to investigate whether they were associated with pulmonary thromboembolism (PTE).The subjects consisted of 101 patients with PTE and 101 healthy controls matched with age and sex, from the same geographic area. All patients were diagnosed by high probability of lung ventilation/perfusion scan and/or multi-slice CT pulmonary angiography as well as medical history and clinical manifestations. Genome DNA was extracted from whole blood using KI-phenol-chloroform. Genotypes and allele frequencies of fibrinogen beta gene -455G/A, -148C/T polymorphisms were examined by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Restriction enzyme HaeIII and HindIII digestion were used for detecting -455G/A, -148C/T polymorphisms respectively.Regarding fibrinogen beta gene -455G/A and -148C/, the allele frequencies G and A of fibrinogen beta -455 in the controls were 0.931, 0.069 while C and T of -148 were 0.777, 0.223 respectively, which were in good agreement with Hardy-Weinberg equilibrium. There was significant difference of -455G/A genotype frequencies distribution of AA, GA, GG between cases and in controls respectively, but no significant difference was found in the -148C/T polymorphisms. The frequencies of mutation allele -455A were 0.193, 0.169 in cases and in controls with P < 0.05 but there was no statistically significant difference of -148T allele. The presence of A allele of fibrinogen beta -455 was found to be a greater risk factor in cases than in controls. The odds ratio (OR) of GA and GA + AA were 3.723 (1.786 - 7.759), 3.749 (1.842 - 7.630), respectively. When compared with GG genotype, the P value was 0.0001.There was a complete linkage disequilibrium between fibrinogen beta -148C/T and -455G/A found. The frequencies of -455A, alleles in PTE disease were apparently higher than that of healthy adults but there was no difference in -148T alleles.
Deep brain stimulation of the subthalamic nucleus is recognized as the most effective treatment for moderate and advanced Parkinson's disease. Programming of the stimulation parameters is important for maintaining the efficacy of deep brain stimulation. Voltage is considered to be the most effective programming parameter. The present study is a retrospective analysis of six patients with Parkinson's disease (four men and two women, aged 37–65 years), who underwent bilateral deep brain stimulation of the subthalamic nucleus at the First Affiliated Hospital of Sun Yat-sen University, China, and who subsequently adjusted only the stimulation voltage. We evaluated motor symptom severity using the Unified Parkinson's Disease Rating Scale Part III, symptom progression using the Hoehn and Yahr scale, and the levodopa equivalent daily dose, before surgery and 1 and 2 years after surgery. The 2-year follow-up results show that rigidity and tremor improved, and clinical symptoms were reduced, while pulse width was maintained at 60 μs and frequency at 130 Hz. Voltage adjustment alone is particularly suitable for patients who cannot tolerate multiparameter program adjustment. Levodopa equivalent daily dose was markedly reduced 1 and 2 years after surgery compared with baseline. Our results confirm that rigidity, tremor and bradykinesia can be best alleviated by voltage adjustment. The trial was registered at ClinicalTrials.gov (identifier: NCT01934881).
The silicone latex with vinyl terminal groups was synthesized by ring-opening polymerization of octamethylcyclotetrasiloxane(D4) by continuous addition of monomer using dodecyl benzene sulfonic acid(DBSA) as catalyst,methacrylic acid 2-hydroxyethyl ester as end-blocking agent.The influences of the reaction conditions on D4 ring-opening polymerization including solid mass fraction,reaction temperature,reaction time,the amount of capping agent and adding time were studied.The results showed that latex particles by continuous addition of monomer were small,light transmittance was good and the emulsion stable.The greater the mass fraction of solids emulsion and the longer reaction time resulted in higher D4 conversion rate,and greater molar mass of the polysiloxane.When the temperature is higher than 80 ℃,the molar mass of the polysiloxane is lower with increasing temperature,while the D4 conversion rate is not change significantly.Shorter the reaction time produced,smaller mole mass polysiloxane emulsion.After D4 was added for 2 hours,adding HEMA gave higher D4 conversion rate and smaller molar mass polysiloxane.When HEMA amount increases,the molar mass of polysiloxane declined significantly,but had little effect on D4 conversion rate.
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