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Propofol Affects Different Human Brain Regions Depending on Depth of Sedation

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Chinese Medical Sciences Journal 2015年第3期30卷 135-142页

作者： xiang Quan Tie-hu Ye Si-fang Lin Liang Zou shou-yuan Tian Department of Anesthesiology Peking Union Medical College HospitalChinese Academy of Medical Sciences & Peking Union Medical College

Objective To investigate the effect of propofol on brain regions at different sedation levels and the association between changes in brain region activity and loss of consciousness using blood oxygen level-dependent functional magnetic resonance imaging(BOLD-f MRI) and bispectral index(BIS) *** Forty-eight participants were enrolled at Peking Union Medical College Hospital from October 2011 to March 2012 and randomly assigned to a mild or a deep sedation group using computergenerated random *** tests were performed a week prior to scanning to determine target effect site concentrations based on BIS and concomitant Observer's Assessment of Alertness/Sedation scores while under *** one week of the preliminary tests where propofol dose-response was established,BOLD-f MRI was conducted to examine brain activation with the subject awake,and with propofol infusion at the sedation *** Mild propofol sedation inhibited left inferior parietal lobe *** sedation inhibited activation of the left insula,left superior temporal gyrus,and right middle temporal *** with mild sedation,deep propofol sedation inhibited activation of the left thalamus,precentral gyrus,anterior cingulate,and right basal *** Mild and deep propofol sedation are associated with inhibition of different brain regions,possibly explaining differences in the respective loss of consciousness processes.

关键词： propofol bispectral index functional magnetic resonance imaging anesthesia

Development and validation of a deep learning model to screen hypokalemia from electrocardiogram in emergency patients

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Chinese Medical Journal 2021年第19期134卷 2333-2339页

作者： Chen-Xi wang Yi-Chu Zhang Qi-Lin Kong Zu-xiang Wu Ping-Ping Yang Cai-Hua Zhu shou-Lin Chen Tao Wu Qing-Hua Wu Qi Chen Department of Cardiovascular Medicine The Second Affiliated Hospital of Nanchang UniversityNanchang University School of MedicineNanchangJiangxi 330006China Department of Anesthesiology The Second Affiliated Hospital of Nanchang UniversityNanchang University School of MedicineNanchangJiangxi 330006China

Background:A deep learning model(DLM)that enables non-invasive hypokalemia screening from an electrocardiogram(ECG)may improve the detection of this life-threatening *** study aimed to develop and evaluate the performance of a DLM for the detection of hypokalemia from the ECGs of emergency ***:We used a total of 9908 ECG data from emergency patients who were admitted at the Second Affiliated Hospital of Nanchang University,Jiangxi,China,from September 2017 to October *** DLM was trained using 12 ECG leads(lead Ⅰ,Ⅱ,Ⅲ,aVR,aVL,aVF,and V1–6)to detect patients with serum potassium concentrations<3.5 mmol/L and was validated using retrospective data from the Jiangling branch of the Second Affiliated Hospital of Nanchang *** blood draw was completed within 10 min before and after the ECG examination,and there was no new or ongoing infusion during this ***:We used 6904 ECGs and 1726 ECGs as development and internal validation data sets,*** addition,1278 ECGs from the Jiangling branch of the Second Affiliated Hospital of Nanchang University were used as external validation data *** 12 ECG leads(leads Ⅰ,Ⅱ,Ⅲ,aVR,aVL,aVF,and V1–6),the area under the receiver operating characteristic curve(AUC)of the DLM was 0.80(95%confidence interval[CI]:0.77–0.82)for the internal validation data *** an optimal operating point yielded a sensitivity of 71.4%and a specificity of 77.1%.Using the same 12 ECG leads,the external validation data set resulted in an AUC for the DLM of 0.77(95%CI:0.75–0.79).Using an optimal operating point yielded a sensitivity of 70.0%and a specificity of 69.1%.Conclusions:In this study,using 12 ECG leads,a DLM detected hypokalemia in emergency patients with an AUC of 0.77 to *** intelligence could be used to analyze an ECG to quickly screen for hypokalemia.

关键词： Deep learning Hypokalemia Electrocardiogram Artificial intelligence

Oversleeve anastomosis in laparoscopic sphincter-preserving surgery for low rectal cancer:an overlapped end-to-end anastomosis technique without prophylactic stoma

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Gastroenterology Report 2021年第1期9卷 77-80,I0003页

作者： Hao Su Man-Dula Bao shou Luo Zheng Xu Peng wang Xue-Wei wang Chuan-Duo Zhao Jian-Wei Liang Qian Liu Xi-Shan wang Zhi-xiang Zhou Hai-Tao Zhou Department of Colorectal Surgery National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Science and Peking Union Medical CollegeBeijingP.R.China

Introduction With recent advances in laparoscopic-surgery techniques and neoadjuvant therapy options,there have been improvements in sphincter-preservation outcomes in patients with low rectal cancer[1-3].However,several issues remain controversial,such as the incidence of anastomotic leakage,the local recurrence rate,and anal-function outcome[4-5].Moreover,prophylactic stoma at the end of sphincter-preserving surgery is necessary to prevent anastomotic leakage,especially in patients undergoing neoadjuvant chemoradiotherapy[7].To avoid prophylactic colostomy and decrease excessive expense,we developed a new method of overlapped end-to-end anastomosis for treating low rectal cancer—a technique referred to as‘oversleeve anastomosis’.

关键词：保肛手术端端吻合低位直肠癌重叠式

Effect of acupuncture at different meridian acupoints on changes of related factors for rabbit gastric mucosal injury

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World Journal of Gastroenterology 2005年第41期11卷 6472-6476页

作者： Jie Yan Ren-Da Yang Jun-Feng He shou-xiang Yi Xiao-Rong Chang Ya-Ping Lin Department of Acupuncture and Moxibustion Hunan College of Traditional Chinese MedicineChangsha 410007 Hunan Province China

AIM： To explore the regularity of multi-meridians controlling a same viscus （MMCSV）. METHODS： The rabbit gastric ulcer model was established by ethanol intragastric instillation. Fifty-six rabbits were randomly divided into normal group, model group （MG）, model plus acupuncture at Foot Yangming Meridian group （YMG）, model plus acupuncture at Foot Taiyin Meridian group （TYG）, model plus acupuncture at Foot Shaoyang Meridian group （SYG）, model plus acupuncture at Foot Jueyin Meridian group （JYG）, model plus acupuncture at Foot Taiyang Meridian group （TYMG）, with eight rabbits in each group. Gastric mucosal nitric oxide （NO） and nitric oxide synthase （NOS） were assayed by the nitric acid reductase method, and prostaglandin E2 （PGE2） and epidermal growth factor （EGF） were measured by radioimmunoassay. The comprehensive effects were analyzed by weighing method. RESULTS： Compared to MG, SYG, JYG and TYMG, the rabbits gastric mucosal injury index （GMII） reduced very significantly in YMG （P〈0.01）. Compared to MG, the GMII also reduced significantly in TYG （P〈0.05）. NO, NOS, PGE2 and EGF increased very significantly in YMG （P〈0.01）. The EGF in YMG also increased significantly than that in TYG compared to those in MG, SYG, JYG and TYMG （P〈0.05）. The PGE2 and EGF also increased very significantly in TYG than those in MG, JYG and TYMG （P〈0.01）. While compared to SYG, the NOS increased significantly in TYG （P〈0.05）. NOS was the highest in YMG （P〈0.01）, and was higher in TYG than in MG （P〈0.01）. CONCLUSION： MMCSV is common. The Foot Yangming Meridian is most closely related to the stomach, followed by Foot Taiyin Meridian, Foot Shaoyang Meridian and Foot Jueyin Meridian. Foot Taiyang Meridian has no correlation with the stomach.

关键词： Relationship between Meridian and Viscus Gastric mucosal injury/acupuncture effects MMCSV

Outcome of surgery for sinus of Valsalva aneurysm with discrete membranous subaortic stenosis

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Chinese Medical Journal 2012年第9期125卷 1552-1555页

作者： GUO Hong-wei CHANG Qian YU Cun-tao SUN Xiao-gang QIAN xiang-yang HU Sheng-shou Department of Surgery Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

Background Sinus of Valsalva aneurysm （SVA） is a rare cardiac anomaly, and SVA with discrete membranous subaortic stenosis is even rarer. The aim of the study was to make sure the incidence of SVA with discrete membraneous subaortic stenosis in SVA and their surgical results. We retrospectively analyzed 234 patients receiving surgical repair of SVA and reported the incidence of ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis. We also reported seven cases of SVA combined with discrete membranous subaortic stenosis and their surgical results.Methods Between January 1999 and December 2009, seven patients of SVA with discrete membranous subaortic stenosis underwent surgical repair of SVA and resection of subaortic discrete membrane. There were six male and one female patients. The mean age was （33.71±13.25） years （range 16–52 years）. Associated cardiovascular lesions were aortic regurgitation （n=7）, ventricular septal defect （n=5）, coarctation of aorta （n=1）, bicuspid aortic valve （n=1）, patent ductus arteriosus （n=1）, and aortic valve stenosis （n=1）. The aortic valve was replaced in four patients and valvuloplasty was done in three. The other co-existing anomalies were corrected at the same time. All the seven patients were followed up from 18 to 125 months （mean （63.14±39.54） months）. Among 234 SVA patients who underwent surgical repair, the number of cases with coexisting ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis was 129, 108, and 7, respectively.Results There was neither early death after operation nor late death during the follow-up period. All the seven patients were in the New York Heart Association （NYHA） functional classes I and II. There was no recurrence of discrete subaortic membrane during the follow-up period. The incidence of ventricular septal defect, aortic valve incompetence, and discrete membranous subaortic stenosis among 234 SVA patients was 55.13%,

关键词： discrete membranous subaortic stenosis sinus of Valsalva aneurysm repair rupture

Structural and Optical Characterizations of ZnO Films Grown by Reactive Electron Beam Evaporation

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Chinese Physics Letters 2000年第9期17卷 694-696页

作者： WU Hui-Zhen XU Xiao-ling QIU Dong-Jiang HE Ke-Ming shou xiang Department of Physics Zhejiang UniversityHangzhou 310028 State Key Laboratory of Silicon Materials Science Zhejiang UniversityHangzhou 310028

Low temperature epitaxial growth of ZnO films is achieved on Si(001)substrates by reactive electron beam evap *** temperature is varied from 125 C to 420 C and the optimum temperature is found between 200°C and 300 C.X-ray diffraction shows that the ZnO films are highly c-axis oriented and the line width of(002)diffraction peak is significantly smaller than that measured from the ZnO films deposited by magnetron sput *** combined photoluminescence and photoluminescence excitation(PLE)spectroscopic measurements demonstrate the sharp band-absorption edge and exciton absorption in the ZnO *** has also revealed that the absorption characteristic near the band edge is remarkably improved with the increase of oxygen content in the ZnO films,although x-ray diffraction analysis shows that the crystalline structure of ZnO films grown under different oxygen pressures remains unchanged.

关键词： absorption films unchanged

经导管二尖瓣缘对缘修复术的超快通道麻醉经验总结

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中国介入心脏病学杂志 2024年第5期32卷 250-256页

作者：邹志瑶朱达陈一鸣王首正高建斌董靖潘湘斌杨克云南省阜外心血管病医院昆明医科大学附属心血管医院麻醉科昆明650102 云南省阜外心血管病医院昆明医科大学附属心血管医院结构性心脏病中心昆明650102 中国医学科学院北京协和医学院国家心血管病中心阜外医院结构性心脏病中心北京100037

目的回顾性总结超快通道麻醉应用于经导管二尖瓣缘对缘修复术(TEER)治疗功能性二尖瓣反流患者的麻醉方法和围术期麻醉管理经验。方法纳入2022年5—9月在云南省阜外心血管病医院因心力衰竭合并中重度或重度功能性二尖瓣反流行TEER手术,... 详细信息

目的回顾性总结超快通道麻醉应用于经导管二尖瓣缘对缘修复术(TEER)治疗功能性二尖瓣反流患者的麻醉方法和围术期麻醉管理经验。方法纳入2022年5—9月在云南省阜外心血管病医院因心力衰竭合并中重度或重度功能性二尖瓣反流行TEER手术,且实施超快通道麻醉的患者。收集患者一般资料、术前合并症、心功能及麻醉分级、术前及术后1年经食管超声心动图检查结果、血清N末端B型脑钠肽前体(NT-proBNP)、手术及拔除气管导管时间、术中麻醉用药、手术及麻醉相关并发症。对麻醉管理、围术期并发症的预防及管理进行分析总结。结果共纳入30例患者,女11例(36.7%),年龄(63.6±6.1)岁。术前纽约心脏病协会(NYHA)心功能分级Ⅳ级14例(46.7%);左心室射血分数(36.0±8.1)%,左心室舒张末期前后径(66.0±8.2)mm;二尖瓣反流程度4+:17例(56.7%),3+:13例(43.3%);NT-proBNP(1934.1±1973.5)pg/ml;采用超快通道麻醉的患者中,有1例(3.3%)患者术中使用大剂量血管活性药。30例患者术后24 h均未发生恶心、呕吐、谵妄、呼吸抑制、围术期经食管超声心动图检查相关消化道大出血、心包积液、脑血管意外、需紧急手术或二次干预及其他术中严重不良事件;无30 d全因死亡发生,平均术后住院(7.4±2.8)d。所有患者完成术后1年随访:左心室射血分数(37.6±11.1)%,左心室舒张末期前后径(63.2±8.6)mm;二尖瓣反流程度2+:7例(23.3%),1+:23例(76.7%);NT-proBNP(1949.2±2576.6)pg/ml。结论超快通道麻醉可应用于TEER治疗功能性二尖瓣反流患者。

关键词：功能性二尖瓣反流二尖瓣缘对缘介入修复麻醉管理超快通道麻醉

Tensile ductility improvement of AlSi9Cu1 alloy by chemical composition optimization

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China Foundry 2017年第2期14卷 80-84页

作者： Bing-rong Zhang Jian-xiang Liu shou-yin Zhang Song-li Zhang Xin-ping Hu School of Mechanical and Automotive Engineering Qilu University of Technology Jinan 250353 China Light Alloy Processing Science and Defense Technology Key Laboratory Nanchang Hangkong University Nanchang 330063 China School of Materials Science and Engineering Jiangsu University Zhenjiang 212013 Jiangsu China Shandong Tailai Aluminum Foundry Tech. Co. Ltd. Laiwu 270100 Shandong China

Diesel engines, characterized by higher breakout pressure and compression ratio in comparison with gasoline engines, require particularly elevated tensile properties for their engine parts. In order to maintain both high strength and high ductility in the cylinder head, i.e., to obtain higher percent elongation without further reducing the tensile strength, Al Si9Cu1 alloy was used to prepare the cylinder head in an aluminum diesel engine. At the same time, the effect of different modification elements, Na or Sr, and Fe content on the reduction of secondary dendrite arm spacing(SDAS) was discussed, and the design of T7 heat treatment parameters were analyzed in order to improve the tensile ductility. The result shows:(1) The SDAS is as small as 18±3 μm for the Sr modified alloy.(2) The percent elongation of the alloy with Sr modification increases by 66.7% and 42.9%, respectively, compared with the unmodified alloy and the alloy with Na modification.(3) Lower Fe content alloy(0.10%) gives good results in percent elongation compared to the alloy with higher Fe content(0.27%); in particular, after Sr modification and T7 heat treatment, the elongation of over 5% is obtained.

关键词： diesel engine cylinder head high temperature tensile properties aluminum alloys modification combination of strength and ductility

Cascaded optical frequency transfer over 500-km fiber link using regenerative amplifier

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Chinese Physics B 2020年第5期29卷 260-264页

作者： Xue Deng Dong-Dong Jiao Jie Liu Qi Zang xiang Zhang Dan wang Jing Gao Rui-Fang Dong Tao Liu shou-Gang Zhang National Time Service Centre Chinese Academy of SciencesXi’an 710600China University of Chinese Academy of Sciences Beijing 100049China Key Laboratory of Time and Frequency Standards Chinese Academy of SciencesXi’an 710600China

We demonstrate a 300-km+200-km cascaded coherent phase transfer via fiber *** transfer is divided into a 300-km span and a 200-km span with independent phase locking loops,aiming to extend the phase control bandwidth of the whole *** phase noise and transfer instability of the cascaded transmission are investigated and compared with those in the case of a single-span 500-km *** achieve the transfer instabilities of 1.8×10^-14 at 1 s,8.9×10^-20 at 104 s for the 300-km+200-km cascaded transmission,and 2.7×10^-14 at 1 s for the 500-km single-span transfer.

关键词： optical frequency fiber link transfer