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| 1 | Sedation and safety of propofol for therapeutic endoscopic retrograde cholangiopancreatography显示文摘Endoscopic retrograde cholangiopancrea tography(ERCP) is the most complex gastrointestinal procedure,which needs patients’ cooperation. The aim of this study was to observe the quality and safey of sedation with propofol in patients undergoing therapeutic ERCP. METHODS:Seventy patients who had undergone therapeutic ERCP were randomly divided into two groups.One group, given intravenously propofol, and the other sedated with routine method, served as the control. Blood pressure, heart rate,oxygen saturation were monitored and cardiorespiratory event was observed. Patient cooperation,performance, recovery time and amnesia served as variables postoperation. RESULTS:Blood pressure elevated in four patients in the propofol group, less than in the control group(P<0.01). Seven patients showed decreased blood pressure after administration of propofol,but none in the control group (P<0.01). Twelve patients in the control group showed mild or significant resistance, but none in the propofol group (P<0.01). The time for performance in the propofol group(P<0.05) was shorter than in the control group. Patient recovery was quicker in the propofol group than in the control group (P<0.01). The degree of amnesia better in the propofol group than in the control group ( P<0.01). The degree of amnesia was also better in the propofol group than in the control group (P<0.01). CONCLUSIONS:Propofol proves to be an excellent sedative for therapeutic ERCP. Being effective and safe, it shows a shorter ERCP duration but quick recovery and better amnesia. It is better than other routine sedatives. | Digestive Department (Chen WX, Lin HJ, Gu Q, Zhong XQ, Yu CH, Li YM and Gu ZY) and Department of Intensive Care Unit (Zhang WF), First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003 , China | 2005 | Hepatobiliary & Pancreatic Diseases International2005，4，3： | 10 |
| 2 | Early lactate clearance as a reliable predictor of initial poor graft function after orthotopic liver transplantation显示文摘BACKGROUND:Initial poor graft function (IPGF) following orthotopic liver transplantation is a major determinant of postoperative survival and morbidity.Lactate clearance is a good marker of liver function.In this study,we investigated the clinical utility of early lactate clearance as an early and accurate predictor for IPGF following liver transplantation.METHODS:This was a prospective observational study of 222 patients referred to the surgical intensive care unit (SICU) after orthotopic liver transplantation.The IPGF group consisted of patients with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) >1500 IU/L within 72 hours after orthotopic liver transplantation.Early lactate clearance was defined as lactate at SICU presentation (hour 0) minus lactate at hour 6,divided by lactate at SICU presentation.The model for end-stage liver disease (MELD) score,Child-Pugh score and laboratory data including AST,ALT,total bilirubin (TB) and prothrombin time (PT) were recorded at SICU presentation and compared between the non-IPGF and IPGF groups Receiver operating characteristic (ROC) curves were plotted to measure the performance of early lactate clearance,MELD score,Child-Pugh score,TB and PT.RESULTS:IPGF occurred in 45 of the 222 patients (20.3%).The early lactate clearance in the non-IPGF group was markedly higher than that in the IPGF group (43.2±13.8% vs 13.4±13.7% P<0.001).The optimum cut-off value for early lactate clearance predicting IPGF was 24.8% (sensitivity 95.5%,specificity 88.9%).The area under the curve of the ROC was 0.961,which was significantly superior to MELD score,Child-Pugh score TB and PT.Patients with early lactate clearance ≤24.8% had a higher IPGF rate (OR=169) and a higher risk of in-hospital mortality (OR=3.625).CONCLUSIONS:Early lactate clearance can serve as a prompt and accurate bedside predictor of IPGF.Patients with early lactate clearance less than 24.8% are associated with a higher incidence of IPGF. | Jian-Feng Wu,Rong-Yao Wu,Juan Chen,Bin Ou-Yang,Min-Ying Chen and Xiang-Dong Guan Department of Surgical Intensive Care Unit,First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，6： | 6 |
| 3 | EFFECTS OF FLOW INTENSITY, OBSTACLE ALIGNMENT AND CROSS-SECTION GEOMETRY ON SCOUR AT BRIDGE ABUTMENTS显示文摘Experiments are reported on the effects of flow intensity, obstacle alignment and cross-section geometry on the equilibrium scour depth around abutments. The effect of flow intensity was studied for clear-water flow conditions, the obstacle alignment was studied for a wide range of angles of the obstacle with the flow direction, and tests on the cross-section geometry apply only to the case where the abutment extends into the main channel of a compound cross-section (two-stage channel). The channel bank and flood plain were built up with sand. The hypothesis of zero scour for flow velocities smaller than approximately 50% of the threshold velocity for the beginning of motion in the approaching flow cannot be rejected; maximum scour occurs for obstacles protruding at right angle from the cross-section walls, the reduction being small when obstacles point upstream; compared with rigid banks, the scour depth seems to be significantly reduced when channel bank and flood plain are constituted of alluvial material. | A. H. CARDOSO1, J. S. SANTOS2 and M. ROCA3 EFFECTS OF FLOW INTENSITY, OBSTACLE ALIGNMENT AND CROSS-SECTION GEOMETRY ON SCOUR AT BRIDGE ABUTMENTS A. H. CARDOSO1, J. S. SANTOS2 and M. ROCA3 EFFECTS OF FLOW INTENSITY, OBSTACLE ALIGNMENT AND CROSS-SECTIO | 2002 | International Journal of Sediment Research2002，17，2： | 6 |
| 4 | The scoring system for patients with severe sepsis after orthotopic liver transplantation显示文摘BACKGROUND: Because of the complicated pathological features after liver transplantation, severe sepsis is difficult to treat and often leads to death. This study was undertaken to analyze the role of orthotopic liver transplantation (OLT) in patients with severe sepsis and to evaluate the effect of the scoring system. METHODS: Fifty-six patients conformed to the inclusion criteria. They were divided into two groups: non-OLT group (group A) and OLT group (group B). Besides the general data of the patients, the surveillance of blood lactate, the number of failed organs, acute physiology and chronic health evaluationⅡ(APACHEⅡ) and mutiple organ dysfunction score (MODS) were evaluated at the 1st, 3rd and 7th day after OLT. RESULTS: The mortality during hospitalization was 30% in the non-OLT group and 57.6% in the other group. The level of blood lactate at the 1st day of OLT increased more significantly in the OLT group than in the non-OLT group (P<0.01). It was decreased but higher than that in the non-OLT group in the seven days after OLT. The number of failed organs in the OLT group was greater than that in the non-OLT group (P<0.01). The continuous score of APACHEⅡwas not significantly different in the two groups. But the continuous MODS in the OLT group was higher than that in the non-OLT group (P<0.01), which was consistent with the number of failed organs. CONCLUSIONS: The persistently higher level of blood lactate during 7 days may be a dependent risk factor. Immunosuppression may be another risk factor for OLT patients. The mortality of OLT in patients with severe sepsis in 28 days is almost double that in non-OLT patients. The MODS score is better than the APACHEⅡscore in the assessment of organ failure in OLT patients with severe sepsis. The standard scoring system could be improved or a new scoring system that includes the blood lactate score should be established for liver transplantation. | Shun-Wei Huang, Xiang-Dong Guan, Xiao-Shun He, Juan Chen and Bin Ouyang Department of Surgical Intensive Care Unit ,and Department of Transplantation Surgery,First Affiliated Hospital, Sun Yat- Sen University, Guangzhou 510800, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，3： | 3 |
| 5 | Clinical manifestations of patients with chronic pancreatitis显示文摘BACKGROUND: Recent advances in molecular and genomic technologies and pancreatic imaging techniques provided some insights into genetic, environmental, immunologic, and pathobiological factors for chronic pancreatitis (CP). This study was undertaken to investigate the clinical manifestations of patients with chronic pancreatitis at our hospital. METHODS: The data of the patients with CP who had been treated at our hospital between 1997 and 2004 were analyzed. RESULTS: The major symptoms of the patients with CP were abdominal pain, dyspepsia, loss of weight, diabetes mellitus, pancreatic pseudocyst, steatorrhea, and calcification. Biliary diseases were found to be the first cause of CP in this study; but alcohol abuse was the major cause of CP in men and biliary diseases were the first etiological factors for CP in women. The etiological difference of constituent ratio between men and women was related to alcohol comsumption (P<0.01). CONCLUSIONS: During the past 8 years, biliary diseases have been the major etiological factors for CP, but their constituent ratio is decreasing, and the constituent ratio of alcohol abuse is increasing gradually. Alcohol tends to replace biliary diseases as the primary etiological factor for CP. | Wei-Xing Chen, Wei-Fang Zhang, Bo Li, Hui-Jia Lin, Xian Zhang, Hong-Tan Chen, Zhu-Ying Gu and You-Ming Li Department of Gastroenterology, First Afliliated Hospital. Zhejiang University School of Medicine. Hangzhou 310003, China Department of Intensive Care Unit, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China | 2006 | Hepatobiliary & Pancreatic Diseases International2006，5，1： | 2 |
| 6 | Intensity-modulated radiotherapy: current status and issues of interest显示文摘 | Intensity modulated radiation therapy collaborative working group | 2001 | Int J Radiat Oncol Biol Phys2001，51，4： | 1 |
| 7 | Arterial catheterization and invasive measurement of blood pressure in anesthesia and intensive care in adults显示文摘 | French Society of Anesthesia and Intensive Care | 1995 | Ann Fr Anesth Reanim1995，14，5： | 1 |
| 8 | The International Neonatal Network 显示文摘 | The CRIB (clinical risk index for babies) score: a tool for asses- sing initial neonatal risk and comparing performance of neonatal intensive care units | 1993 | Lancet1993，342，8865： | 1 |
| 9 | International Consensus Conferences in Intensive Care Medicine: Noninvasive positive pressure ventilation in acute Respiratory failure显示文摘 | American Thoracic Society European Respiratory Society European Society of Intensive Care Medicine Societe de Reanimation de Langue Francaise | 2001 | Am J Respir Crit Care Med2001，163，： | 1 |
| 10 | Intensity-modulated radiotherapy:current status and issues of interest 显示文摘 | Intensity Modulated Radiation Therapy Collaborative Working Group | 2001 | Int J Radiat Oncol Biol Phys2001，51，： | 1 |
| 11 | UK Prospective Diabetes Group显示文摘 | Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes | 1998 | Lancet1998，352，9131： | 1 |
| 12 | Creatinine and derived glomerular filtration rate estimates显示文摘 | Le Bricon T Leblanc I Benlakehal M Evaluation of renal function in intensive care:plasma cystatin C vs | 2005 | Clin Chem Lab Med2005，43，9： | 1 |
| 13 | Ventilator-associated lung injury in ARDS显示文摘 | International Consensus Conferences in Intensive Care Medicine | 1999 | Am J Respir Crit Care Med1999，160，： | 1 |
| 14 | Saline or albumin for fluid resuscitation in patients with traumatic brain injury显示文摘 | SAFE Study Investigators Australian and New Zealand Intensive Care Society Clinical Trials Group Australian Red Cross Blood Service | 2007 | N Engl J Med2007，357，9： | 1 |
| 15 | Pediatric Section Task Force on Admission and Discharge Criteria, Society of Critical Care Medicine in conjunction with the American College of Critical Care Medicine and the Committee on Hospital Care of the American Academy of Pediatrics显示文摘 | Guidelines for developing admission and discharge policies for the pediatric intensive care unit | 1999 | Crit Care Med1999，27，4： | 1 |
| 16 | Scottish Neonatal Consultants' Collaborative Study Group and the International Neonatal Net- work 显示文摘 | CRIB ( clinical risk index for babies) mortality and impairment after neonatal intensive care | 1995 | Lancet1995，345，8956： | 1 |
| 17 | Intensity-modulated radiotherapy:current status and issues of interest显示文摘 | Intensity Modulated Radiation Therapy Collaborative Working Group | 2001 | Int J Radiat Oncol Biol Phys2001，51，4： | 1 |
| 18 | Ventilator associated lung injury in ARDS显示文摘 | International Consensus Conferences in Intensive Care Medicine | 1999 | Am J Respir Crit Care Med1999，160，： | 1 |
| 19 | Non-invasive positive pressure ventilation in acute respiratory fail- ure 显示文摘 | International Consensus Conferences in Intensive Care Medicine | 2001 | Intensive Care Med2001，27，1： | 1 |
| 20 | The effect pulses on biological cells显示文摘 | Schoenbach K H Xiao S Joshi R P et of intense subnanosecond electrical al | 2008 | IEEE Transactions on Dielectrics and Electrical Insulation2008，36，2： | 1 |
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