Objective To investigate the clinical efficacy and safety of coblation-assisted adenotonsillectomy for treatment of children with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods From June 2007 to May 2008, after monitoring polysomnography (PSG) confirmed 82 cases of OSAHS in children aged 3 to 14 years, with an average age of 6.2 years old, the ENT CoblatorII surgical instrument made by Arthrocare in the US and one-time EVac 70 T amp; A segment was used under complete anesthesia to remove tonsils and(or)adenoid ablation. Polysomnography monitoring was used preoperatively and 6 months postoperatively to determine the therapeutic effect. Results No significant complications occurred among the children both during the operation and postoperatively. Patients were followed for 6 months, and a satisfactory effect was achieved. The lowest oxygen saturation (LSaO2) improved significantly (Plt;0.001); the apnea-hypopnea index (AHI) decreased significantly after the operation (Plt;0.001). In accordance with OSAHS diagnosis and efficacy evaluation standards, 45 patients were cured after 6 months, 21 patients showed an excellent effect, 10 patients showed a good effect, six patients had no effect, and the total effective rate was 92.6%. Conclusion Low-temperature coblation-assisted adenotonsillectomy has good clinical efficacy with a shortened surgical time, less intraoperative and postoperative blood loss, less postoperative pain, few complications, and a simple operation procedure. It can effectively expand the nasopharynx, oropharynx ventilation cross-sectional area, lift the upper airway obstruction, and can be especially suitable for surgical treatment of children with OSAHS.
Objective To investigate the effect of perioperative body temperature on the survival of skin flap grafting. Methods From July 2005 to November 2006, 50 cases of Ⅰ-Ⅱ grade patients undergoing elective skin flap grafting were randomly divided 2 groups. Pharyngeal temperature (PT) and skin temperature(ST) were monitored and recorded every 15 minutes. Operativetime, anesthetic time, time from the end of operation to extubation, the volume of blood transfusion, the volume of fluid transfusion and the flap survival 7 days after operation were recorded. In the experimental group, the body temperature was maintained in normal range with water market and forced air heater. In the control group， the body temperature was only monitored without any treatment. Results There were no significant differences in operating room temperature, operative time, anesthetic time, the volume of blood transfusion and fluid transfusion between 2 groups(Pgt;0.05). After induction, PT decreased gradually inboth groups during the first 45 minutes, compared with the time point of intubation(Plt;0.05),but there were no significant differences between the 2 groups(Pgt;0.05); and ST rose in both groups during the first45 minutes, compared with the time point of intubation (Plt;0.05). After 45 minutes of induction, in the experimental group, PT was in the normal range(36℃), and ST didn’t change compared with that of the timepoint of induction(Pgt;0.05). In the control group, both PT and ST decreasedgradually and timedependently compared with the time point of intubation (Plt;0.05). In the experimental group, PT and ST at each time point were higher than those in the control group (Plt;0.05). All the skin flap grafts survived in the experimental group, and skin flap grafts necrosed in 2 cases in the control group.Conclusion Keeping normal body temperature can improve the survival ofskin flap grafting. Therefore, the body temperature should be monitored and maintained in a normal range.
Objective To conduct a systematic review on the Electrocardiogram (ECG) changes in the workers exposed to high temperatures by means of meta-analysis.Methods The retrospective cohort studies on the relationship between high temperature and ECG abnormalities published from 1990 to May 2009 were searched in CNKI, VIP, WanFang database and CBM database. The literatures meeting the inclusive criteria were selected, the quality was assessed, the data were extracted, and the meta-analyses were conducted with RevMan 4.2.2 software. Results A total of 20 studies were included. The results of meta-analyses showed: the ECG abnormality rate of the high-temperature group was obviously superior to that of the control group with significant difference (OR=2.76, 95%CI 2.37 to 3.20, Plt;0.000 01). The high-temperature severely affected left ventricular hypertrophy (OR=3.49, 95%CI 2.83 to 4.31, Plt;0.000 01), sinus bradycardia (OR=2.83, 95%CI 2.33 to 3.43, Plt;0.000 01), and changes in ST-T segment (OR=2.63, 95%CI 1.48 to 4.68, P=0.000 10), which indicated that the abnormal changes of ECG, such as left ventricular hypertrophy, sinus tachycardia, sinus bradycardia, and changes in ST-T segment could be the sensitive indexes to monitor cardiovascular disease of workers exposed to high-temperature. Conclusion The incidence of ECG abnormalities caused by high-temperature operation is obviously superior to that of the control group, so it is required to strengthen the health monitoring and labor protection for the workers exposed to high temperature.
Objective To systematically review the effectiveness of forced air warming for the maintenance of perioperative core temperature, so as to provide clinical evidence for an appropriate warming plan during the perioperative period. Methods We electronically searched PubMed, The Cochrane Library, EMbase, Web of Science, CBM and CNKI from 2000 to 2012, so as to comprehensively collect randomized controlled trials (RCTs) about the effectiveness of different warming methods for the maintenance of perioperative core temperature (including forced air warming, resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system) for maintenance of perioperative core temperature. References of the included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the quality of the included studies. Then, meta-analysis was performed using RevMan 5.1 software. Results Eleven RCTs involving 577 patients were included. The results of meta-analysis indicated that, in the maintenance of core temperature during the perioperative period, forced air warming was superior to resistive-heating blanket/electric heating pad (SMD= –0.40, 95%CI –0.73 to –0.06), circulating water mattress (SMD= –1.10, 95%CI –1.55 to –0.66), and infrared ray radiant heating system (SMD= –0.69, 95%CI –1.06 to –0.32). In the incidence of hypothermia during the perioperative period, the group of forced air warming was lower than the group of blanket/electric heating pad (RR=1.76, 95%CI 1.15 to 2.69), but it was the same as the group of infrared ray radiant heating system (RR=1.37, 95%CI 0.83 to 2.27). In the incidence of shivering during the perioperative period, the group of forced air warming was the same as the group of blanket/electric heating pad (RR=0.75, 95%CI 0.18 to 3.21) and the group of infrared ray radiant heating system (RR=0.8, 95%CI 0.19 to 3.36). Conclusion Compared with resistive-heating blanket/electric heating pad, circulating water mattress, and infrared ray radiant heating system, forced air warming maintains patients’ core temperature better during the perioperative period, with a lower incidences of hypothermia. Due to the limited quantity and quality of the included studies, more high quality RCTs with large sample size are needed to verify the above conclusion.
Patch clamp is a technique that can measure weak current in the level of picoampere (pA). It has been widely used for cellular electrophysiological recording in fundamental medical researches, such as membrane potential and ion channel currents recording, etc. In order to obtain accurate measurement results, both the resistance and capacitance of the pipette are required to be compensated. Capacitance compensations are composed of slow and fast capacitance compensation. The slow compensation is determined by the lipid bilayer of cell membrane, and its magnitude usually ranges from a few picofarads (pF) to a few microfarads (μF), depending on the cell size. The fast capacitance is formed by the distributed capacitance of the glass pipette, wires and solution, mostly ranging in a few picofarads. After the pipette sucks the cells in the solution, the positions of the glass pipette and wire have been determined, and only taking once compensation for slow and fast capacitance will meet the recording requirements. However, when the study needs to deal with the temperature characteristics, it is still necessary to make a recognition on the temperature characteristic of the capacitance. We found that the time constant of fast capacitance discharge changed with increasing temperature of bath solution when we studied the photothermal effect on cell membrane by patch clamp. Based on this phenomenon, we proposed an equivalent circuit to calculate the temperature-dependent parameters. Experimental results showed that the fast capacitance increased in a positive rate of 0.04 pF/℃, while the pipette resistance decreased. The fine data analysis demonstrated that the temperature rises of bath solution determined the kinetics of the fast capacitance mainly by changing the inner solution resistance of the glass pipette. This result will provide a good reference for the fine temperature characteristic study related to cellular electrophysiology based on patch clamp technique.
Objective To systematically review the efficacy of maternal body temperature preservation during caesarean section. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2015), WanFang Data, CBM and CNKI were searched from inception to July 2015 to collect randomized controlled trials (RCTs) of body temperature preservation in patients with caesarean delivery. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan5.3 software. Results A total of 15 RCTs involving 1 331 patients were included. The results of meta-analysis showed that patients in the temperature preservation group had a smaller body temperature variation (MD= –0.22, 95%CI –0.32 to –0.13, P < 0.000 01) and a lower incidence of shivering (RR=0.53, 95%CI 0.42 to 0.67, P < 0.000 01) than patients in the control group. There were no statistical differences between the two groups in blood loss (MD= –13.77, 95%CI –33.95 to 6.42, P=0.18) and newborn Apgar score (MD=0.12, 95%CI –0.37 to 0.6, P=0.64). Conclusions Current evidence shows that body temperature preservation measures can better protect patients with caesarean delivery. Specifically, body temperature preservation measures could reduce patients’ body temperature variation and incidence of shivering but had no effect on blood loss and newborn Apgar score. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To study the preventive measure of the subambient temperature burn by analysing the pathogenesis feature. Methods The cl inical data were analysed from 351 cases of subambient temperature burn between February 2004 and February 2009, including age, sex, burn season, burn factors, burn position, burn area, burn degree, treatment way, and wound heal ing. Results Subambient temperature burn occurred in every age stage. The susceptible age stages included infant, children, and the elderly. Female patients were more than male patients. The common burn reasons werehot-water bottle burn, honey warm keeper burn, and heating device burn. The peak season was winter. Lower l imb was the most common site of the subambient temperature burn. The deep II degree to III degree were the most common level, and the burn area was always small, often 1% of total body surface area. Most of patients were treated with changing dressings at cl inic and few patients needed hospital ization. Though the surface of wound could heal finally, and the wound healed well with no obvious scar in patients who received operation. Conclusion Subambient temperature burn is the frequently encountered disease in winter. Use of the warming articles should be cautious, at the same time safety awareness should be strengthened so as to decrease the incidence rate of subambient temperature burn and the injury degree.
This paper aims to explore the thermal feelings of different cover materials effect on wheelchair cushion comfortableness, and to build a mathematical model for motorized wheelchair cushion comfortableness. By measuring temperature and humidity between the contact face of motorized wheelchair cushion and human body as well as the setting posture adjustment time while cushion cover materials are nylon cloth, leather, fishnets cloth. At the same time, each volunteer took a questionnaire about the comfort of different cushion cover materials. Results showed that fishnets cloth was most comfortable, leather was worst, while nylon cloth was in between the two. The experimental objective data were consistent with the subjective data. We built a back propagation (BP) neural network mathematical model for motorized wheelchair cushion comfortableness. This study will provide objective reference to motorized wheelchair for the designers and users.
The effect of relaxation time in hyperbolic heat transfer model on the temperature field of microwave ablation of atrial fibrillation was investigated. And the results were compared with those calculated by Pennes model. A three-dimensional model of microwave ablation of atrial fibrillation was constructed. The relaxation time (τ) was 0, 1, 5, 8, 10, 15 and 20 s, respectively. And the temperature field of myocardial tissue was obtained. The results showed that the highest temperature of the hyperbolic model was 21.8 ℃ lower than that of the Pennes model at the beginning of ablation. With the increase of ablation time, the highest temperature tended to be the same. The lesion dimensions appeared at 3, 4, 6, 7, 8, 9, and 10 s, respectively after ablation. Therefore, the influence of hyperbolic model on temperature will decrease with the increase of the ablation time. At the beginning of ablation, the relaxation time will hinder the speed of myocardial thermal diffusion. The larger the relaxation time is, the slower the speed of thermal diffusion is. This study provides a reference for the application of hyperbolic model in microwave ablation of atrial fibrillation.
The nondestructive reconstruction of three-dimensional (3D) temperature field in biological tissue is always an important problem to be resolved in biomedical engineering field. This paper presents a novel method of nondestructive reconstruction of 3D temperature field in biological tissue based on multi-island genetic algorithm (MIGA). By this method, the resolving of inverse problem of bio-heat transfer is transformed to be a solving process of direct problem. An experiment and its corresponding simulation were carried out to verify the feasibility and reliability. In the experiment a high purity polypropylene material, whose thermophysical parameters were similar to the fat tissue being tested, were adopted so that it could avoid the negative results created by the other factors. We set the position P(x, y, z) as the point heat source in the biological tissue and its temperature t as optimization variable, got the experimental temperature values of the points in a module surface, subtracted them from the corresponding simulating temperature values in the same module surface, and then took the sum of absolute value. We took it as the objective function of successive iteration. It was found that the less the target value was, the more optimal the current variables, i.e. the heat source position and the temperature values, were. To improve the optimization efficiency, a novel establishment method of objective function was also provided. The simulating position and experimental position of heat source were very approximate to each other. When the optimum values are determined, the corresponding 3D temperature field is also confirmed, and the temperature distribution of arbitrary section can be acquired. The MIGA can be well applied in the reconstruction of 3D temperature field in biological tissue. Because of the differences between the MIGA and the traditional numerical methods, we do not have to acquire all the data of surface. It is convenient and fast, and shows a prosperous application future.