Objective To observe oxygenation status when different modes of mechanical ventilation were actualized during laparoscopic operations in obese patients. Methods Sixty obese patients for laparoscopy were divided into three groups with 20 patients in each group, receiving volume controlled ventilation (VCV Group), or pressure controlled ventilation (PCV Group), or pressure controlled ventilation with positive end-expiratory pressure (PCV+PEEP Group). Levels of pH value, PCO_2, PO_2/FiO_2, and Qs/Qt were measured at 30 min after pneumoperitoneum (T1), 60 min after pneumoperitoneum (T2), 30 min after extubation (T3), and 60 min after extubation (T4), respectively. Results The oxygenation index was significantly higher in the PCV+PEEP Group at T1 (429.35?51.88) and T4 (231.87?20.47) than in the VCV Group at T1 (346.15?54.48; q=6.771, P

Objective To investigate effects of three types of mechanical ventilation on oxygenation status in laparoscopic gastric banding for the treatment of morbid obesity.Methods Twenty-four morbidly obese patients scheduled for laparoscopic gastric banding were divided into three groups.The Group A was given a tidal volume of 12 ml/kg and a respiratory rate of 10 times/min,the Group B,a tidal volume of 20 ml/kg and a respiratory rate of 10 times/min,and the Group C,a tidal volume of 12 ml/kg and a respiratory rate of 20 times/min,respectively.The measurement of arterial blood for pH value,PO2,PCO2,Plat Pressure,Peak Pressure,and AaDO2 was conducted before(T1) and after pneumoperitoneum(T2). Results After pneumoperitoneum,the Group B had significantly higher Plat Pressure(33.2?1.8 cm H2O) and Peak Pressure(36.3?1.6 cm H2O) than the Group A(Plat Pressure: 29.5?3.9 cm H2O,q=3.053,P

Gestational diabetes mellitus is detrimental to the health of both the mother and the fetus,and therefore greater attention is being paid to the earlier diagnosis and treatment of the condition.This article offers an overview of the research progress in the predictive factors of gestational diabetes mellitus.

The infant with macrosomia has been the focus of attention and controversy for some time, and fetal macrosomia affects neonatal and maternal morbidity and mortality. This review summarized the etiological factors of fetal macrosomia.

Objective To evaluate the predictive performance of the target controlled infusion (TCI) system for propofol using Marsh pharmacokinetic parameters in the elderly patients. Methods Sixteen ASA grade I - Ⅱ patients of both sexes (9 male, 7 female) aged 65-75 yr weighing 49-76 kg scheduled for elective lower abdominal surgery were enrolled in this study. The patients were unpremedicated. Right internal jugular vein was cannulated for drug and fluid administration and left radial artery was cannulated for BP monitoring and blood sampling. Anesthesia was induced with TCI propofol (target plasma concentration was set at 3 ?g?ml-1 ) and TCI fentanyl (target plasma concentration set at 2 ng?ml-1 ) . Tracheal intubation was facilitated with succinyl choline 1.5mg?kg-1 . The patients were mechanically ventilated ( VT 8 ml?kg-1 , RR 10 bpm) . Anesthesia was maintained with TCI propofol and fenlanyl and intermittent i.v. boluses of vecuronium. The target plasma concentration of propofol and fentanyl were the same as that for induction. MAP, HR, SpO2 and BIS were continuously monitored during operation. Blood samples were taken at 5, 10, 15, 20, 30, 45, 60, 90, 120 min during TCI of propofol for determination of plasma propofol concentration with HPLC. The predictive performance was evaluated by PE% [measured concentration (Cm) - predicted concentration (Cp)] /Cp ? 100% , MDPE, MDAPE and wobble. Results BIS was maintained between 38-55. The MDPE was 6%, MDAPE 14% and wobble 18 % with this TCI system incorporating Marsh pharmacokinetic parameters for propofol. Conclusion The TCI system incorporating Marsh pharmacokinetic parameters for propofol is acceptable for elderly patients.

Objective To analyze effects of different anesthesia procedures on heart rate variability(HRV) as an index of autonomic nervous activity and hemodynamics during CO2 pneumoperitoneum pressure in laparoscopic cholecystectomy(LC).Methods 45 patients of ASA I or II phage scheduled for LC were divided into general anesthesia group(Group I,Control Group),general anesthesia combined with esmolol group(Group II) and general anesthesia combined with epidural block group(Group III) according to operation date.HRV,HR and MAP were measured before anesthesia(T1),before pneumoperitoneum(T2) and at 5 min(T3),10 min(T4),20 min(T5),30 min(T6) after pneumoperitoneum.Results As compared with pre-pneumoperitoneum(T2),low frequency(LF),low frequency/high frequency(LF/HF) in the Group I increased significantly(P0.05).Comparisons among the three groups,LF,LF/HF in the Group I at all time points after pneumoperitoneum were significantly higher than those in the II and III Group(P0.05).Conclusions Esmolol can relieve stress reaction induced by pneumoperitoneum,but it can't completely block increasing of sympathetic nerve activity;using general anesthesia combined with epidural block in LC can inhibit sympathetic nerve excitation,sustain automatic never stability.

Epithelial ovarian cancer is the most lethal gynecologic malignancy, drug?resistance will eventually appear after re?peated intermittent chemotherapy. However, second?line chemotherapy only works on a few patients, new drugs with better efficacy and less side effects are needed. There are a number of promising results of molecular targeted therapy in recent clinical trials for patients with recurrent epithelial ovarian cancer, such as Bevacizumab, Olaparib, Pazopanib, etc. They have been demonstrated to improve progression?free survival of patients with platinum?resistant ovarian cancer, which might become a new strategy for such patients. In this review, we summarized the current status and progress of targeted therapy for recurrent epithelial ovarian cancer.

Objective To investigate the effect of electroacupuncture (EA) on oocyte quality in patients with polycystic ovary syndrome (PCOS) undergoing in-vitro-fertilization and embryo transfer (IVF-ET).Method Totally 217 patients with PCOS undergoing IVF-ET were randomized into two groups by the random number table, 119 patients in an EA group and 98 in a control group. In addition to the long-term ovarian hyperstimulation given to the two groups, electroacupuncture was involved in the intervention in the EA group. The spindle, quality of eggs, and pregnancy result were observed and compared.Result The high-quality embryo rate was significantly higher in the EA group than the control group (P<0.05), and compared to the control group, the pregnancy rate was 8.36% higher in the EA group; it’s found that the number of eggs with spindle located between 11 and 1 o’clock was in a significant positive correlation with the level of E2 on the HCG administration day and the high-quality embryo rate (P<0.01); the EA group had a markedly higher ratio of eggs with spindle located between 11 and 1 o’clock compared to the control group (P<0.05); electroacupuncture markedly reduced the dosage and duration of using Gn in the PCOS patients (P<0.05). Conclusion It’s proven the relation between spindle and the quality of eggs; electroacupuncture can enhance the quality of eggs and the pregnancy rate in the PCOS patients.

Objective To investigate the manifestation and the prevention means of video display terminal (VDT) visual fatigue in old people. Methods Conventional eye inspection were performed for 45 patients, including optical muscle movement, position of eye, confluence function and presbyopia. Results We found that the average difference between middle distance correcting lens and 33 cm reading distance from presbyopia correcting lens was about 0.52 DS( P

BACKGROUND:The most effective method for the treatment of acetabular fracture is open reduction and internal fixation, however, this treatment for some special types of acetabular fracture cannot get satisfactory prognosis, and is prone to complications, such as traumatic coxarthrosis and avascular necrosis of femoral head. OBJECTIVE:To evaluate the curative effect of open reduction and internal fixation and total hip arthroplasty in the treatment of special acetabular fracture. METHODS:Twelve cases of acetabular fracture were included, including seven cases of traffic accident wound, three cases of crush injury, and two cases of fal ing injury. The type of bone fracture:two cases of posterior wal fracture, two cases of posterior column and posterior wal fracture, one case of T shaped fracture, five cases of transverse and posterior wal fracture, and two cases of acetabular roof sexual fracture. Complications:one case was femoral head centric dislocation, five cases were latter dislocation, and three cases were caput femoris fractures. Before injury, three cases had coxarthrosis, and two cases were avascular necrosis of femoral head. Al the cases were treated with open reduction internal fixation and total hip arthroplasty, of which nine cases were treated with biological prosthesis, and three cases were treated with bone cement prosthesis. The time from hospitalization to surgery was 3-15 days, and average was 6 days. The patients were fol owed-up once every 2 months in 1 year after replacement, and the Harris score was used to evaluate the hip function recovery. RESULTS AND CONCLUSION:No surgical site and deep wound infection, joint dislocation, lower limb deep vein thrombosis, and death were found in these 12 cases. Among them, 11 cases were fol owed-up for a longtime;the fol ow-up was lasted for 6-82 months. The acetabular fracture was healed at 6-16 months after reduction without prosthesis loosening and sinking. The hip function was evaluated during final fol ow-up according to the Harris score:excellent in eight cases, good in two cases, poor in one case, and the excellent and good rate was 91%. Open reduction internal fixation and one-stage total hip arthroplasty can avoid long-term bed, get out of bed as soon as possible, and reduce complications, thus reconstruct the hip joint painlessly and good functional y.