Objective　To investigate the relationship between the apnea events and the correspondent sleep stage. Methods 68 normal volunteers were studied with polysomnography to confirm the sleep stage of the apnea events. Results Sleep apnea events were found in each different sleep stage. The events happened frequently in light sleep stage, most in stage 2. There were no significant sleep stage distribution difference in different sex .The number and severity of apnea events were also not relative with the sleep stage distribution. Conclusion Apnea events happened most frequently in light sleep stage. The reason is still unclear.

Objective To observe the effect of subarachnoid block with 0.5% bupivacaine at different temperatures during cesarean section.Methods 100 cases of elective cesarean section were randomly divided into room temperature group and heating group,50 cases in each group.Room temperature group: bupivacaine hydrochloride injection and glucose injection equilibrated group in a constant temperature thermostatic bath of 24 degrees thermostatic bath heating for above 30 min.Heating group: bupivacaine hydrochloride injection and glucose injection heated in the constant temperature thermostatic bath of 37 degrees thermostatic bath heatingfor above 30 min.Anesthesia was injected into the subarachnoid space at different temperatures to observe the anesthetic effect.Results The anesthesia increased rapidly, and the analgesia and muscle relaxation effects were better in the heating group than room temperature group, but the heating group had hypotension rate was higher than the room temperature group (36.0% vs.16.0%).There was no obvious difference between the incidence of adverse reactions such as nausea and vomiting in both groups.Conclusion Different temperatures of bupivacaine can be used safely for section anesthesia.The anesthesia effect of the heateding bupivacaine is faster, the anesthesia level is higher, the anesthesic and muscle relaxant effect is better.Bupivacaine at room temperature has relatively small effect on hemodynamics.

Fascia ; Humans ; Laparoscopy ; Rectal Neoplasms

Objective To investigate the effects of compound lidocaine cream applied to tracheal tube on the recovery of tonsil with adenoidectomy in general anesthesia. Methods 120 patients undergoing elective tonsillectomy with adenoidectomy were randomly divided into the experimental group and the control group. In the experimental group, the surface of the tracheal tube was uniformly coated with compound lidocaine cream before anesthesia. In the control group, paraffin oil was given evenly to the surface of the tracheal tube. The changes of hemodynamics and the incidence of complications in the two groups were observed and recorded. Results The indexes of hemodynamics in the experimental group were more stable than those in the control group, and the control group had poor tube resistance, and the incidence of complications such as cough, irritability and sore throat was increased (P<0.05). Conclusion Application of compound lidocaine cream on tracheal tube surface can effectively reduce the cough and other stress response during the general anesthesia recovery period, decrease postoperative irritability and improve the safety of children after surgery.

Objective To discuss the efficacy and safety of transurethral plasmakinetic resection of the prostate(PKRP) for benign prostatic hyperplasia(BPH).Methods A British made Bipolar plasmakinetic resection system(Gyrus) was employed in this series.Started from the 6 o’clock point,the middle lobe of the prostate was resected,followed by the left and right lobes,which were resected down to the prostate capsule.And then the bladder neck was cut down.The apical tissues were resected to the anterior border of the seminal colliculus.After the operation,a F22 three-channel catheter was indwelled for 3 to 5 days after the operation,and a balloon was place in the bladder neck.Results The procedure was completed successfully in all of the cases with a mean operation time of(85.0?12.0) min,and a median blood loss 115.0 ml(30 to 650).Ten patients received blood transfusion during the operation(200 to 400 ml).No case showed transurethral resection syndrome or obturator nerve reflex.Fourteen patients developed inflammatory stricture of the anterior ureter and was then cured by dilating the urinary tract;15 cases showed transient urinary incontinence and was cured after pelvic floor muscle training for 1 to 3 weeks.Follow-up was available in the patients for 1 to 6 months,during which the mean Qmax of the patients significantly increased compared to that preoperation [from(7.6?2.4) ml/s to(22.6?3.4) ml/s,t=13.582,P=0.000),and the IPSS and life quality score markedly decreased [from 27.3?1.5 and 4.3?0.4 to 7.0?1.2 and 2.1?0.8;t=16.394 and 9.761,P=0.000 and 0.005,respectively] Conclusion PKRP is an effective and safe treatment for BPH.

Objective To study the effects of enteral nutrition( EN) on inflammatory factors and cardiac function in elderly patients with heart failure ( HF ) . Methods A total of 96 elderly patients with HF were enrolled in this study and randomly divided into treatment group A,treatment group B and control group( n= 32 in each group) . Patients in group A were provided with 500 mL of EN daily for 1 month, and those in group B were provided with the same dose of EN for 3 months. Control group was treated with normal diet. The nutrition status of each group was assessed by NRS2002. Meanwhile,all patients were evaluated by New York Heart Association(NYHA) class and left ventricle eject fraction(LVEF). The levels of BNP,IL-6, CRP and TNF-α were also measured before and after nutrition treatment. Results In group A and group B,BMI,TSF,AMC, TP,ALB and HGB increased. Symptoms of HF alleviated quickly and LVEF increased compared to the baseline. The levels of BNP,IL-6,CRP and TNF-α were significantly lower after treatment(P<0. 05) in both treatment groups,and the change in group B was more obvious(P<0. 01) than group A. However,in control group,there is neither evident improvement in cardiac function or nutrition status,nor in inflammatory factor levels. Conclusion Adding EN support to the normal treatment of heart failure in elderly malnourished patients with HF not only improves the function of heart and nutrition status, but also helps to support immune system so as to alleviate acute inflammatory response. The benefits from EN depend on the duration of therapy.

Objective To investigate the efficacies of preoperative location with titanium clip and methylene blue staining in laparoscopic colectomy.Methods The clinical data of 31 patients with colorectal polyps which could not be resected under endoscope were admitted to the Third Affiliated Hospital of Sun Yat-Sen University from August 2006 to September 2012 were retrospectively analyzed.According to the methods of preoperative location of colorectal polyps,all patients were divided into the titanium clip group (18 patients) and the methylene blue group (13 patients).Titanium clip group:enteroscopic and pathological examination were firstly performed,and then 1 or 2 titanium clips were placed at the superior and inferior part of the polyps.After enteroscopic examination,abdominal X ray examination was performed to detect the position of polyps according to the positions of the titanium clips.Methylene blue group:after colonoscopy,methylene blue of 1 mL was injected into the adjacent mucosa of the polyps,and 4 positions around the polyps were selected for the injection of methylene blue.If the 2 locating methods were failed,intraoperative enteroscopy was performed.Laparoscopic resection for intestine or mesenterium was performed according to the treatment principle of colorectal neoplasms,and the location efficacy of the 2 methods and the treatment of the 2 groups were analyzed.The measurement data and the count data were analyzed using the t test and chi-square test,respectively.Results The success rates of the titanium clip group and the methylene blue group were 15/18 and 8/13,with no significant difference between the 2 groups (x2=0.284,P ＞0.05).The polyps in 8 patients which were failed to be localized by titanium clip or methylene blue were localized by intraoperative enteroscopy,while the operation time was prolonged to (44 ± 13)minutes.No positioning errors were detected in all the 31 patients.Laparoscopic right colectomy was performed on 4 patients,laparoscopic left colectomy on 11 patients,laparoscopic sigmoid colectomy on 9 patients,laparoscopic anterior resection of rectum on 7 patients.No morbidity or mortality was detected in the 2 groups.The length of specimen,distance between the proximal margin and the superior margin of the tumor,distance between the distal margin and the inferior margin of the tumor (patients with colonic polyps),distance between the distal margin and the inferior margin of the tumor (patients with high rectal polyps),and the number of lymph node resected were (20 ± 7) cm,(11 ± 4) cm,(8.6 ± 3.1) cm,4.2 ± 1.1,8 ± 5 in the titanium clip group,and (20 ± 5) cm,(9 ± 3) cm,(9.1 ± 2.8) cm,4.6 ± 0.5,7 ± 6 in the methylene blue group,with no significant difference between the 2 groups (t =0.053,0.918,0.213,1.486,0.267,P ＞0.05).Fifteen patients had cancerization of the polyps,including 8 patients with TNM Ⅰ stage,6 with TNM Ⅱ] stage and 1 with TNM Ⅲ stage.Conclusions For patients with colorectal polyps located at the intestine above the descending colon,titanium clip locating is easy,safe and effective,and it could be the first choice for locating the colorectal polyps.Endoscopic methvlene blue staining is simple but high technique demanding.Intraoperative enteroscopy is precise for locating the polyps at the intestine below the descending colon.

BACKGROUND: Quite a number of in vitro experiments indicate that low dose He-Ne laser can stimulate the cell growth and blood vessel regeneration therefore to improve the damages caused by ischemia. However, it needs further study on the in vivo experiments.OBJECTIVE: To study the protective effects of intravascular low dose laser irradiation to ischemic reperfusion of rats and explore its mechanism.DESIGN: A randomised and controlled trial based on experinental animals.SETTING: Department of Neurology of a hospital of a university.MATERIALS: The experiment was completed in the Surgery Experimental Animal Center of West China Hospital of Sichuan University. Healthy male SD rats of class Ⅱ which aged between 5 to 6 months with weight of 372 to 418 grams[mean weight(388.48 ± 10. 57) g] were provided by Animal Research Center of Sichuan University.INTERVENTIONS: Middle cerebral artery ischemia model of rats was prepared. Forty SD rats were randomly divided into treatment group and control group with each of 20 rats. Intravascular low dose He-Ne laser irradiation was conducted to rats in treatment group one time every other day, 20 minutes per time and 3 times for a course. Vein puncture was conducted to rats in control group without laser input.MAIN OUTCOME MEASURES: Ratio of infarcted volume RESULTS: The ratio of the cerebral infarction volume in treatment group was (10.43 ± 1.04) and is much lower than that of control group(16.78 ± 1.12).There was statistical difference between two groups( t = 27.14, P ＜ 0.05).CONCLUSION: Intravascular low dose He-Ne laser irradiation has protective effects to cerebral ischemia of rats.

Objective In our previous work, the prevalence of anti-endothelial cell antibodies(AECA) in patients with systemic vasculitis and other autoimmune diseases was analyzed. AECA against a 47 000 endothelial cell antigen was found in patients of a variety of systemic vasculitis and systemic lupus erythematosus (SLE). It was suggested to be α-enolase by the combination of immunoblotting and proteomics methods. The aim of this work is to demonstrate that α-enolase is one of the targets of AECA, and to detect the prevalence of anti-α-enolase antibody in sera of patients with autoimmune disorders including systemic vasculitis. Methods The CDS of human Enol gene was amplified by polymerase chain reaction (PCR), with template of human placenta λzap express Cdna library. The product was then recombined with expression vector. After expression and purification from E.coli, the recombinant protein was analyzed by mass spee-trometry. The prevalence of anti-α-enolase antibody in patients with autoimmune disorders including systemic vasculitis was tested by Western blot and enzyme-linked immunosorbent assay (ELISA). Results The CDS of human Enol gene was subcloned to the expression vector. Recombinant human α-enolase was expressed and purified in E.coli. The recombinant protein was demonstrated to be his-tagged human a-enolase by mass spectrometry. Results of Dot-Blot revealed that the prevalence of anti-α-enolase antibody was 76.7% in systemic vasculitis [including 74.0% in Behcet's disease (BD), 81.5% in Takayasu artefitis (TA), 62.5% in Wegener's granulomatosus (WG), 92.3% in microscopic polyangitis (MPA) and 80.0% in Churg-Stranss syndrome (CSS)], 78.3% in SLE, 63.6% in Sjogren's syndrome (SS) and 78.9% in rheumatoid arthritis(RA). No positive signals were detected in sera of normal controls or patients with polymyositis/ dermatomyositis (PM/DM). There was no statistical significance among positive rates of anti-α-enolase antibody in systemic vasculitis, SLE, SS or RA patients. The prevalence of positive signals at the most extensive level (+++～++++) was 51.7% in patients with systemic vasculitis, 33.3% in SLE, 42.9% in SS and 20.0% in RA. There was statistical significant difference between RA and systemic vasculitis. Conclusion The identification of human α-enolase as one of the targets of AECA and its prevalence in a variety of autoimmune disorders will shed some light on the understanding of the pathogenesis of vascular injury in autoimmune diseases.

Objective To explore the correlation and significance between adult nut-cracker phenomenon (NCP) and varicocele. Methods The clinical characters of 226 adult patient (including inpatients and outpatients)with NCP diagnosed by color Doppler ultrasound examination were analyzed retrospectively, whose chief complaints were asymptomatic bematuria or/and orthostatic proteinuria (microalbuminuria). The ratio of left renal vein inner diameter before and after being compressed≥2 was regarded as the criteria of diagnosis of NCP. Among 226 cases, 184 male NCP patients were taken as study group, and the incidence of varicocele was tested. One hundred and fifty-six male adults who had physical examination in the same period and whose ages matched with study group were taken as control group, they were not NCP patients examined by color Doppler ultrasound. The incidence of varicocele was compared between two groups. The indexes associated NCP were examined in detail in study group. Logistic regression analysis was used to study the correlation between NCP and left varicocele. Results There were 184 male patients in study group, among which there were 22 patients with left sub-clinical varicocele (accounted for 11.96%), 47 patients with left varicocele (accounted for 25.54%).The total incidence of varicocole was 37.50%(69/184). There were 156 male adults in control group, among which there were 13 patients with sub-clinical varicocole(accounted for 8.33%), 8 patients with varicocele (accounted for 5.13%).The total incidence of varicocele was 13.46%(21/156). The total incidence of varicocele in study group was significantly higher than that in control group (P=0.000). In study group, there were 22 patients with left sub-clinical varicocele,with average age (24.73±1.03) years. The inner diameter of left renal vein(LRV) in front of spine was (3.65±0.11) mm(a),the inner diameter of LRV at left side of spine was (8.41±0.11)mm(b), and b/a ratio was 2.31± 0.06. The angle between superior mesenterie artery (SMA) and abdominal aorta(AA) was (15.95±0.59)°. There were 47 patients with left varicocele, with average age(26.62±1.74)years. The inner diameter of LRV in front of spine was (3.43±0.08)mm(a),the inner diameter of LRV at left side of spine was (8.72±0.14) mm (b), and b/a ratio was 2.54±0.08. The angle between SMA and AA was (14.54±0.53)°. In study group, Lagistic regression analysis proved that male patients with NCP were complicated with varicocele easier when the angle between SMA and AA became smaller, the inner diameter of LRV at the left side of spine (b)and age increased. Conclusions Male adult patients with NCP are complicated with left varicocele, which is significantly higher than that in non-NCP male adults at the same age. It shows that NCP is one important cause for varicocele and there is a close correlation between NCP and varicocele in male adults.