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 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 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.

Fascia ; Humans ; Laparoscopy ; Rectal Neoplasms

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.

Objective: To establish the detemination method of bismuth subcarbonate in Weishu Powder. Methods: The samples were ignited, then bismuth subcarbonate in residue was determined by compleximetry. Results: The average recovery was 99.36?0.14%(n=9). Conclusion: This method can be used in quality control of Weishu Powder preparation.

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.

Objective To observe the expressions of Akt and ERK phosphorylation in abdominal aortic aneurysm of rat model, and explore the pathogenesis of abdominal aortic aneurysm. Methods The rat model of abdominal aortic aneu-rysm was established. The diameter of abdominal aorta was measured and the extended rate of the aorta was calculated. HE staining was used to observe the change of pathology. Immunohistochemistry and Western blot methods were used to detect the expressions of Akt and ERK phosphorylation in the level of protein. Results The dilation of aorta was significantly high-er in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). HE staining showed structural disorder and inflammatory cell infiltration in abdominal aortic aneurysm group. The results of immunohistochemistry and Western blot results showed that phosphorylation of Akt expression was significantly higher in abdominal aortic aneurysm group than that of saline group and normal group (P＜0.05). There was no significant difference in phosphorylation of ERK expression between three groups (P>0.05). Conclusion PI3K/Akt signaling pathway may be involved in the development of abdominal aortic aneurysm.

Objective To study the iodine nutritional status and thyroid function of adults in urban and rural areas of Wuwei City Gansu Province.Methods A cross-sectional survey was performed in 200 adults aged 18-45 who had lived more than six months in Wuwei City from April 2009 to January 2010.A random urine and fasting blood samples were collected.Urinary iodine content was measured with arsenic cerium catalytic spectrophotometry.The thyroid-stimulating hormone (TSH),free thyroid hormone (FT4) and three free triiodothyronine (FT3) were quantified by direct chemiluminescence immunoassay.Thyroglobulin antibodies (TGAb) and thyroid microsomal antibodies (TMAb) were detected by radioimmunoassay.Results A total of 99 and 98 copies of urine samples of urban and rural groups were tested,respectively.The median of urinary iodine of urban and rural groups was 189.0 and 258.2 μg/L,respectively,and rural group was higher than urban group (Z =-4.020,P ＜ 0.01).A total of 104 and 95 copies of blood samples of urban and rural groups were detected; mean value of FT4 in urban group [(16.8 ± 3.0)pmol/L] was higher than that of rural group [(15.4 ± 2.4)pmol/L,t =3.539,P ＜ 0.01].The positive rates of TGAb of urban and rural groups were 11.5％ (12/104) and 15.8％ (15/95),respectively; the positive rates of TMAb of urban and rural groups were 13.5％ (14/104) and 14.7％ (14/95),respectively; the positive rates of TGAb of male and female were 5.5％ (6/109) and 23.3％ (21/90),respectively; the positive rates of TMAb of male and female were 6.4％ (7/109) and 23.3％ (21/90),respectively.The positive rates of TGAb and TMAb were lower in male than in female (x2 =13.362,11.661,all P ＜ 0.01).The rates of thyroid function disorders of urban and rural groups were 16.3％ (17/104) and 8.4％ (8/95),of male and female 11.9％ (13/109) and 13.3％ (12/90),respectively.Subclinical hypothyroidism in all thyroid function disorders was the most common,which was 14.4％ (15/104) and 7.4％ (7/95) in urban and rural groups,11.0％ (12/109) and 11.1％ (10/90) in male and female,respectively.Conclusions Iodine nutrition level is appropriate for adults in urban areas,but in rural areas iodine nutrition is high or excessive; subclinical hypothyroidism in all thyroid function disorders is the most common; we should be concerned about the risk of iodine overdose,especially the risk of illness in women.

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.