Objective To observe the effect analysis of inverting suture and 8-character-pattern suture after laparoscopic myomectomy for the operation and postoperative complications. Methods The data of of 142 patients with laparoscopic myomectomy were analyzed retro-spectively. According to the different suture methods,they were divided into inverting suture group (85 cases) with straight mattress inverting suture and 8-character-pattern suture group (57 cases). The operation time, intraoperative bleeding, postoperative complications between two groups were compared. Results The operation time and intraoperative bleeding of varus suture group were less than those of 8-character-pat-tern suture group, single tumor posterior uterine wall parts of operation time and intraoperative bleeding than patients with the anterior wall of the uterus and uterine bottom, 1 cases of pelvic related operation infection after operation in eight suture group,abdominal and pelvic mucosa adhesion in 2 cases,the complication rates between two groups were statistically difference (P<0. 05). Conclusion Laparoscopic myomec-tomy with direct mattress inverting suture can shorten operation time, play a good hemostasis in the operation and reduce the incidence of pel-vic infection and abdominal and pelvic mucosa adhesion.

Objective To investigate the relationship between urine IgG of the first hospitalized children suffered allergic purpura and recurrence within one year. Methods Used immunoturbidimetry to determine acute-stage and convalescent urine IgG of 43 children suffered allergic purpura in the first hospitalized and no recurrence within one year (no recurrence group), and of 29 children suffered allergic purpura and recurrence within one year (recurrence group), and of 28 hospitalized children suffered primary nephrotic syndrome during the corresponding time period before hormonal therapy (nephrotie syndrome group), and of 30 children done medical examination in out-patient clinic (control group), then analyzed.Results There was no significant difference of the urine IgG level in acute-stage between no recurrence group [(1.391± 0.743) g/L] and recurrence group [(1.474 ±0.658) g/L](P>0.05), while they were all lower than that in recurrence group [(2.808 ± 0.683) g/L] (P < 0.01). The level of convalescent urine IgG in nephrotic syndrome group [(0.202 ± 0.154) g/L] was obviously higher than that in no recurrence group [(0.115 ±0.103) g/L] and control group [(0.109 ±0.098) g/L](P<0.05). Conclusion Urine IgG is a significant index to judge the activity and recurrence and prognosis of pedo-allergie purpura.

Objective To evaluate the effects of personality on the development of postoperative cognitive dysfunction (POCD) in elderly patients undergoing gastrointestinal surgery.Methods Fifty-eight elderly patients,aged 65-70 yr,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with Eysenck Personality Questionnaire (EPQ) P rating scale score ＜50,scheduled for elective gastrointestinal surgery under general anesthesia,were enrolled in the study.Personality was assessed by using EPQ at 1 day before surgery.By using a 2 × 2 factorial design,2 empirical factors introversion or extroversion (factor A) and neuroticism (factor B) were used.A1 and A2 were introversion (EPQ E rating scale score＜50) and extroversion (EPQ E rating scale score ≥ 50),respectively.B1 and B2 were emotional stability (EPQ N rating scale score＜50) and emotional instability (EPQ N rating scale score ≥ 50),respectively.The patients were divided into 4 groups:A1B1 group (n=8),A1B2 group (n=10),A2B1 group (n=26),and A2B2 group (n =14).Cognitive function was assessed at 7 days after surgery,and the development of POCD was recorded.Results The incidence of POCD was 0,0,15％ and 57％ in A1B1,A1B2,A2B1and A2 B2 groups,respectively,the incidence of POCD was significantly higher in group A2B1 than in A1B1and A1 B2 groups,and the incidence of POCD was significantly higher in group A2B2 than in the other three groups (P＜0.05).Factor A and factor B produced effects on the development of POCD (P＜0.01),and an interaction between them was found (P＜0.01).Conclusion The incidence of POCD is higher for the non-mentation patients who are extroverted and emotionally unstable.

Objective To evaluate the effects of volume therapy with different doses of 6% hydroxyethyl starch 130/0.4 (6% HES 130/0.4) on lung injury in a rat model of hemonhagic shock.Methods Twenty-four male SD rats weighing 220-300 g were randomly divided into 4 groups ( n = 6 each) : group I sham operation (group S); group II Ringer's solution (group RS); group HI and IV 2 HES groups (group H1, H2 ). The animals were anesthetized with intraperitoneal 1% sodium pentobarbital 45 ing/kg. Right common carotid artery (CCA) and left femoral vein were cannulated for blood letting, MAP monitoring, fluid administration and blood sampling. Hemonhagic shock was induced by withdrawing blood from right CCA in group II , III and IV . MAP was reduced to 35-45 mmHg which was maintained for 90 min. In group RS, hemorrhagic shock was resuscitated with Ringer's solution 3 times of the volume of blood withdrawn, while group H1 and H2 received HES 33 and 50 ml/kg respectively and Ringer' s solution (the total volume was equal to 3 times of the volume of blood removed) . Arterial blood samples were taken before blood letting (T0 , baseline), and at 2, 3 h after volume therapy (T1,2) for blood gas analysis and PaO2/FiO2 was calculated. The animals were then sacrificed by exsanguination and the lungs were immediately removed for microscopic examination and determination of protein concentration in broncho-alveolar lavage fuid (BALF), W/D lung weight ratio and TNF-α, IL-1 β and IL-10 contents in the lung.Results TNF-α, IL-1β and IL-10 content in the lung, protein concentration in BALF and W/D ratio were significantly higher in group RS, H1 and H2, while PaO2/FiO2 was significantly lower at T,2 in group RS and at T2 in group H2 than in group S (P < 0.05). TNF-α and IL-1β contents in the lung, protein concentration in BALF and W/D ratio were significantly lower in group H1 and H2 , while PaO2/FiO2 was significantly higher at T,i2 in group H1 and at T1 in group H2 than in group RS (P <0.05) . PaO2/FiO2 at T2 and IL-10 content in the lung were significantly lower in group H2 than in group H, ( P < 0.05) . The lung damage was significantly ameliorated in group H1 and H2 especially in group H, as compared with group RS. Conclusion Volume therapy with 6% HES 130/0.4 33 or 50 ml/kg can attenuate lung injury in a rat model of hemorrhagic shock and the efficacy of 33 ml/kg is better.

Aim To investigate the effects of 6% hydroxyethyl starch 130/0.4(6%HES 130/0.4)and Ringer's solution resuscitation on early lung injury in hemorrhagic shock rats and its mechanisms.Methods Twenty-four male SD rats were divided into 4 groups:sham,Ringer's solution(RS),two HES groups(H1,H2).Group H1,H2 received HES 33,50 ml·kg~(-1) and Ringer's solutions respectively after 90-minute shock(the dose of Ringer's solutions was 3 times as muchas the maximum shed blood volume minus the dose of HES).Blood samples were taken from artery for blood analysis and the expression of CD11b/CD18 at T_0,T_1,T_4,T_5.The lungs were removed for ultrastructure examination.Results PaO_2 increased in group H1 at T_(1～5) and group H2 at T_5 as compared with T_0.PaCO_2 decreased in all the resusitation groups.The ultrastructure was basically normal except that the mitochondria changed slightly in group H1.In group H2,the perinuclear space was dilated slightly and the rough endoplasmic reticulum expanded slightly,and the degranulation was observed.Compared with group RS,the expressions of CD11b and CD18 decreased at T_4,T_5;compared with group H1,the expressions of CD11b and CD18 in group H2 increased.Conclusions Treatment with 6%HES(130/0.4)33 ml·kg~(-1)and Ringer's solution can attenuate hemorrhagic shock,and the resuscitation reduces lung injury through inhibition of expressions of CD11b and CD18.

Objective To investigate the correlation between the positive rate of PCR-reverse dot blot genotyping test and the loads of the viral nucleic acid. Methods The fluorescent PCR assay was used to detect the high-risk HPV(HR-HPV)DNA loads in the cervical mucus samples from 1162 female pa-tients. Patients with positive HR-HPV DNA were further analyzed by PCR-reverse dot blot hybridization as-say for HPV genotyping. Results The overall positive rate of genotyping test was 68. 8% . The positive rate of genotyping test had a significant positive correlation with the Log Koc of HR-HPV DNA loads(r=0. 944, P﹤0. 01). The quadratic curve fitting formula was Y= -1. 806+0. 558X-0. 031X2(Y for genotyping positive rate,X for Log Koc of HR-HPV DNA loads). There were significant differences with the positive rate of gen-otyping test among patients with different viral loads(P﹤0. 01). When HR-HPV DNA loads were 104-105 copies/ ml,105-106 copies/ ml,106-107 copies/ ml and more than 107 copies/ ml,the positive rate of HPV genotyping test were 27. 8% ,48. 5% ,74. 0% ,97. 5% and 33. 3% ,51. 5% ,78. 0% ,97. 5% respective-ly by using different genotyping detection reagents. Conclusion The positive rate of PCR-reverse dot blot genotyping test was correlated with the loads of HPV nucleic acid.

Objective To investigate the effects of sufentanil,remifentanil and fentanyl oH cellular immune function in patients undergoing radical resection of esophageal cancer.Methods Forty-five ASA Ⅰ or Ⅱpatients aged 45-64 yr undergoing radical resection of esophageal cancer were randomly divided into 3 groups(n=15 each):sufentanil group(SF);remifentanil group(RF)and fentanyl group(F).The patients were premedicated with iv atropine 0.5 mg.Anesthesia was induced with midazolam 0.04 mg/kg,propofol TCI(CT=3μg/ml)and TCI of sufentanil,remifentanil or fentanyl(CT=0.5,5 and 5 ng,ml respectively in the 3 groups).Endobronchial intubation was facilitated with vecuronium 0.1 mg/kg.The patients were mechanically ventilated.PETCO2 was maintained at 30-40 mm Hg.Anesthesia was maintained with inhalation of sevoflurane(0.7-1.5 MAC)and TCI of sufentanil,remifentanil or fentanyl(CT=0.5,5 and 5 ng/ml respectively).Venous blood samples were taken from peripheral vein before anesthesia(T0,baseline),60 min after skin incision(T1),immediately(T2),24 h(T3)and 72 h(T4)after the end of operation for determination of the expression of CD3+,CIM+,CD8+on T cells and CD3-CD16+CD56+on natural killer cells by flow cytometry,CD4+/CD8+ratio,serum concentrations of IL-2 and IL-10 by ELISA.Results Compared with the baseline values,the CD4+T-lymphocytes and CIM+/CD8+ratio were significantly decreased at T2,while the CD3-CD16+CD56+NK cells were significantly increased in all 3 groups.The CD3+T-lymphocytes were significantly decreased at T2 as compared to the baseline value at T0 in SF and RF groups.The CIM+and CD3+T-lymphocytes were significantly decreased at T3 as compared with the baseline value in all 3 groups.Serum IL-2 concentration was significantly higher at T3 in SF group than in RF group.Serum IL-10 concentration was sismficantly higher at T4 in RF group than in SF group.Conclusion Sufentanil,remifentanil and fentanyl can depress cenular immune function to some extent in patients undergoing radical resection of esophageal cancer.

Objective To observe and cpmpare the efficacy and complications of hyperfractional integrated intraeavitary brachtherapy in middle-advanced squamous-cell carcinoma with the traditionsl brachytherapy.Methods In the observed group,328 patients with cervical cancer received hypeffractional integrated intracavitary after loading therapy between Jan 2004 and Jan 2005 were selected.The dose of point A was 2.5 Gy-3.0 Gy/fraction,2 fractions per week,and the total dose of reference point A was 49.8 Gy in stage Ⅱ b,52.6 Gy in stage in Ⅲb.In the control group,331 cases treated with traditional aflerloading brachytherapy between Jan 2002 and Dec 2003 were selected.The dose of point A was 5.0～7.0 Gy/fraction,1 fraction per week,and the total dose of point A was 50.1 Gy in stage Ⅱb,53.5 Gy in stage Ⅲb.In vitro irradiation began at the same time with the intracavitary brachytherapy.The whole pelvic was irradiated with 15 MV X-rays.Results In the observed group,the recent control rate of stage Ⅱb was 97.2%(104/107),94.1%(208/221)for stage Ⅲb.The 3-year survival rate was 80.5%(264/328).and the 5-year survival rate was 68.6%(225/328).The complication rate was 5.2%(17/328)for cystitis, 14.6%(48/328) for proctitis.Out of 331 cases in control group,the recent control rate of stage Ⅱb was 95.4%(103/108),92.8%(207/223)for stage Ⅲb.The 3-year survival rate was 75.2%(249/331),the 5-vear survival rate was 62.5%(207/331).The complication rate was 13.3%(44/331)for cystitis,and 32.3%(107/331)for proctitis.Conclusions Compared with combination of traditional brachytherapy and external radiotherapy,combination of hyperfraetional integrated brachtherapy therapy and external radiotherapy has no significant improvement for recent control rate and long-term survival rate,but could reduce the complication rates of cystitis and proctitis.

PURPOSE: The -1237T/C polymorphism of the Toll-like receptor 9 (TLR9) gene has been implicated in the susceptibility of inflammatory bowel diseases (IBDs), but the results remain conflicting. We further investigated this association via meta-analysis. MATERIALS AND METHODS: Multiple electronic databases were extensively searched until February, 2015. The strength of association was evaluated by calculating the pooled odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS: A total of 2987 cases and 2388 controls from eight studies were analyzed. Overall, association was found between TLR9 -1237T/C polymorphism and the risk of IBDs when all the studies were pooled (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.13, 95% CI: 1.00-1.27, p=0.05). Stratification by ethnicity indicated an association between TLR9 -1237T/C polymorphism and IBDs risk in Caucasians (recessive model, OR: 1.59, 95% CI: 1.02-2.47, p=0.04; homozygote comparison, OR: 1.62, 95% CI: 1.04-2.52, p=0.03; allele model, OR: 1.12, 95% CI: 1.00-1.27, p=0.05). When stratified by disease type, significant correlation were only found in the Crohn's disease subgroup (recessive model, OR: 1.69, 95% CI: 1.05-2.73, p=0.03; homozygote model, OR: 1.74, 95% CI: 1.07-2.82, p=0.02; allele model, OR: 1.15, 95% CI: 1.01-1.32, p=0.04). CONCLUSION: The present study suggested that the TLR9 -1237T/C polymorphism might act as a risk factor in the development of IBDs, particularly in Caucasians.
Alleles ; European Continental Ancestry Group/genetics ; Genetic Predisposition to Disease/*genetics ; Homozygote ; Humans ; Inflammatory Bowel Diseases/ethnology/*genetics ; Odds Ratio ; Polymorphism, Genetic/*genetics ; Risk Factors ; Toll-Like Receptor 9/*genetics/metabolism

Objective To evaluate the effect of facemask ventilation with different pressures on perioperative complications in the patients undergoing gynecological laparoscopic surgery. Methods Seven-ty-five American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes, aged 18-60 yr, with body mass index of 18-24 kg∕m2 , scheduled for elective gynecological laparoscopic surgery under general anesthesia, were divided into 3 groups ( n=25 each) using a random number table method: 10 cmH2 O group ( group P10) , 15 cmH2 O group ( group P15) and 20 cmH2 O group ( group P20) . The pres-sure for facemask ventilation was 10, 15 and 20 cmH2 O during induction of anesthesia in group P10, group P15 and group P20, respectively. Before facemask ventilation ( T0 ) and at 180 s of facemask ventilation ( T1 ) , longitudinal and anteroposterior diameters of the antral area in the supine position were measured u-sing ultrasonography, the antral cross-sectional area was calculated, and the development of serious flatu-lence was recorded. The development of hypoxemia, tidal volume and end-tidal pressure of carbon dioxide in each group were recorded at T1 . The operation time and occurrence of postoperative flatulence and nausea and vomiting were recorded. Results Compared with group P10, the incidence of serious flatulence and postoperative flatulence and nausea and vomiting was significantly increased, and the incidence of hypox-emia was decreased in group P15 and group P20, and tidal volume was increased at T1 in group P20 ( P<0. 05) . Compared with group P15, the incidence of serious flatulence was significantly increased ( P<0. 05) , and no significant change was found in the incidence of hypoxemia and postoperative flatulence and nausea and vomiting in group P20 ( P>0. 05) . There was no significant difference in the end-tidal pressure of carbon dioxide at T1 or antral cross-sectional area at T0 and T1 among the three groups ( P>0. 05) . Con-clusion Pressure of 10-15 cmH2 O for facemask ventilation is optimal during induction of general anesthe-sia and can ensure adequate oxygen supply and reduce perioperative complications in the patients undergoing gynecological laparoscopic surgery.