Objective To study the prevention and treatment of pneumoperitoneum-related complications after laparoscopic cholecystectomy (LC). Methods A retrospective analysis was made on clinical data of 1 100 cases of LC from October 1993 to January 2003. The cases were divided into two groups: 980 cases admitted before September 2001 received a 14 mmHg carbon dioxide pneumoperitoneum (Group A), and 120 cases after September 2001 received a 10 mmHg pneumoperitoneum (Group B). Results Carbonemia happened in 2 cases in the Group A but in no cases in the Group B. The incidence of postoperative shoulder pain was significantly lower in the Group B (19 2%, 23/120) than in the Group A (43 9%, 430/980) ( ? 2 =26 951, P =0 000). The incidence of postoperative nausea and vomiting (PONV) was significantly lower in the Group B (25 8%, 31/120) than in the Group A (61 2%, 600/980) ( ? 2 =54 750, P =0 000). Conclusions Carbonemia, shoulder pain and PONV can be reduced by regulating the ventilation and decreasing the pneumoperitoneum pressure.

0.05). The stepwise regression analysis showed that the logarithm of the duration of residual gas had a parallel relationship with the gas volume under the hemi-diaphragm 24 hours after operation(r=0.616,P=0.006),a negative correlation with the duration of pneumoperitoneum (r=-0.228,P=0.014), and no correlation with patients’ age,body weight,height,operation time and gas volume consumed. Postoperatively, 26 patients reported postoperative shoulder pain. The shoulder pain VAS scores were significantly increased with the increasing of CO_2 pressure in the three groups (F=9.635, P=0.000). The shoulder pain VAS scores had a parallel relationship with the gas volume under the right hemi-diaphragm 24 hours after operation (r=0.333, P=0.005) and the duration of residual gas (r=0.296, P=0.014). Conclusions The CO_2 should be removed as thoroughly as possible at the end of operation to reduce the absorption of residual gas. The different CO_2 pressures of pneumoperitoneum have little effects on the volume of residual CO_2 24 hours after operation and the duration of residual gas. The shoulder pain following LC, will be aggravated with the increasing of pneumoperitoneum pressure. The over-stretching of the diaphragmatic fibers due to insufflation is the main cause of shoulder pain.

Objective To observe the length of duration of free gas presence in abdomen after laparoscopic cholecystectomy (LC). Methods A Series of chest X-ray examinations following LC in 69 patients in this hospital from April 2002 to December 2002 were taken to review the condition of subphrenic free gas. Results Gas was detected on (1.8?1.1) days following LC and was completely absorbed within 6 days after LC. The logarithm of the length of duration of pneumoperitoneum had a parallel relationship with the subphrenic residual gas volume within 24 postoperative hours ( r =0.616, P =0.000), bore a negative relationship with the pneumoperitoneum time ( r =-0.228, P =0.014), and was not correlated with age, body weight, height, operation time and consumption of CO 2. Conclusions Clearing intraabdominal CO 2 gas away so far as possible can shorten the length of duration of gas presence in abdomen.

Objective: To compare the effecte of removing plaque by two toothbrushing methods. Methods: Forty subjects were chosen to take part in the randomized、examiner-blind、crossover study. Results: Modified Bass method has better effect of removing plaque, especially that at the central margin than Vertical method(P

The pre-treatment serum levels of carbohydrate antigen 125 (CA125),cytokeratin 19 fragment 21-1 (CYFRA21-1),squamous carcinoma associated antigen (SCC-Ag),and tissue polypeptide antigen (TPA) were measured in 111 patients with primary non-small-cell lung cancer.And 103 benign lung disease cases and 97 healthy volunteers were also studied as controls.Enzyme linked immunosorbent assay (ELISA) was employed to detect the serum contents of SCC-Ag and TPA.The levels of CA125 and CYFRA21-1 were measured by electrochemical luminescence.The serum level of CYFRA21-1,SCC,TPA and CA125 in cancer patients were significantly higher than those of normal control and benign disease groups (P ＜ 0.01).The combined detection of tumor markers could significantly improve the sensitivity and specificity.And the levels of tumor markers were also correlated with the clinical stages and differentiation degrees.

Objective:To investigate the clinical efficacy of budesonide formoterol combined with tiotropium bromide in the treatment of asthma chronic obstructive pulmonary disease(COPD) overlap (ACO).Methods:From January 2016 to December 2018, 160 ACO patients who met the inclusion criteria in the Department of Respiratory Medicine, Linxi Hospital, Kailuan General Hospitalwere selected as the observation objects.Prospective cohort study was used for observation and analysis.The patients were divided into study group and control group with 80 cases in each group by random number table.Both groups received conventional treatment, on this basis, control group received budesonide and formoterol powder inhalation, 1 inhalation/time, 2 times/d, study group received tiotropium bromide 1 granule/time, once a day based on the control group.Both groups were treated for 12 months.The clinical efficacy, lung function, blood gas analysis, inflammatory factors and T lymphocyte levels were compared between the two groups.Results:The total control rate in study group was 87.5%(70/80), significantly higher than that in control group (70.0%(56/80)), the difference was statistically significant (χ 2=7.32, P<0.05). After treatment, the asthma control test (ACT) scores in both groups increased significantly, while ACT scores in study group((23.12±3.12) point )was significantly higher than that in control group ((20.45±4.28) point, t=4.51, P<0.05). After treatment, the COPD assessment test (CAT) scores in both groups decreased significantly, while CAT scores in study group ((14.25±3.03) point ) was significantly lower than that in control group ((18.69±3.52) point, t=8.55, P<0.05). After treatment, the forced expiratory volume in 1s (FEV1), FEV1%, FEV1 /Forced vital capacity (FEV1/ FVC) and Inspiratory capacity / total lung capacity (IC/TLC) levels in both groups increased significantly, while FEV1((2.20±0.47)L), FEV1%((68.62±7.89)%), FEV1/ FVC((67.63±7.59)%)and IC/TLC levels(48.84±4.86)%) in study group were significantly higher than those in control group ((1.93±0.49)L, (61.88±7.65)%, (62.88±8.41)%, (43.22±5.15)%)(t value were 3.56, 5.49, 3.75, 7.10, all P<0.05). After treatment, the level of partial pressure of oxygen (PaO 2) in both groups increased significantly, while PaO 2 level in study group((78.12±6.45) mmHg) was significantly higher than that in control group ((72.45±7.52) mmHg)( t=5.12, P<0.05). After treatment, the arterial partial pressure of carbon dioxide (PaCO 2) level in both groups decreased significantly, while PaCO 2 level in study group((46.73±7.13) mmHg) was significantly lower than that in control group((49.81±8.02) mmHg) ( t=2.57, P<0.05). After treatment, the levels of IL-6, hs CRP and TNF-α in the two groups were decreased significantly, while IL-6, hs-CRP and TNF-α levels in study group((15.35±6.72) ng/L, (18.14±7.62) mg/L, (56.84±4.92) ng/L) were significantly lower than those in control group((21.42±5.35) ng/L, (23.35±8.64) mg/L, (69.45±8.51) ng/L) (t value were 6.32, 4.05, 11.47, all P<0.05). After treatment, the levels of CD4 + and CD4 +/CD8 + levels in both groups increased significantly, while CD4 + and CD4 +/CD8 + levels in study group((44.20±6.02)%, (1.82±0.31)) were significantly higher than those in control group((38.52±5.56)%, (1.43±0.29)) ( t=6.20, 8.22, all P<0.05). CD8 + level in both groups decreased significantly, while CD8 + level in study group((23.62±7.89)%) was significantly lower than that in control group((27.42±7.65)%)( t=3.09, P<0.05). Conclusion:Budesonide and formoterol combined with tiotropium bromide in the treatment of ACO has good clinical efficacy, reduce the level of inflammation, relieve the clinical symptoms of COPD and asthma, improve the respiratory function and lung function of patients, and have a good effect on improving the cellular immune function.

Objective To investigate the relationship between the serum ferritin levels and disease activity of patients with systemic lupus erythematosus (SLE).Methods One hundred and forty-six patients with SLE and 65 healthy volunteers were involved.Serum ferritin,C-reactive protein (CRP),erythrocyte sedimentation rate (ESR) and anti-double-stranded DNA antibodies (dsDNA) were measured in two groups.The activity of SLE was evaluated by systemic lupus erythematosus disease activity index (SLEDAI) score.The data were recorded and analyzed.SPSS 19.0.statistical software was used in statistical analysis.Analysis of variance was employed in comparison between groups using,t test was used in further pairwise comparisons,Pearson correlation test was adopted to evaluate the correlation between two groups.Results The level of serum ferritin in patients with SLE group was significantly higher than that of control group (505.4 ±408.9) ng/ml and (72.4 ±42.8) ng/ml,respectively,t =6.67,P ＜0.01.57.5％ (84/146) patients with SLE had elevated serum ferritin.Patients with high SLEDAI scores had significantly higher ferritin concentrations than other patients (807.6 ± 412.3) ng/ml and (96.0 ± 44.7) ng/ml,t =6.56,P ＜0.01.The levels of serum ferritin in SLE patients were positively correlated with SLEDAI score and serum CRP (r =0.396,P ＜ 0.01 ; r =0.351,P ＜ 0.01),and it was not related with ESR or dsDNA (r =0.111,P=0.09;r =0.078,P =0.23).Conclusion The level of serum ferritin could reflect the disease activity of patients with SLE,and it might be used as a new biomarker for disease activity of patients with systemic lupus erythematosus.

Objective To evaluate the serum concentrations of estradiol and testosterone in hyperuricemia patients and possible correlations of the two factors and uric acid (UA) in hyperuricemia (HUA) patients.Methods This was a case control study.We involved 90 hyperuricemia patients,103 healthy controls.Estradiol,testosterone,UA,serum glucose,lipid profile,creatinine and body mass index (BMI) were estimated in two groups.The statistical analysis of the data were performed using SPSS version 19.0 software.The estradiol,testosterone,UA,serum glucose,lipid profile,serum creatinine and BMI levels between the two groups were compared using the Student's t-test.Pearson correlation test was used to assess the correlation between serum UA levels and these indexes.Results Serum levels of estradiol in healthy subjects and hyperuricemia patients were 82.2 (55.6-108.8) pmol/L,65.8 (36.6-95.0) pmol/L respectively ;the serum levels of UA were 300.8(207.2-394.4) μmol/L,426.9(370.1-483.7) μmol/L,respectively.The levels of estradiol were higher in the healthy control group than those in the hyperuricemia group.There were significant differences of estradiol levels between these two groups (P ＜ 0.05).Estradiol was negatively correlated with UA (r =-0.319,P ＜ 0.01),so was testosterone (r =-0.312,P ＜ 0.01).Conclusion The findings of the present study suggest that in hyperuricemia patients,there are associations between estradiol and UA and the levels of serum estradiol might be used as biomarkers in hyperuricemia.

Objeetive To evaluate the serum concentration of sialic acid (SA) and High sensitivity C-reactive protein (hs-CRP) in prehypertension patients and possible correlation of the two factors and blood pressure in prehypertension patients.Methods 61 prehypertension patients,70 hypertension patients and 50 healthy controls were included.Lipid profile,hs-CRP,SA,and body mass index (BMI) were estimated in all the groups.Associations between SA and hs-CRP and blood pressure were analyzed by multiple linear regressions.Results The levels of SA and hs-CRP were higher in the prehypertension group than those in the normal group and lower than those in the hypertension group(P ＜ 0.05).There was significant difference in systolic blood pressure (SBP),diastolic pressure (DBP),BMI and HDL among the three groups(P ＜ 0.05).There was significant difference between the prehypertension group and the hypertension group in LDL,TC and FBG.Multiple linear regression showed that FBG,BMI,SA and hs-CRP were correlated with SBP independently while LDL,BMI,SA and hs-CRP were correlated with DBP independently (P ＜ 0.05).Conclusions The findings of the present study suggest that,there is an association between blood pressure and the levels of serum SA and hs-CRP which might be used as screening biomarkers in prehypertension.

Objective To investigate the safety and efficacy of low-dose recombinant tissue plasminogen activator (rtPA) in Chinese patients with acute ischemic stroke. Methods Consecutive patients with acute ischemic stroke received rtPA intravenous thrombolysis within 4. 5 h after symptom onset were enrol ed retrospectively. According to the dosage of rtPA, they were divided into either a low-dose group (0. 5-0. 8 mg/kg, the maximum dose 50 mg) or a standard dose group (0. 9 mg/kg, the maximum dose 90 mg). The incidences of symptomatic intracranial hemorrhage ( sICH) ( the National Institute of Neurological Disorders and Stroke [NINDS], and European Cooperative Acute Stroke Study Ⅱ [ECASSⅡ] , European Safe Implementation of Thrombolysis in Stroke-Monitoring Study [ SITS-MOST ] ), 90 d mortality, 90 d good outcome (the modified Rankin Scale [mRS] score 0-1), and life self-care ability (mRS score 0-2) were compared between the two groups. Results A total of 163 patients were enrol ed, including 74 patients in the low-dose group and 89 in the standard dose group. The constituent ratios of hypertension (44. 6% vs. 68. 5%; χ2 =9. 490, P=0. 002) and diabetes (5. 4% vs. 28. 1%; χ2 =14. 216, P<0. 001) in the patients of the low-dose group were significantly lower than those of the standard group, while the constituent ratios of smoking (56. 8% vs. 38. 2%; χ2 =5. 590, P=0. 018 ) and smal artery occlusive stroke (21. 6% vs. 10. 1%; χ2 =4. 122, P=0. 042 ) in patients of the low-dose group were significantly higher than those of the standard group. After adjusting for age, National Institutes of Health Stroke Scale (NIHSS) score, hypertension, diabetes, smoking, and ischemic stroke typing, multivariate binary logistic analysis showed that there were no significant differences in NINDS defined sICH (10. 8% vs. 9. 0%, odds ratio [OR] 1. 077, 95%confidence interval [CI] 0. 338-3. 436), ECASS Ⅱdefined sICH ( 9. 5% vs. 9. 0%; OR 0. 976, 95% CI 0. 296- 3. 221 ), SITS-MOST defined sICH (8. 1% vs. 4. 5%; OR 2. 269, 95% CI 0. 522-9. 852), 90 d mortality (17. 6% vs. 14. 6%; OR 1. 720, 95% CI 0. 578-5. 119), 90 d good outcome (35. 1% vs. 32. 6%;OR 0. 780, 95% CI 0. 356-1. 709), and life self-care ability (48. 6% vs. 42. 7%;OR 0. 936, 95% CI 0. 441-1. 987) between the 2 groups (al P>0. 05). Conclusions The program of intravenous thrombolysis for the treatment of Chinese patients with acute ischemic stroke with low-dose rtPA is safe and effective.