observation group than in the control group at T1 and T2 (P < 0.01). These findings indicate that dexmedetomidine for sedation after hip replacement can lessen inflammatory response and contribute to the recovery of hip function.

Objective To investigate the feasibility, safety and effect of gasless laparoscopic surgery in the treatment of benign ovarian tumors during pregnancy. Methods Clinical data of 45 pregnant women with benign ovary tumors undergoing gasless laparoscopic surgery from January 2006 to June 2013 were studied retrospectively.Most of the cases were given oophorocystectomy. Adnexectomy was performed for the large sized lesions, lacking of or remaining few normal ovarian tissue, or ovarian cyst torsion. Results All the 45 cases were successfully treated by gasless laparoscopic surgery.No perioperative and postoperative complications were observed.There were 42 cases receiving ovarian tumor resection while 3 cases receiving simple salpingo-oophorectomy.The mean operation time was (40.7 ±14.9) min (25-90 min), the mean blood loss was (27.3 ±16.6) ml (10 -80 ml), and the mean hospitalization time was (4.5 ±1.3) days (3-8 days).At pre-, peri-, and post-operative time, the blood pH value, blood pressure carbon dioxide (PaCO2), and blood oxygen partial pressure (PaO2) showed no statistical difference (F=0.00,P=0.999;F=2.21, P=0.114;F=0.60,P=0.555), and blood bicarbonate (HCO3-) and blood oxygen saturation (SpO2) showed statistical difference but no clinical significance (F=14.96,P=0.000;F=9.45,P=0.999), all of which were in the normal range.The fetal heart rates were all in the normal range.Pathological diagnoses were ovarian mature cystic teratoma in 25 cases (55.6%), serous cystadenoma in 6 cases (13.3%), mucinous cystadenoma in 4 cases (8.9%), mesosalpinx cyst in 3 cases (6.7%), endometrial cyst in 2 cases (4.4%), and luteal cyst in 5 cases (11.1%).No spontaneous abortion was found in post-operational follow-up.Term delivery was obtained in 43 cases, with normal fetal weight and the Apgar scores.Two cases gave up the pregnancy in the postoperative period. Conclusion Gasless laparoscopic surgery for benign ovarian tumors during pregnancy is safe and feasible.

OBJECTIVE:To discuss the effect of trastuzumab combined with chemotherapy on efficacy and serum tumor mark-ers in patients with human epidermal growth factor receptor 2(HER2)positive advanced gastric cancer. METHODS:74 advanced gastric cancer patients in HER2 positive were randomly divided into observation group and control group,37 cases in each group. Control group received cisplatin + capecitabine chemotherapy;based on it,observation group additionally received trastuzumab by intravenous infusion in the first day,8 mg/kg. 21 d was a course,and it lasted for 6 months. The short-term efficacy,long-term effi-cacy,serum tumor marker contents and toxic and side effects were compared between 2 groups. RESULTS:The effective rate (56.76% vs. 32.44%)and control rate(89.19% vs. 65.86%)in observation group were significantly higher than control group,the differences were statistically significant(P<0.05);progression-free survival time and median survival time in observation group sig-nificantly longer than control group,the differences were statistically significant(P<0.05);contents of serum carcinoembryonic anti-gen,carbohydrate antigen (CA)199,CA724 in observation group significantly lower than control group,the differences were statis-tically significant(P<0.05). And there were no significant differences in the incidences of nausea and vomiting,liver damage,bone marrow suppression and hand-foot syndrome in 2 groups (P>0.05). CONCLUSIONS:Trastuzumab combined with chemotherapy helps to reduce serum tumor markers content,and improve short-term efficacy,long-term efficacy of advanced gastric cancer patients with positive HER2.

ObjectiveTo observe the status and related factors of depression symptoms in elders.MethodsRandomized multi-stage sampling method was used to select subjects.504 elders ( aged ≥65 years) in Jining were investigated and assessed by using the scales of Geriatric Depression Scale15 ( GDS-15 ),Katz-activity of daily liying (Katz-ADL) and Lawton instrumental ADL (IADL).ResultsThe GDS scores of males (2.24 ±2.12 ) were significantly lower than that of females ( 3.35 ± 3.49) ( t '=4.236,P ＜ 0.01 ).There were significant differences in GDS scores among different subgroups of age,single or not,physical activity,sleep quality,self-reported health,living condition,economic status and lonely feeling.GDS scores were significantly correlated to lonely feeling,IADL,living condition,economic status,self-reported health and age (F =27.47,P ＜ 0.001 ; R2 =0.372,R'2 =0.358 ),with the total contribution of 35.8％.ConclusionAmong elders,the main factors influencing depression symptoms are lonely feeling,IADL,female,health condition,economic condition and single,respectively.Enhancing IADL of elders can contribute to reduce the risk factors of depression.

Objective To study the effectiveness and safety of combined laparoscopy and gonadotropin-releasing hormone agonist (GnRH-a) in the treatment of endometriosis (EM).Methods From January to December 2010,198 patients with EM undergoing treatment in Department of Obstetrics and Gynecology,Beijing Anzhen Hospital were randomly divided into three groups,which include 52 cases treated by only laparoscopy in laparoscopy group; 76 cases treated by laparoscopy combined with domestic Leuprolide acetate with dose of 3.75 mg every 28 days in Leuprolide acetate group; 70 cases treated by laparoscopy combined with imported Goserelin acetate with dose of 3.6 mg every 28 days in Goserelin acetate group.The efficacy,pregnancy rate and adverse reactions were compared among the three groups.Results Thirteen cases lost following up,including 3 cases in laparoscopy group,6 cases in Leuprolide acetate group and 4 cases in Goserelin acetate group.(1) Effective rates:effective rates were 47 ％ (23/49)in laparoscopy group,77％ (54/70)in Leuprolide acetate group and 74％ (49/66)in Goserelin acetate group.Compared with laparoscopy group,the effective rate of Leuprolide acetate group and Goserelin acetate group was significantly elevated (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(2) Recurrence rate:recurrence rate were 33％ (16/49) in laparoscopy group,13％ (9/70)in Leuprolide acetate group and 12％ (8/66)in Goserelin acetate group.Compared with laparoscopy group,the recurrence rate of Leuprolide acetate group and Goserelin acetate group was significantly declined (P ＜ 0.05).There was no statistically significant difference between Leuprolide acetate group and Goserelin acetate group (P ＞ 0.05).(3) Pregnancy rate:the number of patients require fertility were 28 cases in laparoscopy group,39 cases in Leuprolide acetate group and 35 cases in Goserelin acetate group.After 2 years follow up,pregnancy rate of 62％ (24/39) in Leuprolide acetate group and 60％ (21/35)in Goserelin acetate group were high than 39％ (11/28)in laparoscopy group significantly,which did not reached significant difference (P ＞ 0.05).(4) Adverse drug reaction:rates of a adverse reactions were 21％ (15/70) in Leuprolide acetate group and 20％ (13/66) in Goserelin acetate group,including irregular vaginal bleeding associated with low estrogen level.There was no significant difference in adverse reactions (P ＞ 0.05).Conclusions Compared with laparoscopy alone,laparoscopy combined with GnRH-a is more effective in treatment of,which exhibit lower recurrence rate,higher pregnancy rate and fewer adverse reactions.Domestic Leuprolide acetate have similar safety and efficacy compared with imported GnRH-a.

On the basis of ‘ cooperation between schools and hospitals’,teaching of specialized course of clinical medicine in the second academic year was arranged in affiliated hospitals and teaching hospitals.According to the teaching content and features of specialized courses,flexible teaching methods were adopted,including theoretical instruction,bedside teaching,case studies,situational teaching,integration of teaching,practicing and studying and clinical internships etc.Through selecting and training qualified teachers,establishing practical training base and strengthening teaching management and quality control,the quality of teaching was effectively guaranteed and satisfactory teaching effect was received.

Objective To investigate the possibility and surgical effect of simultaneous tympanoplasty to chronic suppurative otitis media in the period of infection. Methods Forty-eight cases (48 ears) with chronic suppurative otitis media in the period of infection (31 with cholesteatoma, 17 with caries) were underwent simultaneous Wullstein Ⅱ and Ⅲ tympanoplasty on the complete elimination of the lesions (typical or modified mastoidectomy). Results All eases had dry ears within 4-10 weeks with average of 7 weeks. The air-bone gap within 10 dB was in 11 eases, 15 to 20 dB in 25 cases, 25 to 30 dB in 9 eases, no change or worse in 3 eases. Conclusions Infection is not the absolute eontraindication to the tympanoplasty in treating chronic suppurative otitis media, Wullstein Ⅲ tympanoplasty plus mastoid cavity obliteration and eonchaplasty is a suitable choice to treating chronic suppurative otitis media on the complete elimination of lesions and reconstruction of the ventilation system among mastoid cavity, tympanum and eustachian. The malfunction of eustachian is the main eanse to failure of surgery.

Objective To evaluate the quality of life and influencing factors in patients with breast cancer after breast-conserving surgery, so as to provide theoretical support for preoperative health education and postoperative rehabilitative intervention for these patients. Methods 120 breast conserving surgery (BSC) and 140 modified radical mastectomy (MRM) patients were assessed with Functional Assessment of Cancer Therapy-Breast (FACT-B V4.0) one week after operation. Life quality was evaluated between the two groups, and the influencing factors were also analyzed. Results Postoperative breast cancer patients after breast conserving surgery were with good breast complementary attention, lower emotion state. The other scores of quality of life had no statistical difference. Influencing factors on the quality of life of breast cancer patients were anxiety state, relationship of family members, position of surgery and character type. Conclusions It suggests that nursing specialists should make out corresponding, scientific and reasonable nursing intervention schemes based on the characteristics of different groups of people to ease psychological burden, and elevate the quality of life effectively for postoperative breast conserving surgery patients.

Objective To investigate the influence of severity of obstructive sleep apnea hypopnea syndrome (OSAHS)on acute ST -segment elevation myocardial infarction (STEMI).Methods 86 STEMI patients were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).Clinical data about biochemical index,cardiac function index and the duration of STEMI onset were compared between OSAHS group and control group.Logistic statistic analysis was used to investigate the risk factors that influ-ence the circadian rhythm of onset in STEMI.Results A total of 86 patients met the inclusion criteria,they were divided into two groups,STEMI with OSAHS(OSAHS group,n=38)and STEMI without OSAHS(control group,n=48).The incidence rate of STEMI onset during 0600 am~1 159 am was significantly higher in OSAHS group compared to control group(20.8% vs.44.7%,χ2 =5.626,P=0.018).This variation was weaken in mild OSAHS group compared to moderate-severe OSAHS group(20.8% vs.31.3%,χ2 =0.726,P=0.394;20.8% vs.54.5%,χ2 =7.956,P=0.005).Multivariate logistic analysis showed that the severity of OSAHS was a risk factor to the STEMI onset during 0600 am~1159 am(OR=2.458,95%CI 1.110~5.439,P=0.027).Conclusion The severity of OSAHS significantly increases the STEMI onset during 0600 am~1 159 am.

Objective To evaluate the clinical effect of therapy of the trisacryl gelatin microspheres combinee the gelatin sponge particle on embolize the bronchial artery in acute massive hemoptic patients. Methods One huneree cases with massive hemoptysis were selectee as our subjects ane eivieee into control ane research group(n = 50 for each group). Patients in control group were given only gelatin sponge particle,ane in research group were given the trisacryl gelatin microspheres combinee the gelatin sponge particle to embolize the bronchial artery. All cases were followee up for more than 12 months. Ane the effect of therapy was recoreee. Results In research group,42 cases(84. 0% ,42 / 50)were got the bleeeing stop immeeiately after embolization,7 cases in 72 h(14. 0% ,7 / 50),ane the effective rate of hemostasis was 98. 0%(49 / 50). In the control group,41 case(82. 0% ,41 / 50)were got the stop bleeeing immeeiately,8 cases in 72 h(16. 0% , 8 / 50),ane the effective rate of hemostasis was 98. 0%(49 / 50). There was no statistic eifference between two groups(P > 0. 05). After more than one year follow-up,3 cases(6. 12% )were reoccurree in the therapy group ane 15 cases(30. 61% )was in the control group. The eifference was significant between two groups after surgery for one year( χ2 = 9. 801,P < 0. 01 ). There was no serious complication in patients of two groups. Conclusion The operation of BAE is effective therapy for the massive hemoptoe,ane it is provee to be a safe,effective ane lower rate of recurrence approach of the trisacryl gelatin microspheres combinee the gelatin sponge particle for eouble embolzation the bronchial artery.