Objective To observe oxygenation status when different modes of mechanical ventilation were actualized during laparoscopic operations in obese patients. Methods Sixty obese patients for laparoscopy were divided into three groups with 20 patients in each group, receiving volume controlled ventilation (VCV Group), or pressure controlled ventilation (PCV Group), or pressure controlled ventilation with positive end-expiratory pressure (PCV+PEEP Group). Levels of pH value, PCO_2, PO_2/FiO_2, and Qs/Qt were measured at 30 min after pneumoperitoneum (T1), 60 min after pneumoperitoneum (T2), 30 min after extubation (T3), and 60 min after extubation (T4), respectively. Results The oxygenation index was significantly higher in the PCV+PEEP Group at T1 (429.35?51.88) and T4 (231.87?20.47) than in the VCV Group at T1 (346.15?54.48; q=6.771, P

Objective To investigate effects of three types of mechanical ventilation on oxygenation status in laparoscopic gastric banding for the treatment of morbid obesity.Methods Twenty-four morbidly obese patients scheduled for laparoscopic gastric banding were divided into three groups.The Group A was given a tidal volume of 12 ml/kg and a respiratory rate of 10 times/min,the Group B,a tidal volume of 20 ml/kg and a respiratory rate of 10 times/min,and the Group C,a tidal volume of 12 ml/kg and a respiratory rate of 20 times/min,respectively.The measurement of arterial blood for pH value,PO2,PCO2,Plat Pressure,Peak Pressure,and AaDO2 was conducted before(T1) and after pneumoperitoneum(T2). Results After pneumoperitoneum,the Group B had significantly higher Plat Pressure(33.2?1.8 cm H2O) and Peak Pressure(36.3?1.6 cm H2O) than the Group A(Plat Pressure: 29.5?3.9 cm H2O,q=3.053,P

The outstanding progress in the molecular basis of thyroid carcinoma has offered a tool for the development of new drugs,mainly tyrosine kinase inhibitors (TKIs).A number of TKIs are now being applied to the treatment of thyroid carcinomas.Recent clinical trials of TKIs in patients with advanced thyroid cancer have shown some promising preliminary results.This review summarizes the most relevant achievements in the field and the challenges we are facing.

Objective To explore the analgesic effect of ropivacaine and flurbiprofen for patients with secondary upper extremity lymphedema after lymphatic venous anastomosis . Methods A total of 45 cases of lymphatic venous anastomosis under general anesthesia between October 2014 and March 2016 were randomly allocated to 3 groups: ropivacaine group ( group R ) , flurbiprofen preprocessing group (group F1), and flurbiprofen postprocessing group (group F2), with 15 cases in each group.Local infiltration anesthesia was made with 0.2% ropivacaine 10 ml at the incision before the end of operation in the group R .The flurbiprofen 100 mg was intravenously injected at 5 minutes before the induction of anaesthesia in the group F 1 and 5 minutes before the end of operation in the group F 2 .The visual analogue scale ( VAS) scores and the number of patients using analgesics after operation at 1, 2, 6, 12, 24 and 48 h were recorded. Results The rest pain and movement pain VAS scores at postoperative 2 h were lower in the group R than those in the group F1 and F2[rest pain:(3.4 ±0.7) points vs.(4.2 ±0.9) points vs.(4.1 ±1.0) points, F=3.741, P=0.032;movement pain:(3.7 ±0.6) points vs.(4.6 ±0.9) points vs.(4.4 ±1.0) points, F=4.305, P=0.020]. The rest pain VAS scores at postoperative 6 h were lower in the group R than those in the group F 1 and F2 [(2.7 ±0.5) points vs. (3.4 ±0.5) points vs.(3.1 ±0.6) points, F=5.783, P=0.006].The number of patients requiring analgetics was lower in the group R than that in the group F1 and F2 at postoperative 2 h (1 case vs.7 cases vs.5 cases,χ2 =6.058, P=0.048). Conclusion Local anesthesia with ropivacaine in patients after lymphatic venous anastomosis can achieve good postoperative analgesia .

Objective To evaluate the application of capsaicin to improve bladder stability after suprapubic prostatectomy for BPH. Methods 40 patients with BPH underwent suprapubic prostatectomy under epidural anesthesia were randomly divided into A?B?C and D groups (n=10 in each group).Capsaicin of 1 mmol/L was instilled into the bladder preoperatively for 30 minutes in group B and group D had 10 ml of 1 mmol/L capsaicin given epidurally.Group A and Group C received saline only. Results The bladder instability was lessened.The time of bladder perfusion clearance,indwelling catheter delivery,duration of cystospasm and number of postoperative cystospasm cases in group B and D reduced significantly as compared with group A and C.The Pdet and volume were improved significantly,the Qmax and residual urine were also improved. Conclusions The intravesical and epidural capsaicin delivery helps to prevent detrusor instability and reduces the pain caused by postoperative cystospasm.It also improves the bladder function deteriorated by BPH.

OBJECTIVETo evaluate the clinical effects of short-segment transpedicular fixation and vertebroplasty via paraspinal intermuscular approach in treating thoracolumbar fractures.

METHODSFrom January 2009 to January 2012,18 patients with thoracolumbar fractures without neurological symptoms were treated with short-segment transpedicular fixation and vertebroplasty via paraspinal intermuscular approach. There were 11 males and 7 females, aged from 52 to 76 years old with an average of 62.2 years. The duration from injuries to surgery ranged from 8 h to 7 d with an average of 4.2 d. According to the Denis fracture classification, 12 cases got compression fractures and 6 cases got burst fractures.

LOCATION6 vertebra with T12, 9 with L1, 6 with L2, and 3 with L3. Anterior vertebral body height, the sagittal Cobb angle, the sagittal index (SI), condition of internal fixation failure and recurrent kyphosis were observed.

RESULTSAll patients were followed up for 12-28 months with an average of 16.5 months. Operation time was from 80 to 130 min with a mean of 95 min and bleeding volume during operation ranged from 100 to 180 ml with a mean of 145 ml. Anterior vertebral body height ratios preoperation, 3 days after operation and final follow-up was 54.3 +/- 2.8, 90.9 +/- 1.5, 88.6 +/- 1.7, respectively; sagittal Cobb angle was (27.8 +/- 2.5) degrees, (5.3 +/- 0.8) degrees, (6.3 +/- 1.4) degrees, respectively; sagittal index was 52.3 +/- 3.8, 89.2 +/- 5.2, 86.4 +/- 4.5, respectively. Data obtained 3 days after operation obviously improved than preoperation, and there was no statistically significant difference between 3 days after operation and last follow-up. No internal fixation failure, neurological complications and recurrent kyphosis were found.

CONCLUSIONTreatment of thoracolumbar fractures with short-segment transpediclar screw fixation and vertebroplasty via paraspinal intermuscular approach can retain the posterior ligament complex and restore the mechanical strength of the anterocentral column,which proved an ideal method for preventing the failure of internal fixation and reduction of post-traumatic segmental kyphosis.

Aged ; Bone Screws ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery ; Vertebroplasty ; methods

Humans ; Lymphocytes ; cytology ; drug effects ; Micronucleus Tests ; Occupational Exposure ; prevention & control ; Polycyclic Aromatic Hydrocarbons ; toxicity ; Population Surveillance ; methods

0.05).Conclusion The propofol TCI system can be safely used in surgical operation for patients with lymphedema.

Objective To examine the association of pro-hepcidin with iron metabolism and inflammation in maintenance hemodialysis (MHD) patients with erythropoietin (EPO) resistance.Methods Forty MHD patients and twenty healthy controls were enrolled in the study.Among MHD patients,20 were hyporesponsive to EPO therapy and 20 were normal responsive to EPO therapy.Complete blood red cell count (RBC),Hb concentration,hematocrit (Hct),reticulocyte count (Ret),and serum ferritin (SF),serum iron (Fe),total ironbinding capacity (TIBC),saturation rate of transferrin (TSAT),transferrin (TF),hyper-sensitive C-reactive protein (hs-CRP),pro-hepcidin were measured in all the patients and controls.Differences were compared between groups.Influencing factors were analyzed by Pearson correlation.Predicting value of pro-hepcidin was investigated by ROC curve.Results Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in MHD patients than those in healthy controls (P＜0.01),while serum TF was lower in MHD patients (P＜0.05).Serum levels of SF,pro-hepcidin and hs-CRP were significantly higher in EPO resistant patients as compared to normal responsive cases (P＜0.01).Serum prohepcidin level was positively correlated with SF (r=0.843,P=0.000) and hs-CRP (r=0.695,P=0.001).In predicting EPO resistance,area under ROC curve of pro-hepcidin,SF and hs-CRP was 0.713,0.769 and 0.958 respectively.Conclusions EPO resistance is correlated with inflammation and iron metabolism.Serum pro-hepcidin,SF and hs-CRP may be used as markers of EPO resistance in MHD patients.

Objective To analyze effects of different anesthesia procedures on heart rate variability(HRV) as an index of autonomic nervous activity and hemodynamics during CO2 pneumoperitoneum pressure in laparoscopic cholecystectomy(LC).Methods 45 patients of ASA I or II phage scheduled for LC were divided into general anesthesia group(Group I,Control Group),general anesthesia combined with esmolol group(Group II) and general anesthesia combined with epidural block group(Group III) according to operation date.HRV,HR and MAP were measured before anesthesia(T1),before pneumoperitoneum(T2) and at 5 min(T3),10 min(T4),20 min(T5),30 min(T6) after pneumoperitoneum.Results As compared with pre-pneumoperitoneum(T2),low frequency(LF),low frequency/high frequency(LF/HF) in the Group I increased significantly(P0.05).Comparisons among the three groups,LF,LF/HF in the Group I at all time points after pneumoperitoneum were significantly higher than those in the II and III Group(P0.05).Conclusions Esmolol can relieve stress reaction induced by pneumoperitoneum,but it can't completely block increasing of sympathetic nerve activity;using general anesthesia combined with epidural block in LC can inhibit sympathetic nerve excitation,sustain automatic never stability.