Objective To explore the feasibility of classical intrafascial supracervical hysterectomy (CISH). Methods Clinical data of 65 cases of classical intrafascial supracervical hysterectomy were reviewed. Results The classical intrafascial supracervical hysterectomy was accomplished under laparoscope in all the 65 cases. The operation time was 110 7?29 9 min, and the intraoperative blood loss was 45 3?22 1 ml. No conversion to open surgery was required. No severe complication occurred. Conclusions Classical intrafascial supracervical hysterectomy demonstrates excellent safety, minimal invasion, less blood loss, and quick recovery to normal activities. Laparoscopy; Classical intrafascial supracervical hysterectomy

Objective:In the clinical mechanical ventilation practice, the medical workers often set the ventilator parameters only depend on their own experience. In order to change that,we design a Closed-Loop Automatic Mechanical Ventilation Controller.Methods: Design two closed-loop control subsystems to meet the requirements of closed-loop control system. PETCO2 control subsystem used to keep the concentration of PETCO2, and another subsystem design to regulate the respiratory elasticity called PEEP control subsystem. PETCO2 control subsystem can work on its own or work with PEEP control subsystem.Results: Using this closed-loop controller, the partial CO2 pressure and respiratory elasticity of patient was regulated in real time.Conclusion:By using this closed-loop automatic mechanical ventilation controller, the respiratory elasticity was largely reduced with the adequate gas exchange. Therefore, the ventilator using this closed-loop automatic mechanical ventilation controller can improve the ventilation quality and also reduce the risk of lung injury.

In this study, a closed-loop controller for chest compression which adjusts chest compression depth according to the coronary perfusion pressure (CPP) was proposed. An effective and personalized chest compression method for automatic mechanical compression devices was provided, and the traditional and uniform chest compression standard neglecting individual difference was improved. This study rebuilds Charles F. Babbs human circulation model with CPP simulation module and proposes a closed-loop controller based on a fuzzy control algorithm. The performance of the fuzzy controller was evaluated and compared to that of a traditional PID controller in computer simulation studies. The simulation results demonstrated that the fuzzy closed-loop controller produced shorter regulation time, fewer oscillations and smaller overshoot than those of the traditional PID controller and outperforms the traditional PID controller in CPP regulation and maintenance.
Algorithms ; Arterial Pressure ; Cardiopulmonary Resuscitation ; instrumentation ; Computer Simulation ; Coronary Vessels ; physiopathology ; Humans ; Models, Theoretical ; Perfusion ; Thorax

OBJECTIVE: To investigate the analeptic action of Xingnaojing injection(XNJI) in patients undergoing total intravenous anesthesia and the possible mechanism.METHODS: 60 patients undergoing selective abdominal operation with tracheal intubation(scored grade Ⅰ or grade Ⅱ using ASA score) were transferred to post-anesthctic ICU(PACU) after surgery and randomly divided into two groups of 30 each: X group(XNJI 0.5 mL?kg-1) and C group(control group).The X group received XNJI(0.5 mL?kg-1) by drip infusion within 10 minutes,while C group received same amount of normal saline.The vocal reaction recovery time,autonomous breath recovery time,extubation time and duration of PACU stay were recorded.The mean arterial pressure(MAP),heart rate(HR),the concentrations of Epinephrine(E),and Norepinephrine(NE) and ?-endorphin(?-EP) in arterial blood were detected at 0,5,15,30 and 45 minutes before and after medication.RESULTS: No significant differences were noted for X group in hemodynamics parameters after medication as compared with before medication,but significant differences were noted for C group at 30 min and 45 min when compared with before medication or compared with X group at the same different time points.The vocal reaction recovery time,autonomous breath recovery time,extubation time and the duration of PACU stay were all significantly shorter in X group than in C group(P

Mucin as an important member in gastrointestinal mucus layer has become the focus of research. Many studies suggested that MUC1 mucin is involved in the mechanism of Helicobacter pylori( Hp)infection. It is important to understand the relationship between MUC1 mucin and Hp for preventing Hp infection and gastric cancer. This article reviewed the relationship between MUC1 mucin and Hp.

Objective To investigate the expression and function of transforming growth factor (TGF)-β1 and Smad2 in liver fibrosis of biliary atresia (BA). Methods Liver biopsy specimens were collected from autopsy (normal group, n=5), congenital biliary dilatation (CBD group, n=10), BA patients underwent Kasai procedure (early hepatic fibrosis group, n=19) and liver transplantation (transplantation group, n=11). The first three groups were collected from January 2010 to July 2014 in Tianjin Children’s Hospital, and the last group was collected from January 2013 to January 2014 in Tianjin First Central Hospital. The hematoxylin and eosin (HE) stain were used to observe the degree of liver fibrosis of four groups. Immunohistochemistry (IHC) was used to observe expressions of TGF-β1 and Smad2 in liver tissues of these samples. Quantitative real-time polymerase chain reaction (qRT-PCR) was used to test the quantitative mRNA of TGF-β1 and Smad2 in these samples. Results Results of HE showed that no fibrosis in autopsy group, mild fiber cell hyperplasia in CBD group, severe fibrosis in Kasai group and significant pseudolobule in transplantation group. Results of IHC showed that TGF-β1 was expressed in the cytoplasm of hepatocytes, bile duct cells, lymphocytes and neutrophils. The average optical density of TGF-β1 was the highest in Kasai group compared with that of other three groups (P < 0.05). There was no significant difference in Smad2 expression in cytoplasm of hepatocytes, bile duct cells and lymphocytes between four groups (P>0.05). Results of qRT-PCR showed that both TGF-β1 mRNA and Smad2 mRNA were the highest in early hepatic fibrosis group than those of CBD group and transplantation group (P<0.017). Conclusion In early stage of BA, TGF-β1 and Smad2 promote liver fibrosis until the formation of P-P,P-C desmosome structure. However, with BA fibrosis becomes more serious, the pro-fibrogenic function of TGF-β1 and Smad2 becomes less.

Objective To investigate the association of the expression level of anti-apoptosis protein p-AKT and gastric mucasal injury induced by indomethacin in mice.Methods The cytotoxicity induced by indomethacin was measured by LDH assay.The p-AKT expression levels were measured in the gastric mucosal tissues from C57BL/6 mice and rat gastric mucosal (RGM-1) cell lines treated with indomethacin lay western blotting.Results The cytotoxicity induced by indomethacin was in a dose dependent manner.Compared with the control,a typical histological appearance of gastric ulcer was observed in the gastric mucosa of in domethacin-administered mice;p-AKT protein expression in the gastric mucosa of mice and RGM-1 cell lines was decreased after treated with indomethacin.Conclusion The reduction of Anfi-apoptesis protein p-AKT expression may be a new mechanism for the gastric mucosal injury induced by indomethacin.

The disease incidence of aortic dissecting aneurysm showed an increasing tendency.Recently,the clinical application of endovascular stent-graft implantation received good results in treating aortic dissecting aneurysm,which is characterized by minimally invasive,safe,with high success rates.However,the chosen of anesthesia is still in dispute.Local anesthesia,intraspinal anesthesia and general anesthesia can be used in this operation.The investigation demonstrated that intubation general anesthesia is more security in this operation with less complication,which is conductive to controlling blood pressure and braking conditions.

bjective To clarify the heart rate variability (HRV) changes in patients subjected to deliberate hypotension with alprostadil.Methods Eighty-six elderly patients scheduled for nasal endoscopic surgery in general anesthesia were divided into alprostadil group (group A) and nitroglycerin group (group N) with 43 cases each by random digits table.Hypotension was induced with alprostadil and nitroglycerin through continuous infusion respectively,and the mean arterial pressure (MAP) was reduced to about 25％-30％ of baseline MAP.The MAP,heart rate (HR),total power ( TP ),low frequency (LF),high frequency (HF),and LF/HF were continuously monitored and blood was taken for analysis of lactate (LAC) before deliberate hypotension (T0),at the time of dropping to target blood pressure (T1),at 5 and 30 min after deliberate hypotension (T2 and T3),stopping deliberate hypotersion (T4) and 30 min after recovery from hypotension (T5).Results HR at T1-T4 was faster than that at T0in group N(P ＜ 0.05),and faster than that in group A( P ＜ 0.05 ),HR at T5 was faster than that at T0 in group N( P ＜ 0.05 ),but HR was stable at T1-T5 in group A (P ＞ 0.05 ).There was no significant difference in LAC of group A and group N whether in interior group or between two groups (P＞ 0.05).TP,LF and HF at T1-T4 were lower than those at T0 in two groups ( P ＜ 0.05 ),HF at T1-T4 was higher in group A than that in group N(P ＜ 0.05 ) ; LF/HF was no change at T1-T4 compared with that at T0 in group A (P ＞ 0.05),but increased in group N (P ＜ 0.05 ) which was higher than that in group A at the same time ( P ＜ 0.05 ) ;TP,LF and HF was recovered at Ts in two groups,and HF at T5 in group A was higher than that in group N( P ＜ 0.05 ) ; LF/HF at T5 in group A maintained the level at T0,but decreased in group N and lower than that at T5 in group N(P ＜ 0.05).Conclusion Alprostadil for deliberate hypotension is more likely to maintain cardiac autonomic nerve balance that is helpful for perioperative security of elderly patients.

OBJECTIVETo evaluate the effect of colonic J-pouch coloanal anastomosis after low anterior resection for mid or low rectal cancer on improving defecation and anorectal physiology.

METHODSTo make a meta-analysis, prospective randomized controlled trial of with or without colonic J-pouch after low anterior resection for mid or low rectal cancer was conducted. The key words included rectal cancer, J-pouch (or J-pouch) and those randomized from selected reports. The data on bowel function and physiological function of the anal canal and (neo) rectum were meta-analyzed using fixed effect model and random effect model.

RESULTSEight randomized trails including 378 patients entered this study. After one year follow-up, the functional results showed that there were significant differences in stool frequency per day, urgency and use of medication between colonic J-pouch group and straight coloanal anastomosis group. On physiological function of the anal canal and (neo) rectum, there was significant difference only in rectal compliance between the two groups. But there was no significant difference in other 4 items.

CONCLUSIONSThe functional improvement gained from colonic J-pouch coloanal anastomosis continues to benefit the patient with mid or low rectal cancer for at least 12 months. It is necessary to further study about the effect of colonic J-pouch coloanal anastomosis on physiological function of the anal canal and (neo) rectum.

Adult ; Aged ; Aged, 80 and over ; Anal Canal ; surgery ; Anastomosis, Surgical ; methods ; Colonic Pouches ; Female ; Humans ; Male ; Middle Aged ; Randomized Controlled Trials as Topic ; Rectal Neoplasms ; surgery ; Rectum ; surgery ; Treatment Outcome