Objective To compare the effect of epidural anesthesia on vaginal total hysterectomy.Methods Eighty patients with vaginal total hysterectomy were selected and randomly divided into group Ⅰ(40 cases)and groupⅡ(40 cases).The patients of group Ⅰ were punctured with two-point method to the first tube of epidural in L1-2 and to the tail tube in L3-4 The patients of group Ⅱwere punctured with one-point method to the first tube of epidural in L2-3.Observed the level of anesthesia,induction period and anesthetic effect of all patients.Results The upper bound level of anesthesia was higher in group Ⅰthan that in group Ⅱ(P＜0.05),the induction period Wag shorter in group Ⅰthan that in groupⅡ(P＜0.05).The anesthetic effect Wag better in group Ⅰ(92.5%,37/40)than that in group Ⅱ(70.0%,28/40)(P＜0.05).There were significant difference in maintain time,dose of boost and total between group Ⅰand groupⅡ(P＜0.05).Conclusion Two-point method of epidural anesthesia is better for vaginal total hysterectomy,as it can provide rapidly and completely anesthetic effects.

Objective To explore the relationship between preoperative plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and recurrence of atrial fibrillation (AF) after cardiac valve replacement (CVR) combined with radiofrequency ablation.Methods Fifty-eight patients with AF undergoing CVR combined with radiofrequency modified Maze procedure were enrolled in this study.The patients were allocated to either AF recurrence group (AF group,18 cases) or AF no recurrence group (SR group,40 cases) according to whether patient's AF recurrence or not within 3 months after surgery.NT-proBNP were respectively measured in two groups in 1st day before operation and 9th day after operation by radioimmunoassay.Results All the 58 patients were involved in the final analysis.NT-proBNP levels in 1st day before operation and 9th day after operation in AF group was significantly higher than that in SR group (2061.30 ng/L vs.579.00 ng/L,996.60 ng/L vs.209.20 ng/L,P＜ 0.01 ).NT-proBNP levels in 1st day before operation in two groups was significantly higher than that in 9th day after operation (P ＜ 0.01 ).Conclusions There is a good relationship between preoperative plasma NT-proBNP levels and recurrence of AF.It has a clinical value in predicting of recurrence AF after CVR combined with radiofrequency modified Maze procedure.

In order to improve the accuracy of blood pressure measurement in wearable devices, this paper presents a method for detecting blood pressure based on multiple parameters of pulse wave. Based on regression analysis between blood pressure and the characteristic parameters of pulse wave, such as the pulse wave transit time (PWTT), cardiac output, coefficient of pulse wave, the average slope of the ascending branch, heart rate, etc. we established a model to calculate blood pressure. For overcoming the application deficiencies caused by measuring ECG in wearable device, such as replacing electrodes and ECG lead sets which are not convenient, we calculated the PWTT with heart sound as reference (PWTT(PCG)). We experimentally verified the detection of blood pressure based on PWTT(PCG) and based on multiple parameters of pulse wave. The experiment results showed that it was feasible to calculate the PWTT from PWTT(PCG). The mean measurement error of the systolic and diastolic blood pressure calculated by the model based on multiple parameters of pulse wave is 1.62 mm Hg and 1.12 mm Hg, increased by 57% and 53% compared to those of the model based on simple parameter. This method has more measurement accuracy.
Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Cardiac Output ; Electrocardiography ; Heart Rate ; Heart Sounds ; Humans ; Pulse Wave Analysis ; Regression Analysis

In order to understand the situation of schistosomiasis in Fujian Province, the surveillance and field survey data of 16 counties (cities or districts) were statistically analyzed from 2003 to 2008 according to the national and provincial surveillance protocols. The snail areas were 69 400 m~2 in 2003, and 506 700 m~2 in 2004, then decreased to 57 700 m~2 in 2008 after the snail control in 2005 and 2006. Serological examinations were conducted in 18 000 people, among which 5 412 people were the mobile population from schistosome-endemic areas, and 110 persons were positive, among which 8 persons had eggs and miracidia in their stools, among 7 885 appendix samples, Schistosoma japonicum eggs were found in 8 samples of the patients who came from the o-riginal endemic areas. By the stool examination, 2 709 head of farm cattle in the region with snails were not found infected with Schistosoma japonicum. It is suggested that the areas of residual snails are large and widespread, and the imported patients are found frequently, so the danger of schistosomisis transmission still remains.

Objective:To investigate the diagnosis and treatment of intravenous leiomyomatosis involving the heart.Methods:From March 2009 to December 2018, 5 patients with intravenous leiomyomatosis with cardiac involvement were collected from The First Hospital of Lanzhou University.All patients were admitted to the hospital as space occupying lesions of right atrium.The relevant data such as echocardiography, CT and MRI were recorded.The preoperative diagnosis, surgical methods and therapeutic effect of the patients were analyzed and summarized.Results:All the 5 patients were female with an average age of (45.8±2.2) years old.Their clinical manifestations were chest tightness and shortness of breath.Three patients had a history of giant hysteromyoma.Echocardiography was performed in all patients, and 3 of them obviously extended to the inferior chamber.Cardiopulmonary bypass was established and thoracoabdominal incision was performed, and the tumors were completely resected in 5 patients, and the origin of tumors was consistent with the result of MRI in 3 cases.The tumor originated from the right uterine vein in 3 cases, and 2 cases originated from the right ovarian vein and was intubated in the femoral vein.The operation was smooth and the postoperative recovery was good.All patients were discharged smoothly.No tumor recurrence was found in pelvic cavity, inferior vena cava and heart after 1 year follow-up.Conclusion:Venous leiomyomatosis involving the heart is rare and easy to be misdiagnosed.Most of them are diagnosed as right atrial space occupying lesions.The diagnosis can be improved by echocardiography, CT and MRI before operation.The operation mode should be adjusted according to the intraoperative findings and different origins, and the tumor should be completely removed as far as possible, and combined with gynecology consultation if necessary.The short-term follow-up showed good prognosis.

Objective:To understand the distribution characteristics of pulse oxygen saturation (SpO 2) in the high altitude areas. Methods:From September 2016 to December 2017, all healthy and full-term live births in the First Hospital of Lanzhou University and Dunhuang, Jiuquan, Jingning and Lintao branches were selected as the research objects.Critical congenital heart disease or pulmonary diseases were excluded in advance.SpO 2 in different parts of newborns within 12 hours of birth was measured.Statistical comparisons of SpO 2 in different parts of male and female neonates in the same area and SpO 2 in different parts of different regions were made.The number of SpO 2 and the distribution of percentile difference between the lower limbs and the right upper limb of newborns at different altitude areas were obtained. Results:There were no significant difference between male and female infants in SpO 2 value at any lo-wer extremity and right upper extremity and the difference value in the same area (all P>0.05). There were significant differences in the median ( M) values of SpO 2 and the M value of the difference between the two values of any lower limb and right upper limb at different altitudes (all P<0.05). The results showed that the M value of SpO 2 of the right upper limb ( M=96%) in Lanzhou (1 520 m above sea level) was lower than that in Dunhuang (1 138 m above sea level, M=97%) and Jiuquan (1 481 m above sea level, M=97%), and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan ( M=1%) ( P<0.05). The M of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Jingning areas (1 668 m above sea level) were lower than that in Dunhuang and Jiuquan area (all P<0.05). The median value of SpO 2 of any lower limb ( M=96%) and right upper limb ( M=96%) in Lintao area (1 883 m above sea level) was lower than that in Dunhuang and Jiuquan areas, and the M value of the difference between the two values ( M=2%) was higher than that in Dunhuang and Jiuquan (all P< 0.05). When the altitude was lower than 1 500 m, the M value of SpO 2 was 97%, P3- P97 was 93%-100%; the M value of the difference between any lower limb and right upper limb was 1, and P3- P97 was 0-4.When the altitude was higher than 1 500 m, the M value of SpO 2 was 95%-96%, P3- P97 was 89%-100%; the M value of SpO 2 of an lower limb and right upper limb was 1%-2%, and P3- P97 was 0-9%. Conclusions:The SpO 2 number and percentage distribution of the difference between any lower limb and right upper limb of newborns at different altitudes are different.