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

Objective To evaluate the predictive performance of the target controlled infusion (TCI) system for propofol using Marsh pharmacokinetic parameters in the elderly patients. Methods Sixteen ASA grade I - Ⅱ patients of both sexes (9 male, 7 female) aged 65-75 yr weighing 49-76 kg scheduled for elective lower abdominal surgery were enrolled in this study. The patients were unpremedicated. Right internal jugular vein was cannulated for drug and fluid administration and left radial artery was cannulated for BP monitoring and blood sampling. Anesthesia was induced with TCI propofol (target plasma concentration was set at 3 ?g?ml-1 ) and TCI fentanyl (target plasma concentration set at 2 ng?ml-1 ) . Tracheal intubation was facilitated with succinyl choline 1.5mg?kg-1 . The patients were mechanically ventilated ( VT 8 ml?kg-1 , RR 10 bpm) . Anesthesia was maintained with TCI propofol and fenlanyl and intermittent i.v. boluses of vecuronium. The target plasma concentration of propofol and fentanyl were the same as that for induction. MAP, HR, SpO2 and BIS were continuously monitored during operation. Blood samples were taken at 5, 10, 15, 20, 30, 45, 60, 90, 120 min during TCI of propofol for determination of plasma propofol concentration with HPLC. The predictive performance was evaluated by PE% [measured concentration (Cm) - predicted concentration (Cp)] /Cp ? 100% , MDPE, MDAPE and wobble. Results BIS was maintained between 38-55. The MDPE was 6%, MDAPE 14% and wobble 18 % with this TCI system incorporating Marsh pharmacokinetic parameters for propofol. Conclusion The TCI system incorporating Marsh pharmacokinetic parameters for propofol is acceptable for elderly 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.

Objective To investigate the effect of electroacupuncture (EA) on oocyte quality in patients with polycystic ovary syndrome (PCOS) undergoing in-vitro-fertilization and embryo transfer (IVF-ET).Method Totally 217 patients with PCOS undergoing IVF-ET were randomized into two groups by the random number table, 119 patients in an EA group and 98 in a control group. In addition to the long-term ovarian hyperstimulation given to the two groups, electroacupuncture was involved in the intervention in the EA group. The spindle, quality of eggs, and pregnancy result were observed and compared.Result The high-quality embryo rate was significantly higher in the EA group than the control group (P<0.05), and compared to the control group, the pregnancy rate was 8.36% higher in the EA group; it’s found that the number of eggs with spindle located between 11 and 1 o’clock was in a significant positive correlation with the level of E2 on the HCG administration day and the high-quality embryo rate (P<0.01); the EA group had a markedly higher ratio of eggs with spindle located between 11 and 1 o’clock compared to the control group (P<0.05); electroacupuncture markedly reduced the dosage and duration of using Gn in the PCOS patients (P<0.05). Conclusion It’s proven the relation between spindle and the quality of eggs; electroacupuncture can enhance the quality of eggs and the pregnancy rate in the PCOS patients.

OBJECTIVETo explore efficacy enhancing and detoxification roles of Jiedu Quyu Zishen Recipe (JQZR) in treating systemic lupus erythematosus (SLE) by studying its effect on Toll like receptor 9 (TLR9) signal pathway of murine macrophage cells after JQZR stimulated CpG oligodeoxynucletide (CpG ODN).

METHODSMurine macrophage cells in vitro cultured were randomly divided into 4 groups, i.e., the blank serum group, the CpG ODN stimulus group, the CpG ODN + dexamethasone group, the CpG ODN + medicated serum group. Murine macrophage cells were collected after 24-h intervention. The expression of TLR9, myeloid differentiation factor 88 (MyD88), NF-KB, IFN-α mRNA were analyzed by RT-PCR. The expression of TLR9 and NF-κB protein were analyzed by Western blot. Changes of the NF-KB transcriptional activity were assayed by Dual-Luciferase reporter assay system.

RESULTSmRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were enhanced, showing statistical difference when compared with those of the blank serum group (P <0. 05, P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of MyD88, NF-κB, and IFN-α, the protein expression of NF-κB and the NF-κB transcriptional activities decreased in the CpG ODN + dexamethasone group with statistical difference (P <0. 01). Compared with the CpG ODN stimulus group, mRNA expressions of TLR9, MyD88, NF-κB, and IFN-α, protein expressions of TLR9 and NF-κB, and NF-κB transcriptional activities were decreased in CpG ODN+ medicated serum group with statistical difference (P <0. 01).

CONCLUSIONEfficacy enhancing and detoxification roles of JQZR in treatment of SLE might be realized through regulating TLR9 signal pathways.

Animals ; Cell Line ; Drugs, Chinese Herbal ; pharmacology ; Humans ; Macrophages ; metabolism ; Mice ; Myeloid Differentiation Factor 88 ; NF-kappa B ; RNA, Messenger ; Signal Transduction ; Toll-Like Receptor 9 ; metabolism

OBJECTIVETo observe the effect of electro-acupuncture (EA) treatment on the oocyte quality in polycystic ovarian syndrome (PCOS) patients undergoing in vitro fertilization-embryo transfer (IVF-ET).

METHODSTotally 217 PCOS patients undergoing IVF-ET were assigned to two groups by random digit table, the EA group (119 cases) and the control group (98 cases). All patients received long program ovarian hyperstimulation with gonadotropin-releasing hormone agonist. Patients in the EA group received EA treatment in the process of controlled ovarian hyperstimulation till the oocyte retrieval day. The position relation of the spindle to the polocyte, the number of retrieved oocytes, the fertilization rate,the cleavage rate,the high quality embryo rate, the ovarian hyperstimulation syndrome (OHSS) incidence rate, the clinical pregnancy rate, the early abortion rate, the gonadotropins (Gn) dose and time, levels of estradiol (E2), progesterone (P), and luteinizing hormone (LH) on the day of human chorionic gonadotropin (HCG) were observed between the two groups.

RESULTSThe ratio of oocytes in which the meiotic spindle deviation angle was < 60 degrees to the all oocytes was obviously higher in the EA group than in the control group (P < 0.05). The oocytes in which the meiotic spindle deviation angle was < 60 degrees was positively related to level of E2 on the HCG day and the high quality embryo rate (r = 0.19,P < 0.01). Compared with the control group, the high quality embryo rate increased significantly (P < 0.05), the dose and days of Gn decreased significantly (P < 0.05) in the EA group. The clinical pregnancy rate was improved by 8.36%.

CONCLUSIONSThe spindle was positively correlated with the oocyte quality. EA could improve the quality of oocytes and the clinical pregnancy rate in PCOS patients undergoing IVF-ET.

Acupuncture Therapy ; methods ; Embryo Transfer ; Estradiol ; Female ; Fertilization in Vitro ; Gonadotropin-Releasing Hormone ; Gonadotropins ; Humans ; Luteinizing Hormone ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Polycystic Ovary Syndrome ; therapy ; Pregnancy ; Pregnancy Rate ; Progesterone

Purpose To investigate the clinicopathlogical characteristics, diagnosis and differential diagnosis of ovarian small cell car-cinoma hypercalcemic type ( OSCCHT) associated with acute renal dysfunction. Methods A case of OSCCHT associated with acute renal dysfunction was reported. The clinical and pathologic data, treatment and pathological examinations were analyzed and the related literatures were reviewed. Results A 29-year-olds women was presented to hospital with inappetence and significant weight loss for 2 months. The laboratory examination showed abnormal renal function, and pelvic cavity mass, possibly coming from adnexa of the uterus was seen by radiography. Serum levels showed significantly increased serum calcium with acute renal dysfunction. An emergency opera-tion was performed just after renal function partially recovered by 2 times hemodialysis. During surgery, right ovary tumor with a size of 12 cm × 10 cm × 10 cm was inspected. Microscopically, the tumor cells were arranged in a diffuse solid pattern, mutiple nodules were separated by fibrous tissue. some small folliculars and pseudoglandular cavities with acidophilia secretion within nodules could been ob-served. Tumor cells were medium to large with eosinophilic cytoplasm, round or oval vesicular nucleus, increased karyoplasmic ratio and pathologic mitosis. Immunohistochemistry revealed that the tumor cells expressed EMA, CKpan, C-erbB-2 ( +) , CA125 ( focal+) and Ki-67 proliferation index was about 60%, while ER, PR, Syn, CgA, PTH, Inhibin, CD99, AFP, PLAP, CD30 and CD20 were not expressed. Conclusion Ovarian small cell carcinoma hypercalcemic type with acute renal dysfunction is a very rare with a rapidly progressive and highly malignant tumor. The final diagnosis mainly lies on clinical information ( hypercalcaemia) , morphology and immunohistochemistry, combined with electron microscopy and molecular biological detection when necessary.

Background Trachoma is a common disease in ophthalmology,but few reports about the pathogenetic genotype are reported.Objective This study was to investigate the genotypes of Chlamydia trachomatis.Methods Conjunctival specimens were collected in 16 patients with trachoma in Beijing Tongren Eye Center from January,2003 and August,2006.Variable sequence 4 (VS4) of ompl fragment was amplified by nested PCR(n-PCR) using specific primer of Chlamydia trachomatis,and then the PCR products were sequenced.The DNA sequences were analyzed by software Clustal X and MEGA2,and the genetic characteristics were compared with the known sequences of GenBank.Results The PCR product fragment of MOMP gene of trachoma was 277 bp.Three types of Chlamydia trachomatis strains were idcntified in the 16 specimens,including B-genotype in 9 strains (56.3％),C-genotype in 4 strains(25.0％) and D-genotype in 3 strains(18.7％).High homology was seen in the gene sequences of Chlamydia trachomatis strains between the B-genotype or C-genotype strains and the same genotypes of GenBank or those from some districts of China.However,some differences were exhibited among the Dgenotype strains.Conclusions Identification of genotype of Chlamydia trachomatis has differential effect on trachoma and inclusion conjunctivitis.

OBJECTIVETo evaluate the prognostic factors of ureter transitional cell carcinoma (TCC).

METHODSBetween January 2001 and December 2005 133 TCC patients were treated. And the data was retrospectively analyzed.

RESULTSA mean age of the 133 patients was 68 years (range 43 - 87 years) at diagnosis. Altogether the non-invasive ureter TCC was found in 42 patients (31.6%) and the invasive ureter TCC in 91 patients (68.4%). Invasive ureter TCC growth was more common in distally located tumors (82.5%) compared to mid (62.5%) and proximal ureter (47.1%). Tumor stage, grade and location of the tumor were all correlated with disease specific survival in a univariate analysis. In a multivariate Cox analysis, tumor stage and grade were significantly associated with disease specific survival.

CONCLUSIONSMore invasive tumors are found in ureter than in bladder. Ureter cancer is more frequently found in the distal part. Distally located ureteral tumors are more likely invading into the muscular cell layers compared to proximally located tumors. Tumor stage and grade are still the more important prognostic factors for ureter TCC.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Transitional Cell ; pathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Survival Analysis ; Ureteral Neoplasms ; pathology ; surgery