Objective To investigate the effects of epidural anesthesia on blood glucose and hemodynamics in patients undergoing gynecological laparoscopic surgery .Methods 108 cases undergoing laparoscopic gynecology surgery in our hospital from January 2012 to January 2014 were randomized into the observation group and control group equally .The observation group was treated by epidural anesthesia for surgery , while the control group was trea-ted by general anesthesia .The hemodynamics and blood glucose in the two groups were compared before anesthesia , after pneumoperitoneum and surgery .The operative time , blood loss during operation , volume of fluid infusion and pneumoperitoneum time were recorded .Results The operative time , blood loss during operation , volume of fluid in-fusion and pneumoperitoneum time had no significant differences between the two groups (p>0.05).The heart rate in the observation group was significantly higher than that in the control group at the time point of 5 min after pneumo-peritoneum.The blood pressure in the observation group was significantly lower than that before anesthesia at the time of 30 min after pneumoperitoneum , as well asafter operation .Theblood pressure after pneumoperitoneum in the control group was significantly higher than that before anesthesia , with DBP after operation higher than that before anesthesia (p<0.05).Postoperative blood glucose in the control group was significantly higher than that before anesthesia (p<0.05).Both systolic blood pressure and diastolic blood pressure in the observation group after pneumoperitoneum and operationwere significantly lower than thosein the control group (p <0.05).Conclusion Epidural anesthesia is more ideal to reduce stressresponse ,control blood pressure , and maintainnormal blood sugar levels .

Objective To summarize the clinical experience of surgical intervention for cardiac neoplasm in a fetus . Methods A 32-year-old pregnant woman was admitted to our hospital for complaint of fetal cardiac neoplasm .A separated het-erogenic cardiac occupying lesion was identigied at right atrium of the fetus by echocardiography , whose size is 2.85 cm ×2.25 cm, but the pathogenic origin still remained uncertain, maybe originate from ether pericardium or atrium.The annulus of tri-cuspid valve was compressed nearly 50% with the presence of amount of pericardial effusion.The fetal heart rate decreased at some fetal position resulting in the compression to the heart.So an Ex-utero Intrapartum Therapy(EXIT) procedure was per-formed under the supply of placenta at the 32 weeks of pregnancy.Cesarean section was performed with intact umbilicus and fe-tal circulation by obstetricians.Consequently, the median sternotomy of this fetus and pericardiotomy were performed , with 30 ml clear pericardial effusion drained .The tumor was confirmed to be giant right atrial neoplasm after the intraoperative explora-tion.Considering on the high risk of the cardiopulmonary bypass and limited time for EXIT , the giant atrial neoplasm was left alone with delayed sternum closure after the effectively decompression of the heart .The omphalotomy was successfully per-formed after the EXIT surgery.The neoplasm resection and the repair for its defect on right atrium were performed with cardiop-ulmonary bypass 2 days later.Results Convalesce of this mother was quite good after cesarean resetion .Hemodynamics of the premature baby was satisfatory after the resection of right atrial neoplasm which pathological report was benign hemangioma . Conclusion Via multiple disciplines collaboration , EXIT intervention for fetus is feasible and safe under adequate prepara-tion.