Adult ; Aged ; Aging ; physiology ; Evoked Potentials, Somatosensory ; physiology ; High-Frequency Ventilation ; Humans ; Middle Aged ; Somatosensory Cortex ; physiology

Objective To evaluate analgesic effect of bupivacaine infiltration in trocar incision after laparoscopic surgery.Methods 90 patients were randomly divided into 3 groups after laparoscopic cholecystectomy.In group 10.25% bupivacaine 20 ml(50 mg) injection, in group 2 sterile NS 20 ml infiltrated in the muscular fasciae of the trocars, in group 3 patient-controlled intravenous analgesia(PCIA) was used.In 2, 6, 12 and 24 hours after the intervention, the pain intensity was recorded with the use of a Visual Analogue Scale ( VAS), time of flatus passing was recorded as well.Results Patients with bupivacaine or PCIA had statistically significant in pain score compared with patients with NS especially within 12 hours after the surgery (t2h = 8.475; t6h = 5.356; t12h = 3.496, P ＜ 0.05) while the difference was not statistically significant between the 3 groups at 24 hours.The time of passing flatus in group 1 patients with bupivacaine was earlier than with PCIA ( x224h = 5.406, P ＜ 0.05 ) .Conclusions Bupivacaine infiltrated in trocar incision after laparoscopic surgery reduced postoperative pain, and did not disturb peristalsis reflex recovery of the intestines.

OBJECTIVETo investigate the prevalence and subtype distribution of human papillomavirus (HPV) infection and its correlation with age among women in Beijing urban area, and provide some epidemiological evidence for the clinical application of HPV vaccines.

METHODSWe collected cervical specimens from 1999 women in the Outpatient Department of our hospital, performed genetyping of HPV-DNA, and analyzed the incidence of HPV infection in different age groups.

RESULTSHPV infection was detected in 502 (25.2%) of the 1999 women patients, with 391 (19.6%) cases of high-risk HPV, which included 326 (83.4%, 326/391) cases of single infection. HPV-16 was the most common type (21.2%, 69/326), followed by HPV-52 (19.3%, 63/326) and HPV-58 (16.0%, 52/326). The prevalence of HPV infection was the highest among the women aged 41 -50 years and the lowest among those over 60 years.

CONCLUSIONThe subtype- and age-specific distribution of HPV infection among women in Beijing urban area shows an obvious heterogeneity, which deserves due consideration in the clinical application of HPV vaccines.

Adolescent ; Adult ; Age Distribution ; Aged ; China ; epidemiology ; Female ; Genotype ; Humans ; Middle Aged ; Papillomaviridae ; classification ; genetics ; Papillomavirus Infections ; epidemiology ; Young Adult

Objective To define the indications and evaluate the results of various surgical treatment options in patients with nonparasitic hepatic cysts. Methods The clinical data of 284 patients with nonparasitic hepatic cysts treated in our hospital from January 1995 to December 2005 were retrospectively analyzed. Results Percutaneous aspiration and sclerotherapy were performed in 161 cases and complications occurred in 9 (5.59%), recurrence in 53 (32.92%) and the mortality was 0%.Open surgery was conducted in 71 cases and the complications occurred in 16 (22.54%), recurrence in 8 cases (11.27%) and the mortality was 2.82%. Laparoscopic surgery was employed in 52 cases and complications occurred in 7 ( 13.46%), recurrence in 6 (11.54%) and the mortality was 1.92%.Conclusion There is currently no general agreement in the literature concerning when nonparasitic hepatic cysts should be treated. Laparoscopic surgery was more favorable than other therapeutic options.However, we should choose individually suitable methods according to different clinical symptom of patients.

Objective To investigate the effect of acute blood glucose on the level of glutathione peroxidase (GSH-Px),interleukin-6 (IL-6),and the expression of nuclear factor-κB (NF-κB).Methods The Wistar rats were infused intermittently or consistently with 50％ glucose solution.The level of GSH-Px was investigated with colorimetry.The level of IL-6 was measured with enzyme-linked immunosorbent assay (ELISA).The expression of NF-κB was investigated with immunohistochemisty.Results The level of GSH-Px in aorta homogenate in the acute blood glucose fluctuation group [(6.26 ± 0.38) nmol/mgprot] was evidently lower than that of consistently high blood glucose group [(8.98 ± 0.56) nmol/mgprot] and the control group [(10.02 ±1.10)nmol/mgprot] (P ＜0.05).The level of IL-6 [(20.56 ±3.78)pg/ ml] and the expression of NF-κB in the aorta in the acute blood glucose fluctuation group [(16.35 ±2.45) pg/ml] were evidently higher than the other two groups (P ＜ 0.05).Conclusions Acute glucose fluctuations induced the enhancing of oxidative stress and expression of inflammatory cytokines in the aorta,which leads to start NF-κB signaling pathway.

Objective To evaluate the effects of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on weight control in morbidly obese patients.Methods 48 patients with morbidly obesity underwent obese surgery (laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy) from Dec.2013 to Dec.2015,and 1-year follow-up study.The general situation of obesity and biochemical indicators were compared and analyzed.Results There were 20 cases in gastric bypass group and 28 cases in sleeve gastrectomy group.The excess weight loss percentage(％EWL)was 73±0.04 in gastric bypass group and 59±0.05 in sleeve gastrectomy group(P=-0.03).There was no statistical difference in weight change between the two groups.Low density lipoprotein cholesterol (LDL) level in gastric bypass group was significantly lower than that in sleeve gastrectomy group at 1 year after surgery (2.42±0.16 vs 3.29±0.20,P=0.006),while folic acid level was significantly higher than that in sleeve gastrectomy group(15.58±1.99 vs 7.59±1.59,P=0.022).Conclusions The one-year follow up shows there is no significant difference in the efficacy of weight control between the two groups.Gastric bypass group may be superior to gastrectomy group in nutrition indexes.However,it is just a short-term postoperative efficacy in morbidly obese patients,long-term weight control effects and obesity related diseases control need to be further explored.

Objective To investigate the strategy to improve successful treatment for severe acute pancreatitis (SAP). Methods The study period was divided into from 1992 to 2000, and from 2001 to 2009.The patients during these two phases were comparable as regard to sex and age. Results The proportion of patients received anti-inflammatory medications from 2001 to 2009 was 88.7% (94/106), medications which can improve the pancreatic microcirculation were used in 93.4% (99/106), early enteral nutrition was used in 58.5% (62/106), medications which can protect intestinal barrier function were used in 98.1% ( 104/106),all these parameters were significantly higher than those (22.4%, 19/85; 43.5%, 37/85; 29.4%, 25/85;17.7%,15/85) from 1992 to 2000. Also from 1992 to 2000, more patients underwent operation such as basin-shaped open drainage, pancreatic necrosis debridement. While more patients underwent operation such as laparoscopic drainage, CT or B-ultrasound guided percutaneous drainage from 2001 to 2009. The proportion of patients underwent surgical treatment decreased from 56.5% (48/85) to 32. 1%(34/106); the survival rate increased from 68.8% to 84.0%. Conclusions The research progress of medications was the foundation to improve successful treatment for SAP. Operation was an important option during SAP therapy. The individualized treatment was beneficial to improve successful treatment for SAP.

Objective To observe the impact of laparoscopic Roux-en-Y gastric bypass on bowel habits in patients with type 2 diabetes mellitus(T2DM).Methods 70 cases of T2DM undergoing laparoscopic Roux-en-Y gastric bypass were studied.Changes in bowel habits, frequency and odor of flatulence, and social life were estimated at least 6 months after surgery using a self-administered questionnaire.Results 67.1%of the patients had normal bowel habit, 68.6%of patients maintained normal flatus before undergoing surgery, and visual ana-logue scale reveals bowel and flatus habit would cause little trouble on daily life.47.1% of patients maintained their normal bowel habit, and 45.7%of patients had loose stools and diarrhea after surgery.The number of pa-tients with loose stools significantly increased(28/70, 40% after surgery vs 5/70, 7.1% before surgery), with statistical difference( P<0.001) .42.9%patients believed that eating high-fat diet was related with loose stools (P<0.001).Patients with constipation decreased significantly after surgery(5/70, 7.1% vs the preoperative 16/70, 22.9%), with statistical difference(P=0.016).Visual analogue scale showed that 57.1% of patients thought their daily life and social activities were not affected(P=0.05).50%of patients considered an increase flatus, and 55.7%had malodorous flatus, which had statistical significance compared with those before surgery ( P<0.001) .A visual analogue scale showed that 60%of patients thought that this change would not affect their daily life and social activities( P=0.212) .Conclusions After laparoscopic Roux-en-Y gastric bypass surgery, some patients had loose stod, diarrhea, increased flatus and and offensive odor, but after proper treatment these changes do not affect their daily life and social activities.

Objective To study the safety, surrounding tissue injury and cervical wound appearance of the video-assisted thyroidectomy. Methods 230 patients had video-assisted thyroidectomy (group endoscopy) and 204 had conventional open thyroidectomy (group open). Operative duration, postoperative hospital stay, complications,cervical wound healing and appearance, and recurrence rate were compared. Results Operative duration and postoperative hospital stay were (33±29)min and (2±1)days for group endoscopy and (40±21)min and (5±2)days for group open (P=0.025, P=0.000) respectively. Cosmetic result of wound evaluated by numeric scale was in favor of group endoscopy (P=0.000). There were no significant differences in infection of incisional wound, between two groups (P=0.270). After 6-30 months' follow-up, the recurrence rate showed no difference between two groups(P=0.909). Conclusions Compared with conventional surgery, endoscopic thyroidectomy for thyroid diseases was a practical and safe procedure with excellent cosmetic benefits, short hospital stay and less postoperative complications.

Objective To investigate the change in quality of life (QoL) following laparoscopic Roux-en-Y gastric bypass (LRYGB) for T2DM with obesity.Methods A total of 46 overweight T2DM cases (mean baseline BMI (32.7 ± 3.9) kg/m2) undergoing LRYGB were followed by QoL questionnaires (SF-36) before and after 6 and 12 months.Results The preoperative physical QoL scales (physical component summary,PCS) was significantly different from the general population(GP) scales (P ＜ 0.01),and the improvement in QoL was significant at 6 months postoperative and continued to consistently increase up to 12 months (P ＜ 0.01).For mental component summary (MCS),the preoperative scales was not significantly different from the GP scales,however,the 6 and 12 postoperative scales improved significantly (P ＜0.01).As for physical function,role physical,role emotion,the 6 (78 ± 8,76 ± 17,70 ± 23) and 12 months' (85 ± 7,82 ± 18,77 ± 18) postoperative scales were markedly higher than those in the preoperative controls (P ＜ 0.01),and there were no differences between the 12 month's postoperative scales and GP scales.The preoperative bodily pain,general health and social function (66 ± 14,55 ± 12,63 ±15) was different when compared with (76 ± 12,75 ±6,75 ± 13) at 6 months and (82 ±9,79 ±6,94 ±9) at 12 months (P ＜0.01).The preopertive mental health (71 ± 12) was not significantly different from GP scales,nor there were significant difference when compared with (71 ± 10) at 6 months and (73 ±8) at 12 months.Conclusions There were improvements in physical and mental QoL in T2DM patients with obesity after LRYGB.