Objective To explore the appropriate pneumoperitoneum pressure in different surface area children during pediatric laparoscopic surgery,so as to attenuate the intederence with physiological function and avoid pneumoperitoneum correlative complications.Methods 120 patients underwent laparoscopic surgery were divided into three groups by different surface area:A(0.43～0.67m2),B(0.68～0.92m2),C(0.93～1.17m2).Each group was divided into two subgroups again by different pneumoperitoneum pressure:A1(4 mm Hg),A2(6mm Hg),B1(7mm Hg),B2(9mm Hg),C1(10mm Hg),C2(12 mm Hg).The cardiorespiratory function and blood gas analysis in different time point before and after pneumoperitoneum were monitored.Results The increase of PET CO2,Paw,HR,MAP and PaCO2 in A2,B2,C2 were more obvious than in A1,B1,C1(P ＜ 0.01).The eligible pneumoperitoneum pressure for A,B,C were 4,7,10mmHg respectively.The complications of gastric contents back-streaming and respiratory acidosis were 7 cases in A2,B2,C2 in all,and 3 cases in A1,B1,C1.Conclusion Using a compatible pneumoperitoneum pressure for different surface area children could attenuate the interference of physiological function and avoid pneumoperitoneum correlative complications.

Background The advantages of endothelium keratoplasty(EK)include without corneal surface incision and sutures,remaining normal corneal topography,minimizing astigmatism and providing a healthy donor endothelial cell count and function.Using anterior segment optical coherence tomography(AS-OCT) to examine the morphology of the corneal graft after EK is helpful for the evaluation of the outcome of EK.ObjectiveThis study applies AS-OCT to observe the relationship of recipient cornea and donor graft and offer a basis for the evaluation of operative outcome.MethodsThe clinical data from 44 eyes of 42 patient who received DSAEK in Peking University Eye Center from September 2007 through April 2009 was reviewed retrospectively.These patients included 30 male and 12 female with the age from 15 to 83 years.Structure of cornea and relationship between recipient cornea and graft disc after surgery were clinically examined and recorded by slit-lamp digital camera and AS-OCT.This study was approved by the Ethics Committee of Peking University.Written informed consent was obtained from all of the patients before the operation.ResultsThe donor graft attached to posterior central surface of recipient in 28 eyes under the slit-lamp microscopy and AS-OCT.The thickness of donor graft was decreased,and graft sticked more closely to recipient cornea and was more transparent with the lapse of time.Complete dislocation of the donor graft in early stage was found in 5 eyes(11.36%) and partial dislocation in 2 eyes(4.55%).Curliness of graft edge occurred in 1 eye(2.27%) and eccentricity of donor graft in 8 eyes(18.18%).ConclusionAS-OCT can display the morphology and structure of cornea as well as the relationship between donor graft and recipient after DSAEK.It is helpful for evaluating the clinical effectiveness of DSAEK.

Objective To establish a risk warning model for surgical site infection(SSI), provide support for screening high risk population and finding suspected cases.Methods Clinical data of 5 067 patients who underwent abdominal surgery in 6 domestic hospitals from January 2013 to December 2015 were collected retrospectively, all cases were randomly divided into modeling group and validation group according to a 6:4 ratio, warning model was established by employing logistic regression, the area under the receiver operating characteristic curve (AUC) was used to evaluate discriminant ability of evaluation model, the maximum Youden index was as the optimum cut-off point.Results For the warning model of high-risk patients, AUC was 0.823, sensitivity and specificity were 78.81% and 74.33% respectively, positive predictive value and negative predictive value were 19.67% and 97.78% respectively.For the discriminant model of suspected infection cases, AUC was 0.978, sensitivity and specificity were 93.38% and 95.62% respectively, positive predictive value and negative predictive value were 62.95% and 99.45% respectively.Conclusion The early-warning model established in this study has better discrimination ability, which can provide a reference for the development of early warning and discrimination of healthcare-associated infection information system.

Objective To explore the relationship between size,shape and function of the left atrium appendage (LAA) and its thrombosis in patients with atrial fibrillation (AF) by transesophageal echocardiography (TEE) to provide evidence for clinical risk assessment,prognosis evaluation and treatment guidance.Method Length,diameter,end-diastolic volume (EDV) and ejection velocity (PEV) of LAA were measured in 41 patients with AF,and thrombus in LAA was detected by TEE.Results Thrombus in LAA was detected in seven of 41 patients of AF (17%).No significant difference in size and EDV was found between the patients with and without thrombus,but there was significant difference in PEV between them (P

Objective To explore the changes in plasma melatonin (MT) and glucocorticoid (GC) and the expressions of melatonin receptor 1 (MR1) and glucocorticoid receptor alpha (GR alpha) after neonatal asphyxia. Methods Full-term asphyxia neonates (22 cases of mild asphyxia, 28 cases of severe asphyxia) hospitalized from May 2014 to December 2015 were selected. Another 50 non-asphyxiated full-term newborns hospitalized with single disease such as infection and jaundice at the same time were selected as the control group. Peripheral blood samples were collected within 24 hours after birth and 7 days after birth, and plasma and mononuclear cells were separated. The plasma MT and GC expression levels were detected by ELISA. Real-time PCR was used to detect MR1 and GRα mRNA expression. Results The plasma GC concentrations in mild and severe asphyxia group increased significantly within 24 hours after birth, higher than that in control group. In addition, the plasma GC concentration in severe asphyxia group was significantly higher than that in mild group (P<0.05). The concentration of plasma GC in mild and severe asphyxia group decreased on the 7th day after birth (P<0.05) and was significantly lower than that at 24 hours after birth, but it was still higher in the severe asphyxia group than that in mild group; both the mild and severe asphyxia group had higher GC level than that in control group; the differences are statistically significant (P<0.05). Within 24 hours after birth, the plasma MT concentration in severe asphyxia group was lower than that in mild asphyxia group and control group, and there were significant differences (P<0.05). Compared with 24 hours after birth, the concentrations of plasma MT in severe and mild asphyxia groups increased significantly, higher than that in control group on the 7th day, and there were significant differences (P<0.05). The level of GR alpha mRNA expression decreased within 24 hours after birth in severe asphyxia group, but was increased in the mild asphyxia group, and there were significant differences among the three groups (P<0.05). The expression levels of GRα in both mild and severe asphyxia groups recovered on the 7th days after birth, and there were no significant differences compared with control group (P>0.05). Compared with 24 hours after birth , the expression level of MR1 mRNA in severe asphyxia group increased on the 7th day after birth, higher than that in control group and in mild asphyxia group, and there were significant differences (P<0.05). Conclusions The stress caused by severe asphyxia exceeds the adaptation range in the newborn, and results in the high expressions of MR1 and endogenous MT.

OBJECTIVE: To study the effectiveness of direct amplification with PowerPlex 16 HS system for DNA detection in three conventional materials: fresh blood, oral swab, and cigarette butt. METHODS: The genetic data of 11 samples of fresh blood, 10 samples of oral swab and 10 samples of cigarette butts were analyzed with PowerPlex 16 HS kit. The result was statistically analyzed. RESULTS: Success rate of whole genetic map test in fresh blood and oral swab samples was 100%. Success rate in cigarette butt samples was 90%. CONCLUSION Direct amplification with PowerPlex 16 HS system is effective method to three types of conventional evidence material including fresh blood, oral swab and cigarette butt.
Blood Stains ; DNA/genetics* ; DNA Fingerprinting/methods* ; Forensic Genetics/methods* ; Humans ; Nucleic Acid Amplification Techniques/methods* ; Polymerase Chain Reaction/methods* ; Saliva/metabolism* ; Sensitivity and Specificity ; Tandem Repeat Sequences ; Tobacco

OBJECTIVETo investigate the cause of liver failure after hepatectomy for hepatocellular carcinoma and explore its prevention and treatment.

METHODSThe clinical data of 1000 patients with hepatocellular carcinoma undergone hepatectomy from July 2000 to June 2008 were retrospectively analyzed. There were 922 male and 78 female, aging from 21 to 89 years old.

RESULTSAmong the 1000 patients, there were 18 patients with liver failure after hepatectomy (1.8%). Among the 18 patients with liver failure, 13 patients were more than 65 years old, 14 patients were with more than 20% of indocyanine green retention rate at 15 minutes, 14 patients were with more than 1000 ml blood loss during operation, 6 patients were with F4/F3 liver fibrosis (Metavir Scores), and 9 patients were with less than 40.0% liver volume of residue liver.

CONCLUSIONSPatients with hepatocellular carcinoma with less than volume of residue liver, much more blood loss or transfusion, more than 20% of ICGR15, F4/F3 liver cirrhosis are prone to be with liver failure after hepatectomy. Artificial liver or liver transplantation may be the important alternative for liver failure after hepatectomy.

Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular ; surgery ; Female ; Hepatectomy ; adverse effects ; methods ; Humans ; Liver Failure ; etiology ; therapy ; Liver Neoplasms ; surgery ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Retrospective Studies ; Young Adult

OBJECTIVETo assess the clinical efficacy and safety of cellulose on functional constipation.

METHODSA prospective, self-controlled, multicenter clinical trial of cellulose was conducted for 2 weeks in 240 patients with functional constipation according to the Rome III( criteria. Symptoms and characters of feces before and after the treatment were observed and evaluated according to a score scheme.

RESULTSIn the 240 patients, the frequencies of defecation increased and the characters of feces was improved significantly after 2-week treatment. There were no adverse reactions observed throughout the clinical trial. The total efficacy was 82.1% at day 7 and 90.7% at day 14. The satisfactory rate of doctors was 83.8% and of patients was 83.8%.

CONCLUSIONCellulose is effective and safe in the treatment of chronic functional constipation.

Adolescent ; Adult ; Aged ; Cellulose ; therapeutic use ; Constipation ; drug therapy ; Female ; Humans ; Male ; Middle Aged ; Prospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo explore the characteristics of severe acute respiratory syndrome (SARS) transmission in the population base on analyzing the first imported case and the chains of transmission.

METHODSFor the first imported SARS case and cases who were transmitted by the index case, epidemiological investigations were conducted using the guidelines for surveillance and case investigation issued by the Ministry of Health. Data as the date of onset of symptoms, date of hospitalization, contact history etc. for each of the cases and their close contacts were collected and analyzed.

RESULTSThe first imported SARS case introduced to Beijing had infected 9 people within the family and at the hospital, with two of whom died of the same disease. The incubation period for that index case was 4 days, and that for the cases considered to be the secondary and tertiary generations were 7 and 8 days, respectively. The shorter the incubation period, the longer the fever would last and clinically more severe.

CONCLUSIONOne of the epidemiological characteristics of SARS in Beijing was noticed that the disease clustered in families and hospitals. Infection through droplets and close contact has been viewed as the primary mode of transmission.

Adult ; China ; epidemiology ; Contact Tracing ; Cross Infection ; transmission ; Family Health ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional ; Male ; Middle Aged ; Severe Acute Respiratory Syndrome ; epidemiology ; transmission

OBJECTIVETo investigate the effects of 54G/C polymorphism of sterol regulatory element-binding protein-1c gene (SREBP-1c) on serum lipid ratios and their response to high-carbohydrate/low-fat (HC/LF) diet in healthy youth.

METHODSAfter a regular diet for 7 days of wash-out, 56 healthy youth (22.89 +/- 1.80 yrs) were given HC/LF diet for 6 days. The regular diet contained 54% carbohydrate, 15% protein, and 31% fat of the total energy. The HC/LF diet contained 70% carbohydrate, 15% protein, and 15% fat of the total energy. The serum lipids and glucose were measured on the 1st, 8th and 14th days. The ratios of TG/HDL-C, log (TG/HDL-C), TC/HDL-C, and LDL-C/HDL-C were calculated. The 54G/C polymorphism of SREBP-1c gene was analyzed by PCR-RFLP method.

RESULTSNo significant difference was found in lipid ratios and glucose at baseline and after regular diet in subjects with different genotypes in either the whole studied population or in males or females only. However, after HC/LF diet, LDL-C/HDL-C was significantly lower in females carrying the C allele than those of GG homozygotes (P< 0.05). Compared with those before HC/LF diet, TC/HDL-C and LDL-C/HDL-C were significantly decreased in all the subjects (P< 0.05). When gender was taken into account, significant increase of TG/HDL-C and log(TG/HDL-C) was found only in females with GG genotype (P< 0.05). All the subjects experienced significant decrease of TC/HDL-C and LDL-C/HDL-C regardless of their genders and genotypes (P< 0.05).

CONCLUSIONThe 54G/C polymorphism of SREBP-1c gene can influence the response of TG/HDL-C and log(TG/HDL-C) to HC/LF diet in females. The C allele may be a protective factor to prevent the increase of TG induced by HC/LF diet in females.

Adult ; Dietary Carbohydrates ; pharmacology ; Dietary Fats ; pharmacology ; Female ; Gene Frequency ; Genotype ; Health ; Humans ; Lipids ; blood ; Male ; Polymorphism, Single Nucleotide ; Sex Characteristics ; Sterol Regulatory Element Binding Protein 1 ; genetics ; Young Adult