Objective To explore the accuracy rate of classical anatomical landmark technique ( anterior , central , and posterior ap-proach) for internal jugular vein (IJV) by ultrasound technique.Methods Sixty-four patients with selective operation were included in this study.The anesthetist marked the anterior approach , central approach, and posterior approach for internal jugular vein at 0°(neu-ral), 30°,and 80°of head rotation, respectively.The accuracy of each anatomical landmark were examined by other anesthetist with ul -trasound technique .Results The accuracy rate of anterior approach and central approach were significantly higher than posterior ap -proach at 0°of head rotation, respectively.The accuracy rate of anterior approach was higher than posterior approach at 30°of head rota-tion.The accuracy rate was similar among anterior , central, and posterior approach at 80°of head rotation.Conclusion The accuracy rate was different in different approach of anatomical landmark for internal jugular vein .

Objective To evaluate the accuracy of non?invasive blood pressure monitoring in bilat?eral upper and lower extremities in lateral position in patients undergoing surgical procedures. Methods Forty patients of both sexes, aged 24-64 yr, BMI 20-27 kg∕m2 , of American Society of Anesthesiologists physical statusⅠ or Ⅱ, scheduled for elective neurosurgical procedures, were included in this study. Blood pressure of bilateral upper and lower extremities was monitored and recorded using appropriate cuffs. At 5 min after induction of anesthesia ( T0 ) , 10 min after the patients were turned to lateral position ( T1 ) , 30, 60 and 90 min after start of surgery ( T2-4 ) , and 10 min after the patients were turned to supine posi?tion ( T5 ) , non?invasive blood pressure was measured, and invasive blood pressure was recorded. Results Compared with the value measured on the healthy side, systolic blood pressure ( SBP ) and diastolic blood pressure (DBP) of upper extremities on the affected side were significantly decreased at T1-4, and SBP of lower extremities on the healthy side was significantly increased at T0-5 (P<0.05). SBP of upper extremities on the healthy side was increased by (23±9) mmHg when compared with that of upper extremi?ties on the affected side, and DBP increased by (23±8) mmHg. SBP of upper extremities was increased by (34±12) mmHg when compared with that of lower extremities on the healthy side in lateral position. Com?pared with SBP and DBP of lower extremities measured on the healthy side, no significant change was found in SBP and DBP of lower extremities on the affected side at T0-5 ( P>0.05) . There was no significant differ?ence between non?invasive SBP and invasive SBP of lower extremities on the healthy side, and between non?invasive DBP and invasive DBP of lower extremities on the healthy side (P>0.05). Conclusion For the patients undergoing surgical procedures, the blood pressure of upper extremities is higher on the healthy side than on the affected side when the patients are in lateral position, and there is no significant difference in the blood pressure between bilateral lower extremities; and there is no significant difference between non?invasive blood pressure and invasive blood pressure of lower extremities on the healthy side.

Objective:To evaluate the efficacy and safety of dienogest (DNG) in the treatment of refractory endometriosis-associated pain (REAP).Methods:In this study, REAP was defined according to the following criteria: (1) the pain duration was ≥12 months and visual analogue scale (VAS)≥60 mm; (2) the previous treatments with over two medicines like oral contraceptives and levonorgestrel-releasing intrauterine system failed to achieve satisfactory relief of pain, with VAS reduction less than 50%; with gonadotropin-releasing hormone agonist or mifepristone, the pain could be controlled temporarily, but it recurred after discontinuation of medicines; (3) the pain could not be relieved by surgery or even repeated surgeries. In the present study, 48 patients with REAP were treated with DNG 2 mg/day orally and the clinical outcomes were retrospectively analyzed. The VAS scores, levels of CA 125, estradiol, FSH, LH and changes in the size of endometriotic lesions before and after treatment were compared respectively. The side effects were also analyzed. Results:The average duration of DNG treatment was (20.1±12.8) months. After 3 months of medication, the VAS score was significantly reduced from (77.9±15.8) mm to (20.8±10.7) mm ( P<0.01), and CA 125 level was significantly reduced from (95±139) kU/L to (38±45) kU/L ( P<0.05). The effects were maintained with continuation of DNG treatment. Endometriotic lesions tended to shrink, after 12 months of DNG treatment, the size of ovarian endometriomas was reduced significantly from (3.1±1.0) cm to (1.9±1.2) cm ( P<0.05). The mean level of estradiol was maintained at 124.82-221.04 pmol/L and levels of FSH and LH did not change significantly during the treatment. The major side effect was irregular bleeding (75%, 36/48). Conclusions:DNG could effectively relieve REAP and is a well-tolerated therapy. It may supply an alternative option for patients with REAP.

Social isolation represents the development of a certain level, either partial or complete, of deprivation of socialization and may have adverse effects in many aspects for the elderly, which can be physiological, psychological and social.Meanwhile, during the course of human life, aging becomes an inevitable process and brings about changes in cognitive ability, which become an important focus of our attention.This paper reviews the research progress on the relationship between social isolation and cognitive ability in the elderly, in order to provide a new perspective for future research on social isolation and cognitive ability in the elderly and also to offer new insight on how to construct a model of intervention and health management for the elderly population with social isolation.