Objective:To evaluate the clinical effects of amended concave position in gynecological laparoscopy surgery.Methods: Eighty ASAⅠ~Ⅱ patients with gynecological laparoscopy surgery were randomly divided into two groups, the patients in group A were adopted Trendelenburg position; the patients in group B were adopted amended concave position. The Ppeak and PETCO2 in the two groups were recorded during surgery, the time of extubation and the adverse effects as nausea, vomiting, shivering was recorded after surgery.Results: The Ppeak and PETCO2 of group A were higher than that of group B(t=2.526,t=2.838, t=2.881;P<0.05). The time of extubation of group A were higher than that of group B after surgery(t=2.515,t=2.436;P<0.05).Conclusion: Adopting amended concave position can reduce Ppeak and PETCO2 in gynecological laparoscopic surgery, and it is helpful for postoperative recovery of the patients with gynecological laparoscopy surgery.

Objective To investigate the relationship between different types of acute ischemic stroke in elderly patients and serum oxidized low-density lipoprotein (OX-LDL),blood sugar,C-reactive protein(CRP) and interleukin 6 (IL-6) levels.Methods 100 patients with acute cerebral infarction (group A) and 30 heathy patients (group B)were investigated.The levels of serum OX-LDL,blood sugar,CRP and IL-6 were detected by automatic biochemical analysis.Results The levels of OX-LDL(627.2 ± 174.7 ) μg/L,blood sugar ( 8.8 ± 1.7 ) mmol/L,CRP ( 107.5 ±19.4)mg/L and IL-6(79.5 ± 12.1 )ng/L in patients of group A were significantly higher than group B[ OX-LDL(506.1 ± 152.4) μg/L,blood sugar(6.9 ± 1.5) mmol/L,CRP(87.2 ± 13.6) mg/L and IL-6(58.5 ± 10.3) ng/L](t=2.74,3.18,2.61,2.91,allP＜0.05).Conclusion Elderly patients with acute cerebral infarction were closely related to the elevated levels of plasma OX-LDL,blood sugar,CRP and IL-6.Increased plasma OX-LDL was a risk factor for the main artery atherosclerosis type,and hyperglycemia was primary factor for the small artery atherosclerosis type of acute cerebral infarction.

Objective To study the relationship between serum high sensitive C-reactive protein(Im-CRP) and acute coronary syndrome(ACS). Methods We detected and analyzed the levels of hs-CRP in 38 clinical deft-trite patients with ACS. Results Patients with ACS had significantly higher serum hs-CRP levels than the control group(P < 0.05). Conclusion Serum hs-CRP level has high correlation with ACS, and the hs-CRP maybe a arthero-sclerosis marker,which reflected the process of coronary artery disease.

Adult ; China ; epidemiology ; Dust ; Humans ; Iron ; Male ; Metallurgy ; Occupational Exposure ; Pneumoconiosis ; diagnostic imaging ; epidemiology ; prevention & control ; Radiography ; Risk Factors ; Steel ; Welding

Alimentary tract duplications are rare congenital anomalies that usually present in childhood and occasionally in adults. They are most common in the ileum, but can occur anywhere along the alimentary tract from the mouth to the anus. We report a 24-year-old woman who presented with a giant chylous ileum cyst duplication. To our knowledge, there is only one other report of a patient with a giant chylous cyst in the literature.
Abdominal Pain ; Adult ; Cysts ; diagnosis ; pathology ; surgery ; Female ; Humans ; Ileum ; surgery ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed

Objective To observe the recent effects and toxicity in advanced gastric carcinoma by two kinds of neoadjuvant chemotherapies ( PF and FOLFOX).Methods A total of 60 patients with advanced gastric cancer ( Ⅲ ～ Ⅳ ),they were randomly divided into 2 groups; PF group ( 30 cases) and FOLFOX group ( 30 cases).All patients were given 3 cycles of docetaxel or L-OHP chemotherapy preoperatively,to observe the recent effects and toxicity in advanced gastric carcinoma.Results The total effective rate in PF group was 77.67％,while it was 50.00％ in FOLFOX group,it had significant difference between in two groups ( x2 =4.59,P ＜ 0.05 ).There is no difference in the incidence of neutropenia,transaminase elevation,nausea and diarrhea two groups.The incidence of hair loss in PF group is higher than in FOLFOX group,but there is no difference between two groups; The incidence of peripheral nerve paresthesia in FOLFOX group is higher than that in PF group( x2 =5.08,P ＜0.05).Conclusion PF as neoadjuvant chemotherapy is a very effective and well-tolerated regimen in patients with advanced gastric cancer.

Objective To investigate the clinical effect of application of dezocine combined with sufentanil in patients under‐going thoracic surgery ,and discuss its security .Methods Selected 60 cases of patients undergoing thoracic surgery treatedn in the hospital from January to June 2013 ,then divided into two groups with 30 cases in each group randomly .ASA grade Ⅰ - Ⅱ ,the ob‐servation group took dezocine combined with sufentanil after the surgery ,the control group took sufentanil for analgesia ,then ob‐served the analgesia and sedative effect and the occurrence rate of adverse reaction between two groups of patients .Results The observation group′VAS pain score on postoperative 6 ,12 ,24 ,48 h were (3 .21 ± 0 .76)% ,(3 .01 ± 0 .77)% ,(2 .79 ± 0 .69)% , (2 .67 ± 0 .66)% and significantly better than the control group(P<0 .05);The observation group′Ramsay sedation score on post‐operative 6 ,12 ,24 ,48 h were (2 .12 ± 0 .23)% ,(2 .07 ± 0 .22)% ,(2 .02 ± 0 .24)% ,(2 .01 ± 0 .21)% ,the sedative effect was better than the control group(P<0 .05);48 h after the surgery the pressing times and effective analgesia pump frequency and adverse re‐action of the patients in the observation group were lower than that of the control group(P<0 .05) .Conclusion The effect for se‐dation and analgesia of dezocine combined with sufentanil in patients undergoing thoracic surgery is better and safe .

Objective To study the clinical efficacy of recombinant human epidermal growth factor (rhEGF) in the treatment of sacrococcygeal decubitus ulcers grade Ⅲ with direct polymerizing suture after appling rhEGF to reinforce wound bed preparation (WBP). Methods From January 2007 to October 2009, 60 patients with sacrococcygeal decubitus ulcers Grade Ⅲ, were divided into control group and treatment group. The ulcer size was 3 cm × 4 cm to 10 cm × 12 cm and all ulcers were infected for 15-70 d. Treatment group received traditional dressing change and appling rhEGF to reinforce wound bed preparation. Control group received traditional dressing change only. The operative technique that we used in two groups was direct polymerizing suture. Cure rate of stage Ⅰ and complication morbidities were analyzed. Results Cure rate of stage Ⅰ was 87% in treatment group and 70% in control group. Complication morbidities were 13% in treatment group and 30% in control group. The difference between these two groups was statistically significant (P ＜ 0.05). Conclusion Appling rhEGF to reinforce wound bed preparation before operation could make subsequent treatment more effective and improve the cure ratio of operation with decreasing complications and morbidities. And more, dissecting under fascia possesses the advantages of easiness to perform and rich blood supply.The method of appling rhEGF with direct polymerizing suture is a simple, high efficient approach for the first repairment of sacrococcygeal decubitus ulcers grade Ⅲ, especially desirable for the elderly.

Objective To investigate the safety and therapeutic effect of intra-carotid infusion with cold sa line in rats with acute focal cerebral ischemia-reperfusion injury.Methods 60 rats were randomly divided into six groups:sham operated group,normal infusion group,stroke group,local hypothermic group,local normothermic group,and systemic infusion group.Brain infarct volume and cerebral water content were analyzed 48 h after ischemia.Neurological deficits were assessed using the mNSS 24 h and 48 h after infarction.Results In the local hypothermic group,brain temperature was reduced to 33 to 34 ℃ within 5 to 10 minutes,and this significantly low temperature maintained to nearly 60 minutes after infusion continued.Physiological variables were not significantly different among each time point (P ＞ 0.05).No significant morphological abnormality was found in brain sections stained with TTC and HE.Animals receiving local cold infusion significantly decreased infarct volume and brain water content compared to stroke group (P ＜ 0.05).Both 24 h and 48 h mNSS in local hypothermic group was significantly lower than those in other groups (P ＜ 0.05).Conclusions Intra-carotid infusion with cold saline can quickly and effectively reduce brain temperature and is a relatively safe cooling method.Local hypothermia significantly reduced brain infarct volume,decreased brain water content and improved neurological functional outcomes after brain ischemia.

Objective To study the effect of astrocyte on synapse formation and the molecular mechanism. Methods Cortical astrocytes were isolated and purified from neonatal rats.On the 2h,7th day,14th day and 21th day after passage,we counted the number of astrocytes and the culture medium(astrocyte-conditioned medium,ACM)was harvested to measure the concentration of estrogen(E 2)by using ELISA techniques.Based on the model of pure culures of neonatal cortical neurons,the experimental groups were designed as follows:1.pure neuron cultures(group N);2.ACM cultures(group A);3.mixed cultures(group M);4.E 2 cultures(group E 2);5.ACM+Tamoxifen(estrogen receptor antagonist)cultures(group A+T);6.Tamoxifen cultures(group T).Then synaptic puncta in every group was stained and counted through immunofluorescence,and we also compared the differences in puncta number among those six groups(at 9th day in culture,number/per neuron). Results The numbers of astrocytes were:1?10 4/ml, 1.1?10 6/ml, 1.4?10 6/ml, 1.5?10 6/ml; The concentrations of E 2 were:(ng/L):0, 117?22, 266?22,252?27 respectively.No estrogen was detected in the primary culture medium.The concenteration of estrogen increased in correspondence with the culturing days and reached the peak around at the 14th day, then decreased gradually but kept at a certain high level,and the numbers of synaptic puncta of per neuron in group N,A,M,E 2,A+T,T were:14?3;79?5;83?8;80?6;32?3;29?3 respectively.The treatment of pure neuron culture with ACM increased the number of synapses on per neuron by up to 6 fold by comparison with pure neuronal culture.Exogenic estradiol added into pure neurons can mimick the effect of the ACM.Tamoxifen which is antagonist of estrogen receptor could decrease the effect of ACM by 75%.Conclusion The astrocytes of neonatal rat cortex do secrete E 2.Astrocyte-derived estrogen may be the molecule regulating the synaptic formation through estrogen receptors.