Objective To determine the risk factors for acute kidney injury following type Stanford A Aortic Dissection surgeryies.Methods It's a restrospective study.The clinical data of 176 patients undergoing type Stanford A Aortic Dissection surgery from Septerary 2009 to December 2011 were retrospectively analyzed.There were 115 males and 61 females with mean ages(43.20 ± 10.14)years old.The patients were divided into two groups according to whether AKI occurred after operation.Univariate and multivariate analyses were used to evaluate possible pre-,intra-,and post-operative parameters associated with AKI according to AKI Network.Results Among all the patients,AKI occurred in 78 (44.32％),21 (11.93％) of whom underwent continuous renal replacement therapy (CRRT).In hospital mortality was 3.41％ in all discharges while 6.45％ in AKI patients (P ＜ 0.01).Conclusion Multivariate Logistic regression analysis revealed that increased age,pre-operative left ventricular insufficiency,pre-operative renal insufficiency and long extracorpeal circulation (CPB) time ＞ 140 min were risk factors for the development of AKI.AKI is the most common complication of type Stanford A Aortic Dissection surgery,and is the risk factor of mortality after the surgery.It is important to enhance peri-operative protection of the renal function.

Leptin is a kind of energy-modulation hormone expressed by fat tissue. Its receptor has a wide distributing in human body which affects much physiological systems and metabolize access. With the further researches to leptin, its function is not localized fatness and thinness. Leptin is closely associated with the function of gastric mucosa. It attends the pathophysiological course of gastric cancer and gastric -related disease.

Sixty gynecological patients undergoing laparoscopic surgery during October 2010 to June 2011were randomly divided into 2 groups:laryngeal mask airway proseal ( PLMA group,n =30 ) and laryngeal mask airway classic (CLMA group,n =30).Laryngeal mask was inserted after induction.The heart rate (HR),mean arterial pressure (MAP),airway sealing pressure,the average time of placement,the pulmonary satisfaction and complications were recorded.There was no significant difference in heart rate and MAP between the two groups(P＞0.05).The airway sealing pressure [ (26 ±6) cm H2O ( 1cm H2O =0.098 kPa) vs.(16±5) cm H2O],the average time of placement [(36±5) vs.(24±6) s)] and the excellent lung ventilation(90％ vs.73％ ) in the PLMA group were more significantly increased than those in the CLMA group(P ＜0.05).PLMA can assure good airway sealing and is more suitable for gynecological patients undergoing laparoscopic surgery.

Objective To discuss the clinical epidemiology features and change trend of aortic dissection (AD) in Henan Province.Methods Retrospective analysis of consecutive 906 patients with AD over 10 years in Henan Provincial People' s Hospital,the First Affiliated Hospital of Zhengzhou University and Henan Provincial Chest Hospital.Hospital records and prognosis were compared between two five-year periods.Results 906 cases with AD were hospitalized during the past 10years.The mean age was (50.2 ± 9.8) years.The male/female ratio was 3.49 ∶ 1.Hypertension was present in 60.3 ％ of all patients.Heavy smoking history was elicited in 32.2％ of all patients.Type A dissection were identified in 57.8％ of all the cases,and type B in 42.2％.In-hospital mortality of acute type A dissection was 21.8％,acute type B dissection 6.8％.In two five-year periods,the total number of cases increased by 216％,among which type A was the fastest,increased by 294％,Changes of mean age and male/female ratio were not significant.For acute AD,changes of prognosis in one year improved,and reach statistical significance (P ＜ 0.05).Conclusion This study provides insight into current regional profiles of AD.The number of hospitalized patients with AD is increasing dramatically.The mean age of the first-attack is much younger and the male ration is much higher than that reported by other regional researchers.These data support the urgent need for further improvement in prevention and treatment of AD.

Objective To develop a new ambulance aid on airport rescue of pilot and solve the difficult problems on medical staff, which carry the wounded from high aircraft cabin to the ground. Methods The device owned QG 0.85 trailer chassis. On the basis of it, self-made manual flexible extension-jib, flexible extension ladders and safety board were designed. The safety board was used to fix wounded pilots to protect secondary injury of backbone and C-spine. Results The maximal speed of equipment was 80km/h and spreading time is 3～7min, operating time is 4min and lifting height is 6 000mm. Conclusion The ambulance aid can be used in the location of flight accident quickly and rescued the pilots rapidly, adapted to any type fighters and met the needs of medical support in flight.

Objective To investigate the significance of 25 hydroxyvitamin D3 (25 (OH)D3) in patients with type 2 diabetes mellitus by comparing the differences of serum 25-hydroxyvitamin D levels between type 2 diabetes mellitus patients and healthy people.Methods One hundred and forty-seven patients with type 2 diabetes mellitus were selected as the T2DM group,and 135 healthy people were selected as the normal control (NC) group.The level of serum 25 (OH) D3 was detected by ELISA.Clinical data were recorded and biochemical indexes were also detected.Statistical analysis was performed.Results (1) Serum 25 (OH) D3 level in T2DM group was low,but there was no significant difference between two groups((23.10 ± 1.59) μg/L vs.(23.11 ± 1.65) μg/L; t =0.064,P =0.949),as well as between men and women in the 2 populations (T2DM men vs.women(23.22 ± 1.54) μg/L vs.(22.95 ± 1.65) μg/L; t =0.209,P ＞0.05; NC men vs women(23.03 ± 1.73) μg/L vs.(23.18 ± 1.59) μg/L; t =0.436,P ＞0.05) ; (2)The prevalence of vitamin D insufficient and deficiency in T2DM group was high,but it was not statistically significant between two groups (98.0％ vs.94.8 ％ and 2.0％ vs.5.2％ ; x2 =2.034,P =0.154) ; (3) Serum 25 (OH) D3 in T2DM group has a significant negative correlation with triglycerides (r =-0.218,P ＜ 0.01).Conclusion (1) Vitamin D level was low in both the healthy and T2DM populations in the southern region of China,the prevalence of vitamin D insufficient and deficiency was up to 90％.(2)Triglyceride is the only independent risk factor to T2DM population.

Objective To evaluate the optimum ratio of medicine dosage for dexmedetomidine mixed with sufentanil used for patient?controlled intravenous analgesia ( PCIA) after Nuss procedure in pedi?atric patients with pectus excavatum. Methods Sixty pediatric patients diagnosed with pectus excavatum, aged 5-12 yr, weighing 18-50 kg, of ASA physical statusⅠorⅡ, scheduled for elective Nuss procedure under general anesthesia, were randomly divided into 3 equal groups using a random number table:different ratios of medicine dosage while dexmedetomidine was added to sufentanil groups ( SD1-3 groups) . Postopera?tive analgesia was as follows: group SD1 received sufentanil 1 μg∕kg + dexmedetomidine 2 μg∕kg; group SD2 received sufentanil 1 μg∕kg + dexmedetomidine 3 μg∕kg; group SD3 received sufentanil 1 μg∕kg +dexmedetomidine 4 μg∕kg. A mixture of tropisetron 0?1 mg∕kg and dexamethasone 0?1 mg∕kg ( in 100 ml of normal saline) was added in each group. The PCA pump was programmed to deliver 0?5 ml with a lockout interval of 15 min and background infusion at 2 ml∕h. The PCA pump was connected immediately after the end of operation, and sufentanil with a dosage of 0?1μg∕kg was used as a rescue analgesic within 48 h post?operatively. The VAS score was maintained below 4. The requirement for rescue analgesics was recorded. The Ramsay sedation scores was recorded at 4, 8, 12, 24 and 48 h postoperatively, and the occurrence of adverse reactions such as nausea and vomiting, bradycardia, over?sedation, respiratory depression, agitation and shivering was recorded within 48 h after surgery. Results No pediatric patients developed nausea and vomiting, respiratory depression, bradycardia, over?sedation, and shivering. No pediatric patients required rescue analgesics in SD2 and SD3 groups. Compared with group SD1 , the requirement for rescue analgesics and incidence of agitation were significantly decreased, and Ramsay sedation scores were increased at 4 and 8 h after operation in SD2 and SD3 groups. Ramsay sedation scores were significantly higher at 4 h after oper?ation in SD3 group than in SD2 group. Conclusion Dexmedetomidine 3 μg∕kg mixed with sufentanil 1μg∕kg is the optimum ratio of medicine dosage when used for PCIA after Nuss procedure in pediatric patients with pectus excavatum.

Objective To investigate the influence of different respiratory parameter setting during gynecological laparoscopic surgery on early postoperative cognitive function.Methods Eighty patients undergoing elective ovarian cancer or cervical cancer were grouped randomly into groups A, B,C and D.In group A patients were ventilated with respiratory parameters of VT 8 ml/kg,RR 12 times/min.While patients in groups B,C and D with identical minute volume 105 ml/kg though with respective RR of 12,1 5 and 18 times/min respectively.Patients in four groups were all graded by the MMSE at time points of preoperation(T0 ),postoperative 1 h(T1 ),6 h(T2 ),24 h(T3 ),48 h(T4 ), 72 h(T5 ).PaCO2 of arterial blood gas were tested before pneumoperitoneum(Ta)and immediately af-ter pneumoperitoneum(Tb).Results PaCO2 at Tb was higher in each group than that at Ta(P <0.05).Patients in group A showed the highest PaCO2 at Tb while PaCO2 in group C were lowest. The MMSE scores in group C were significantly higher than those in other groups at T1-T3 (P <0.05).The values at T4 in group A were lower (P <0.05)than those in other groups.Values at T1-T4 in group A were lower than that at T0 (P <0.05).In groups B and D at T1-T3 MMSE scores were lower than those at T0 and patients in group C showed lower MMSE scores at T1 and T2 (P <0.05).Conclusion Early postoperative cognitive function can be improved by regulating intraoperative respiratory parameters properly and increasing minute volume adequately in gynecological laparoscopic surgery.

After the current situation of knowledge service in aviation medicine was analyzed, the major problems in restrict security systems, few information access approaches, and difficulties in team construction for the knowledge service in aviation medicine were pointed out, with measures that should be taken in knowledge service put for-ward, such as keeping abreast of the key task in research of aviation medicine, making use of open access re-sources, digitalizing paper-type resources, organizing and revealing the knowledge in resources by making use of information technologies.

Objective To demonstrate medical aid techniques and ways of rescue helicopter,explore the variety and quantity of equipped medicines and instruments,develop medical aid equipment on board and solve the problems of lacking standard medical aid equipment in the rescue helicopter of our army.Methods The service demand of medical aid equipment in rescue helicopter was demonstrated by means of investigating and material analyzing.The medical aid equipment was developed.Results The technical specifications of technical methods,treatment principles and drugs,the volume of equipment goods and equipment were formed.The medical aid helicopter has features of small size and light weight,and has a fully furnished on fixation and spread of medical equipment.The helicopter of vibration,noise,jolt,low pressure has no effect on job status of the equipment,which performance stability and reached the design requirements.Conclusion The medical aid technique,method and equipment of rescue helicopter are researched to meet the needs of curing the wounded pilots who had to parachute in emergency situation and solve the problem of training demand in the army.