The effects of positive end-expiratory pressure (PEEP) on pulmonary shunt were studied during gen- eral anesthesia and postoperative period.Twenty cholecystectomy patients were randomly divided into experiment group (group P) and control group (group Z). PEEP and ZEEP were used separately after induction. Artery blood and mixed blood from the right ventricle were taken for blood gas analysis and determine the amount of pulmonary shunting before anesthesia. half and hour, one and half an hour and two and half an hour after anesthesia and one hour after the operation.The results showed that shunt in group P decreased gradually during general anesthesia and returned to the level of preoperation at an hour after operation. Shunt in group Z was increased continually and the level was significantly higher than preoperation an hour after operation. Shunt between two groups was significant difference (P

Background The ocular nerve of trigeminus is the sensation and nutrition nerve of cornea.Whether trigeminal neuralgia affect the function of ocular surface and the morphology of corneal nerve plexus or not is below understanding.Confocal microscope is a non-invasive method for in vivo corneal examination.Objective This study was to analyze the ocular surface findings and observe the morphology and density of corneal nerve under the confocal microscopy in patients with trigeminal neuralgia.Methods Thirty-three eyes of 33 patients with trigeminal neuralgia were collected from the Department of Pain Management in Henan Provincial People's Hospital.The corneal perceptual sensitivity was examined using corneal aesthesiometer,and the function of lacrimal secretion (Schiemer Ⅰtest),tear break-up time (BUT) were performed to evaluate the influence of trigeminal neuralgia on ocular surface.The change of corneal nerve was observed under the confocal microscopy.The fellow eyes served as controls.The informed consent was obtained from the subjects before any examination.Results The fiber length of corneal perceptual sensitivity was (54.348±6.793)mm and (55.217±6.480)mm in trigeminal neuralgia group and control group without a significant difference between them (t=0.641,P=0.528).No significant differences were found in the mean value of Schiemer Ⅰtest (9.390±6.583mm vs 9.300±5.295mm) and BUT result (6.09±4.177s vs 6.13±4.799s) between trigeminal neuralgia and control group(t=0.070,P=0.945;t=-0.085,P=0.933).The densities value of corneal subepithelial nerve plexus at the nasal,temporal,superior,inferior and central area was insignificantly changed between trigeminal neuralgia group and control group(P=0.840,0.459,0.268,0.120,0.607).Tenuous,bending and circling nerve fibers were seen in corneal stroma under the confocal microscope,while the nerve fibers were strict in controls.Conclusion Trigeminal neuralgia does not dramatically affect eye surface function and corneal subbasal nerve plexus density,but corneal nerve fibers with trigeminal neuralgia are more bending than normal people.

Child ; Female ; Gastroscopy ; Humans ; Pylorus ; abnormalities

Objective To ob serve the clinical effect of blood-activating and stasis-dissolving drugs combined with western medicine ( WM) for the treatment of recurrent spontaneous abortion ( RSA) induced by prethrombotic state ( PTS). Methods A total of 120 patients with RSA at PTS were randomly assigned to treatment group (68 cases) and control group (52 cases). Patients in both groups were treated with aspirin and low molecular weight heparin, while those in the treatment group additionally received Chinese medicine for activating blood and dissolving stasis. Before and after treatment, indexes of coagulation-fibrinolysis and the development of embryos were compared between the two groups. Results The therapeutic effective rate was 88.24% in the treatment group, higher than that of the control group ( 69.23%, P<0.05). The levels of plasma thrombin time ( TT) , D-dimer, fibrinogen and antithrombin Ⅲ ( AT-Ⅲ) were all improved ( P<0.05) in the two groups after treatment. Besides, the treatment group had better effect on improving levels of plasma D-dimer, fibrinogen and AT-Ⅲ ( P<0.05). During the treatment, no drug-induced adverse reaction was found. Neither neonatal deformity nor maldevelopment occurred. Ninety-seven cases achieved successful pregnancy, and 45 cases had given term girth ( 29 cases from the treatment group and 16 from the control group). Fifty-two cases were in stable middle- and late-stage of pregnancy. Conclusion Therapy of activating blood and dissolving stasis is an effective method for RSA at PTS. It has obvious effects on improving high coagulation state during pregnancy. Chinese medicine combined with WM shows better therapeutic efficacy than WM alone.

Objective To analyze the relationship between pre － pregnancy body mass index ( BMI) ，gestational weight gain ( GWG) and the birth weight of infants，and explore the effect of weight change before and during pregnancy on low birth weight ( LBW) and macrosomia． Methods Women were enrolled by the Chinese Pregnant Women Cohort Study during first trimester． Each respondent＇s weight before and during pregnancy and the birth weight of infant were collected after fellow up． Prepregnancy BMI was divided into underweight，normal and overweight /obesity groups and GWG was divided into suitable， insufficient and excessive groups． Multivariate Logistic regression was adopted to explore the relationship be- tween pre－pregnancy BMI，GWG and newborn＇s birth weight． Ｒesults Women＇s prepregnancy BMI and GWG were associated with neonatal birth weight ( all P＜0. 05) ． Prepregnancy overweight or obesity ( OＲ=2. 339，95% CI: 1. 674－2. 282，P＜0. 001) and excessive GWG ( OＲ= 1. 398，95% CI: 1. 188－1. 978，P= 0. 048) were shown as risk factors for macrosomia． Insufficient GWG increased LBW risk ( OＲ = 1. 479， 95% CI: 1. 461－1. 679，P= 0. 035) while excessive GWG declined LBW risk ( OＲ= 0. 428，95% CI: 0. 225 －0. 817，P= 0. 010) ． Under weight－insufficient GWG was risk factor of LBW ( OＲ= 1. 335，95% CI: 1. 048 －2. 319，P= 0. 048) while normal BMI－excessive GWG ( OＲ= 1. 088，95% CI: 1. 016－1. 675，P= 0. 038) and overweight /obesity－excessive GWG ( OＲ= 1. 498，95% CI: 1. 244－2. 017，P= 0. 046) were associated with higher risk of delivering macrosomia． Conclusions Prepregnancy BMI and GWG were associated with infant＇s birth weight and women were suggested to maintain their weight in recommended range before and during pregnancy．

Adolescent ; Adult ; Dust ; Female ; Humans ; Male ; Mental Health ; statistics & numerical data ; Middle Aged ; Occupational Exposure ; Steel ; Surveys and Questionnaires

Adult ; Choristoma ; diagnostic imaging ; Female ; Head and Neck Neoplasms ; diagnostic imaging ; Humans ; Thymoma ; diagnostic imaging ; Tomography, Spiral Computed

Objective To investigate the clinical efficacy of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery for patients at the early stage of traumatic brain injury (TBI). Methods 72 patients with TBI hospitalized from January, 2013 to October, 2014 and 30 healthy controls matched gender, age and educational background were assessed with the Chinese version of LOTCA battery and Mini-Mental State Examination (MMSE) respectively. Results The score of MMSE and LOTCA were correlated (r=0.56, P<0.01). Compared with the controls, the scores of all the subtests of LOTCA decreased (P<0.01) in the patients, especially the orientation, visuomo-tor organization and thinking operation;with the more incidence of medium and serious dysfunction of all the subtests of LOTCA except perception (P<0.01), in which thinking operation was the most and attention was the least. The area under the receiver operating curve (ROC) was (0.84±0.04) in LOTCA, less than that of (0.91±0.03) in MMSE (P<0.05). Conclusion Cognition is widely impaired in patients after TBI, most involved thinking operation. LOTCA is less effective to identify cognitive dysfunction than MMSE, and can be used as an al-ternation or a supplement.

Objective To test the reliability and validity of the Chinese version of the John Hopkins Adapted Cognitive Exam ( ACE) in NICU patients. Methods The English ACE was translated and adapted into the Chinese version . Cognitive functions of 40 critically ill patients in NICU were assessed with the Chi?nese version of ACE and MMSE battery.The scores of ACE and MMSE were analyzed to test the content va?lidity,construct validity,concurrent validity,internal consistency,inter?rater reliability and test?retest reliabil?ity.Result The correlation coefficient between each factor and the total score ranged from 0.617 to 0.938, and the content validity was good.The ACE was significantly correlated with MMSE( r=0.822, P<0.05). Five factors were extracted by main principle analysis, the cumulative contribution was 85. 90%, the factor loading of each item was all over 0.5,the scale had good construct validity.There existed a good internal con?sistency ( Cronbach’ α=0.756 ) as well as a good inter?rater reliability ( ICC>0.95) and test?retest reliabil?ity (ICC=0.652?0.979) of the Chinese version of ACE.Conclusions The Chinese version of ACE has been proved to be a reliable and valid screening tool for cognitive impairment in NICU patients.

Objective To investigate the incidence of auditory nerve pathway injury complicated with cere- bral palsy(CP) and its related factors relationship between the incidence rate of it and sexes,classification and risk factors. Methods The clinical data of 272 children with CP,including the data of brainstem auditory evoked po- tentials,were retrospectively reviewed.The incidence of auditory nerve pathway injury and the related factors were analyzed.Results In the 272 CP children,the incidence of auditory nerve pathway injury was 29.8% (81:272), which had a significantly relationship with the clinical types of CP (P0.05).In addition,it was found that the pathological jaundice (OR=2.945,95% CI:1.649-5.260) and intrauterine infection (OR=3.319,95% CI:1.037-10.625) were significantly related to auditory nerve pathway injury. Conclusion The auditory nerve pathway injury is common in CP children,especially in those with athetosis and mixed CP.Pathological jaundice and intrauterine infection are the risk factors of auditory nerve pathway injury.