OBJECTIVETo compare the cardiorespiratory factors and surgical conditions during total intravenous anesthesia for prolonged laparoscopic pelvic surgery with or without supplemental muscle relaxants.

METHODSForty female ASA I or II patients undergoing laparoscopic pelvic surgeries were randomized into two groups A and B, both with standardized anesthesia via a intravenous bolus injection of rocuronium (0.6 mg/kg). The patients in group B received continuous rocuronium infusion upon observation of one TOF twitch response with the T1 value maintained within 0-10% and rocuronium withdrawal at 20 to 30 min before the completion of the surgery. The patients in group A received no supplemental muscle relaxants. The cardiorespiratory parameters were measured during the operation. The respiratory system compliance (Ceff rs) was calculated as the quotient of the tidal volume (VT) and peak inspiratory pressure (PIP), and the operative conditions were graded by the operating gynecologist.

RESULTSThe cardiorespiratory parameters significant increased and Ceff rs decreased after pneumoperitoneum, but no significant differences were found between the two groups. The surgical conditions were also comparable between the two groups, but the duration of intubation and the operating time were significantly shorter in the group A.

CONCLUSIONPneumoperitoneum severely affects the cardiorespiratory parameters during laparoscopy, which can not be lessened by neuromuscular block agents. A single intubating dose of rocuronium can suffice the requirement of prolonged gynecologic laparoscopic surgery.

Androstanols ; administration & dosage ; Anesthesia, Intravenous ; Female ; Gynecologic Surgical Procedures ; Humans ; Laparoscopy ; methods ; Neuromuscular Nondepolarizing Agents ; administration & dosage

Objective To observe the progression of intestinal fibrosis in chronic radiation intestinal injury(CRII)and study the protective mechanisms of autophagy agonist rapamycin on intestinal fibrosis in CRII.Methods Thirty C57/B6male mice were randomly divided into the control group(CO group),the radiation group(SR group)and the rapamycin intervention group(RI group).The CO group was not treated.In SR group,the CRII model(single dose of9Gy radiation)was established first,and the samples were taken after 3months.In RI group,the rats were treated with rapamycin(2mg/kg,intraperitoneal injection)for 1 week after modeling,other treat-ments were the same as that in SR group.Hematoxylin-eosin staining and Masson staining were used to evaluate the degree of intestinal mucosal injury and intestinal fibrosis.Enzyme-linked immunosorbent assay was used to detect the serum levels of interleukin-1 β(IL-1β)and interleukin-6(IL-6).The level of intestinal α-smooth muscle actin(α-SMA)was detected by immunohistochemistry.The levels of transforming growth factor-β1(TGF-β1),connective tissue growth factor(CTGF)and autophagy-related proteins(p62 and LC3)were detected by Western blot.Results Histopathological staining showed that compared with CO group,the intestinal muco-sal damage was aggravated(P＜0.05),and the degree of intestinal fibrosis was increased in SR group(P＜0.01).Compared with SR group,the intestinal mucosal damages were relieved(P＜0.05),and the intestinal fibrosis was greatly decreased in RI group(P＜0.01).Compared with the CO group,the levels of IL-1 β and IL-6 in the SR group were significantly increased(P＜0.01),while those in the RI group significantly decreased compared with the SR group(P＜0.01).The results of immunohistochemistry and Western blot showed that the expression levels of α-SMA,TGF-β1 and CTGF in the SR group were greatly higher than those in the CO group(P＜0.05),while significantly lower in the RI group than those in the SR group(P＜0.05).The expression of autophagy indexes in SR group were lower than that in the CO group(P＜0.05),and significantly higher in the RI group than that in the SR group(P＜0.05).Conclusion Rapamycin-induced autophagy could improve the process of intestinal fibrosis in CRII,and the mechanism may be related to the inhibition the differentiation and function of intestinal myofibroblasts and reduce the inflammation of intestine.

To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12-13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98.The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12-13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need.
Adolescent ; Child ; China ; epidemiology ; Cross-Cultural Comparison ; Data Collection ; Dental Health Surveys ; methods ; standards ; Female ; Health Services Needs and Demand ; statistics & numerical data ; Humans ; Male ; Malocclusion ; diagnosis ; epidemiology ; Needs Assessment ; statistics & numerical data ; Observer Variation ; Orthodontics, Corrective ; standards ; statistics & numerical data ; Reference Values ; Reproducibility of Results ; Sensitivity and Specificity

Objective To investigate distribution and antimicrobial resistance among nosocomial pathogens from 13 teaching hospitals in China in 2009. Methods Non-repetitive pathogens from nosocomial BSI, HAP and IAI were collected and sent to the central lab for MIC determination by agar dilution method.WHONET5.6 software was used to analyze the data. Results A total of 2 502 clinical isolates were collected. The top three pathogens of BSI were Escherichia coli [27. 1% (285/1 052 )] , coagulase-negutive staphylococcus [12. 6% ( 133/1 052)] and Klebsiella pneumoniae [10. 8% ( 114/1 052)]. The top three pathogens of HAP were Acinetobacter baumannii [28. 8% (226/785)], Pseudomonas aeruginosa [16. 1% (126/785)] and Klebsiella pneumoniae [14.6% (115/785 )] . The top three pathogens of IAI were Escherichia coli[31.0% ( 206/665 )], Klebsiella pneumonia [11.3% ( 75/665 )] and Enterococcus faecium [10. 8% (72/665)]. Against Escherichia coil and Klebsiella spp. , the antimicrobial agents with higher than 80% susceptibility rate included imipenem and meropenem (98. 1%-100% ), tigecycline (95.3%-100% ), piperacillin-tazobactam ( 88.6% -97. 1% ) and amikacin ( 88. 3% -92. 5% ). Against Enterobacter spp. , Citrobacter spp. and Serratia spp. , the susceptibility rates of tigecycline were 93.5% -100% whereas the value of imipenem and meropenem were 92.9% -100%. Other antimicrobial agents with high activity included amikacin ( 85.2% -96. 7% ), pipcracillin-tazobactam ( 82.4% -96.4% ), cefepime ( 79. 6% -96. 7% ) and cefoperazonc-sulbactam (78. 7%-90. 0% ). Polymyxin B showed the highest susceptibility rateagainst Pseudomonas aeruginosa ( 100% ), followed by amikacin ( 81.9% ) and piperacillin-tazobactam (80.1% ). Polymyxin B also showed the highest susceptibility rate against Acinetobacter baumannii (98. 8% ), followed by tigecycline (90. 1% ) and minocycline (72. 0% ). The incidence of carbapenemresistant Acinetobacter baumannii was 60. 1%. The MRSA rate was 60. 2% and the MRSCoN rate was 84. 2%. All Staphylococcus strains were susceptible to tigecycline, vancomycin, teicoplanin and linezolid except for one isolate of Staphylococcus haemolysis with intermediate to teicoplanin. Two Enterococcus faecalis isolates which were intermediate to linezolid and one Enterococcus faecium isolate which was resistant to vancomycin and teicoplanin was found in this surveillance, while the MICs of tigecycline against these three isolates were 0. 032-0. 064 μg/ml. Conclusions Tigecycline, carbapenems, piperacillin-tazobactam,amikacin and cefepime remain relatively high activity against nosocomial Enterobacteriaceae. Pseudomonas aeruginosa exhibite high susceptibility to polymyxin B, while Acinetobacter baumanni shows high susceptibility to polymyxin B and tigecycline. Tigecycline, vancomycin, teicoplanin and linezolid remain high activity against nosocomial gram-positive cocci.

To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12–13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98. The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12–13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need. International Journal of Oral Science (2012) 4,