Objective To compare the effect of combined spinal epidural anesthesia and general anesthesia for cesarean section surgery on pediatric respiration,discuss the choice of anesthesia in caesarean operation.Methods 140 cases of maternal line cesarean section were randomly divided into control group and observation group,70 cases in each group.Control group used propofol,sufentanil and cis atracurium intravenous induction,after fetal take out used conventional medicine.The observation group used combined spinal epidural anesthesia with ropivacaine.Recor-ded the operation time,cut skin to fetal childbirth time and uterine incision to fetal childbirth time.Fetal umbilical arterial blood for blood gas analysis,compared the two groups of Apger score at 1min,5min,10min after birth,the first breath of time,and the use of auxiliary breathing,chest compressions and total drug recovery.Results The operation time,cut skin to take time out and uterine incision to fetus fetus in the two groups had no statistical differences(t =0.974,P =0.332;t =0.067,P =0.947;t =0.803,P =0.423).Apger score at 1min in the observation group [(8.91 ±0.75)min]was better than the control group[(9.26 ±0.86)min](t =-2.566,P =0.011),while Apger score between the two groups at 5min,10min had no statistically significant differences(t =-0.533,P =0.595;t =-0.299,P =0.765).The pediatric first breath[(7.17 ±3.26)s]of the observation group was shorter than the control group[(21.34 ±5.75)s](t =17.936,P <0.001).pH,PaCO2 ,PaO2 in umbilical artery blood of the two groups had no statistically significant differences(t =-0.438,P =0.662;t =0.102,P =0.919;t =-0.524,P =0.601).In the observation group used auxiliary breathing,chest compressions and drug recovery in all 7 cases,which was less than 15 cases in the control group,but there was no statistically significant difference (χ2 =3.451,P =0.063).Conclusion The effect of combined spinal epidural anesthesia for cesarean section in pediatric breathing is smaller,it can be used in a cesarean section safely,and worth popularizing in clinical application.

In order to clarify the cellulose-utilizing mechanism of the Cerambycidae, the microorganism in the Apriona germari(Hope) larvae's gut was cultured and identified. A strain of facultative anaerobic cellulose-utilizing bacteria was isolated from the midgut fluid of A. germari larvae with the cellulose-congo red agar medium. The colonies of the bacteria were white and round with regular margin. Clear zones of cellulolysis surrounding the colonies might reach 10m～20mm. The size of the bacteria was 0.5μm～0. 8μm× l～3μm approximately. The cell was gram-positive rod with polar flagella. It hadn't spores. With the results of biochemical tests, the bacteria were tentatively identified as Cellulomonas.

In order to clarify the cellulose utilizing mechanism of the Cerambycidae, the microorganism in the Apriona germari(Hope) larvae’s gut was cultured and identified. A strain of facultative anaerobic cellulose utilizing bacteria was isolated from the midgut fluid of A. germari larvae with the cellulose congo red agar medium. The colonies of the bacteria were white and round with regular margin. Clear zones of cellulolysis surrounding the colonies might reach 10mm～20mm. The size of the bacteria was 0.5?m～0.8?m?1～3?m approximately. The cell was gram positive rod with polar flagella. It hadn't spores. With the results of biochemical tests, the bacteria were tentatively identified as Cellulomonas.

ObjectiveTo investigate the therapeutic value of noninvasive mechanical ventilation in patients with conscious disturbance due to severe chronic obstructive pulmonary disease (COPD) with respiratory failure. MethodsForty-two patients with conscious disturbance due to COPD complicated with respiratory failure were selected in the study. GALILEO or PAPHAEL large EMT ventilator produced by Switzerland Hamilton Company was used for noninvasive mechanical ventilation with P-SIMV+PSV+PEEP mode. Meanwhile, the change of vital signs, consciousness, the degree of inspiratory muscle fatigue and blood gas indexes were observed before and after treatment. Glasgow coma scale (GCS) was applied to evaluate the consciousness, and scale for accessory muscle use was adopted to measure the degree of inspiratory muscle fatigue. ResultsAll the patients were treated successfully. Compared with admission, the pH value, the pressure of arterial carbon dioxide (PaCO2) and the arterial oxygen pressure/inhaled oxygen concentration (PaO2/FiO2)were significantly improved 2 hours, 4 hours and 24 hours after treatment. The respiration rate and heart rate were markedly decreased 24 hours after treatment, which indicated that the condition of the patients tended to be stable and the patients could endure the therapy. The average GCS was increased from 5.69-1-0.93 to 10.45±1.23 (t= 31.68, P<0.001), and the state of consciousness was improved significantly. The scale for accessory muscle use was decreased from 3.70±0. 45 to 2. 06±0. 52 (t = 31.21, P < 0. 001), and the respiratory muscle fatigue was relieved. ConclusionsNoninvasive mechanical ventilation has obvious clinical curative effect on severe infection and conscious disturbance due to severe COPD complicated with respiratory failure.

OBJECTIVES: The number of gestational women has been increased in recent years, resulting in more adverse pregnancy outcomes. It is crucial to assess the coagulation function of pregnant women and to intervene in a timely manner. This study aims to analyze the influencing factors on thrombelastography (TEG) and explore the evaluation of TEG for gestational women. METHODS: A retrospective study was conducted on 449 pregnant women who were hospitalized in the obstetrics department in Xiangya Hospital of Central South University from 2018 to 2020. We compared the changes on the TEG parameters among normal pregnant women between different age groups, different ingravidation groups, and different stages of pregnancy groups. The influence on TEG of hypertensive disorders in pregnancy (HDP) and gestational diabetes mellitus (GDM) as well as two diseases synchronization was explored. RESULTS: Compared with the normal second trimester women, the R values and K values of TEG were increased, and α angle, CI values and LY30 values were decreased in third trimester women (all P<0.05). Compared with normal group, the R values and CI values of TEG of the HDP group have significant difference (both P<0.05). There were no significant difference of TEG between the GDM group, the HDP combined with GDM group and the normal group (all P>0.05). Multiple linear regression analysis showed that the influencing factors for R value in TEG were weeks of gestation (P<0.001) and mode of conception (P<0.05), for α angle was weeks of gestation (P<0.05), for MA value was mode of conception (P<0.05), and for CI value was weeks of gestation (P<0.05). The analysis of correlation between TEG with platelet (PLT) and coagulation routines represented that there was a correlation between TEG R values and activated partial thromboplastin time (APTT) (P<0.01), and negative correlation between TEG CI values and APTT (P<0.05). There was a negative correlation between TEG K values and FIB (P<0.05). The correlation of α angle (P<0.05), MA values (P<0.01) and CI values (P<0.05) with FIB were positive respectively. CONCLUSIONS The TEG parameters of 3 stages of pregnancy were different. The different ingravidation approach has effect on TEG. The TEG parameters were consistent with conventional coagulation indicators. The TEG can be used to screen the coagulation status of gestational women, recognize the abnormalities of coagulation and prevent the severe complication timely.
Female ; Humans ; Pregnancy ; Thrombelastography/methods* ; Blood Coagulation Tests/methods* ; Retrospective Studies ; Blood Coagulation ; Blood Platelets ; Diabetes, Gestational/diagnosis*