Objective To investigate the effects of goal-directed fluid therapy(GDFT)based on pulse pressure variation(PPV)on postoperative cognitive function in patients undergoing Da Vinci robot-assisted radical resection of gynecological malignancies.Methods A total of 60 patients who underwent robot-assisted radical resection of gynecological malignancies were randomly divided into control group and observation group using a random number table method,with 30 patients in each group.The control group received conventional fluid replacement regimen,while the observation group received GDFT regimen based on PPV.The surgical conditions,hemodynamic indices[heart rate(HR),mean arterial pressure(MAP),PPV],cerebral oxygen saturation(rSO2),gastrointesti-nal function,renal function,cognitive function[Mini-Mental State Examination(MMSE)score],and postoperative conditions of the two groups were compared.Results The amount of crystalloid fluid and urine output in the observation group were less than those in the control group,while the amount of colloid fluid was more than that in the control group,with statistically significant differences(P＜0.05).Five minutes after anesthesia induction,the levels of MAP,HR and rSO2 in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).Five minutes after anesthesia induction,1 hour after the Trendelenburg position,and imme-diately after the end of surgery,the PPV levels in the observation group were lower than those in the control group,with statistically significant differences(P＜0.05).After surgery,the levels of lactic acid and urea nitrogen in both groupswere higher than those before surgery,but those in the observa-tion group were lower than those in the control group,with statistically significant differences(P＜0.05).After surgery,the creatinine levels in both groups were lower than those before surgery,but those in the observation group were higher than those in the control group,with statistically signifi-cant differences(P＜0.05).The time to first flatus in the observation group was earlier than that in the control group,with a statistically significant difference(P＜0.05).On days 3,7 and 30 after surgery,the MMSE scores in the observation group were higher than those in the control group,with statistically significant differences(P＜0.05).The drainage tube indwelling time and hospital stay in the observation group were shorter than those in the control group,with statistically significant differences(P＜0.05).There was no statistically significant difference in the overall incidence of postoperative complications between the two groups(P＞0.05).Conclusion GDFT based on PPV can stabilize the hemodynamic status and rSO2 in patients undergoing Da Vinci robot-assisted radical resection of gynecological malignancies and reduce postoperative cognitive impairment.

Objective To investigate the relationship between vitamin A and vitamin E concentra-tions and preeclampsia. Methods A total of 160 pregnant women who were finished normal perinatal care and tested for serum vitamin A and vitamin E concentrations in the First Affiliated Hospital of Shenzhen Uni-versity (Shenzhen Second People's Hospital) from March 1, 2018 to February 28, 2019, including 80 pre-eclampsia cases and 80 healthy control cases were enrolled in the study. The concentrations of serum vita-mins A and E in early pregnancy ( <14 weeks) and late pregnancy (≥34 weeks) were determined by high performance liquid chromatography tandem mass spectrometry. The collected clinical and test data were sta-tistically analyzed. Results ⑴There was no significant difference in vitamin A concentration between pre-eclampsia group and control group during early pregnancy (P=0. 360) and there was no significant differ-ence in vitamin A concentration between preeclampsia group and control group during late pregnancy ( P=0. 450). ⑵ The concentration of vitamin E in early pregnant women in preeclampsia group was [(9. 51 ± 2. 82)mg/L], which was lower than that in healthy control group [(11. 19 ± 3. 04)mg/L], with significant statistically difference (t=8. 85, P=0. 01); the vitamin E concentration in late pregnant women in pre-eclampsia group was [(13. 52 ± 4. 40)mg/L], which was lower than that in healthy control group [(16. 20 ± 5. 00)mg/L], with significant statistically difference (t=10. 9, P=0. 01). ⑶Logistic regression anal-ysis showed that there was a correlation between vitamin E concentration in early pregnancy and late preg-nancy and preeclampsia. Conclusions There was no significant correlation between vitamin A concentra-tion and preeclampsia. Vitamin E may be involved in the pathogenesis of pre-eclampsia.

Objective To study the effects of thymus transplantation(TT)combined with CD4--DLI on T cell reconstitution after allogeneic hematopoietic stem cell transplantation(allo-HSCT). Methods BALB/c mice were randomly divided into three groups:hematopoietic stem cell transplantation (HSCT group),hematopoietic stem cell transplantation combined with thymus transplantation(TT group)and hematopoietic stem cell transplanta-tion combined with thymus transplantation plus CD4+ T cell-depleted lymphocyte infusion(CD4--DLI group). On day-1,the mice were treated with the lethal dose of radiotherapy. On day 0,C57BL/6 mice were used as donor for hematopoietic stem cell transplantation. The mice were sacrificed on 5 days,2 weeks,4 weeks and 3 months after transplantation,respectively. The peripheral blood and spleen cells of mice were collected for determinations of T cell surface antigen,T cell receptor,naive T cells and intracellular cytokines. HE staining was used to assess the development of donor thymus. Results TT and CD4--DLI did not impair each other′s effects on T cell reconstitu-tion. TT combined with CD4--DLI increased the number of T cell reconstruction. CD4--DLI promoted the effect of TT on enlargement naive CD4+and CD8+T cell pool. Combination of TT and CD4--DLI enhanced the cytokine pro-duction of T cells. Conclusion TT combined with CD4--DLI had no side effects on TCR repertoire and thymus. Conclusion TT combined with CD4--DLI can enhance the reconstitution of T cell number and function via thymus dependent and thymus independent mechanism.