ABSTRACT
Objective:To evaluate the effects of the second generation laryngeal mask airway (LMA) under general anesthesia on maternal and neonatal outcomes in cesarean delivery.Methods:This study retrospectively enrolled 544 patients who underwent cesarean delivery under general anesthesia with airway intervention in Peking University First Hospital between January 2015 and December 2019. Patients were divided into endotracheal tube group (ETT group, n=379) and LMA group (Supreme TM LMA, n=165) according to the airway devices used under general anesthesia. Propensity score matching was carried out using a multivariable logistic regression model and 133 cases of singleton pregnancies were matched in each group. The main outcome was the incidence of neonatal asphyxia at one minute after birth (1 min Apgar score ≤7). The secondary neonatal outcomes were the incidence of severe asphyxia at one minute after birth (1 min Apgar score ≤3) and asphyxia at five minutes after birth (5 min Apgar score ≤7) and the percentage of neonates transferred to neonatal intensive care unit. The secondary maternal outcomes included the incidence of regurgitation, aspiration and hypoxemia, the percentage transferred to intensive care unit, post-operation all-cause morbidity and fatality before discharge. Two independent samples t-test, Mann-Whitney U test and Chi-square test were used for statistical analysis. Results:Two of the 544 (0.4%) patients had difficulty in intubation and one of them was successfully ventilated with LMA after failed intubation. No regurgitation, aspiration or anesthesia-related death was reported. After the propensity score matching, the incidence of neonatal asphyxia at one minute after birth in the LMA group and the ETT group had no significant difference [15.8% (21/133) vs 19.5% (26/133), χ2=0.646, P=0.422]. Moreover, there were no differences between the LMA and ETT group regarding the incidence of severe asphyxia at one minute after birth [2.3% (3/133) vs 3.0% (4/133), χ2<0.001, P>0.999] or asphyxia at five minutes after birth [4.5% (6/133) vs 4.5% (6/133), χ2<0.001, P>0.999], neonatal intensive care unit admission [27.8% (37/133) vs 38.3% (51/133), χ2=3.328, P=0.068], maternal hypoxemia during the operation [1.5% (2/133) vs 4.5% (6/133), χ2=1.160, P=0.281], maternal intensive care unit admission [3.8% (5/133) vs 9.0% (12/133), χ2=3.079, P=0.079] or post-operation all-cause morbidity [2.3% (3/133) vs 2.3% (3/133), χ2=0.171, P=0.680]. Conclusions:Like tracheal intubation, the second generation LMA (Supreme TM) can be used in cesarean section under general anesthesia without increasing the risk of adverse maternal and neonatal outcomes.
ABSTRACT
Aspirin is a non-steroidal anti -inflammatory drug,has good antipyretic and analgesic effects , but also inhibits platelet aggregation and antithrombotic effects ,commonly used in clinical coronary heart disease and cerebrovascular disease in first grade , two grade prevention .The need to pay attention to the medication time , interaction,the risk of bleeding ,medication use in special populations in the process ,to ensure the reasonable clinical medication of aspirin .This review summarizes the research progress of aspirin prophylaxis .
ABSTRACT
Objective To investigate the effect of the different phases of menstrual cycle on the incidence of post-operative nausea and vomiting (PONV)after laparoscopic gynecological surger-ies.Methods A total of 228 women undergoing laparoscopic gynecological surgeries were enrolled from Mar 2016 to Feb 2017 in our hospital.They were classified into three groups according to the different phases of menstrual cycle at the time of surgeries:group follicular phase (n =98),group o-vulatory phase (n =79),and group luteal phase (n =59).The incidence of PONV and the use of res-cue antiemetic drugs were recorded within 0-2 h,0-24 h periods after surgeries.Multivariate Logistic regression analysis was applied to identify independent risk factors of PONV.Results The incidence of 0-2 h PONV and 0-24 h PONV were 23.2% (53/228)and 54.8% (125/228)respectively.Univa-riate analysis showed that the incidence of PONV in the different phases of menstrual cycle was not statistically significant,as well as 0-24 h.Multivariate logistic regression analysis showed that the risk of 0-2 h PONV in group luteal phase might be higher than that in group follicular phase,however, the difference was not statistically significant (OR =2.289,95%CI 0.979-5.355,P =0.056).And two independent risk factors of 0-2 h PONV were identified:duration of operation > 1 h (OR =3.176,95% CI 1.567-6.436,P = 0.001 )and history of PONV (OR = 5.711,95% CI 1.710-19.080,P =0.005).Three independent risk factors of 0-24 h PONV were identified:duration of op-eration>1 h (OR = 2.714,95%CI 1.525-4.829,P = 0.001 ),postoperative PCA (OR = 2.717, 95%CI 1.233-5.986,P = 0.013 )and application of metronidazole (OR = 3.926,95%CI 1.808-8.527,P =0.001).Conclusion There was no significant effect of different phases of menstrual cycle on the incidence of nausea and vomiting after gynecologic laparoscopic surgeries.
ABSTRACT
Objective:To investigate the effect of heavy ion beam on the invasion and metastasis associated gene RhoC expression in tongue squamous cell carcinoma Tca8113 cells. Methods:Real-time PCR and Western-blot were used to detect the expression of RhoC mRNA and RhoC protein respectively after Tca8113 cells were irradiated by heavy ion beams of 12 C6+. Results:The expression levels of RhoC mRNA in the experimental group were lower than that in the control group(P<0. 05) except for the levels at 12 h after 2 Gy and 4 Gy 12 C6+ irradiation. In addition, the expression levels of RhoC protein increased in a dose-dependent manner at 12 h af-ter irradiation, reaching a peak at 4 Gy, and subsequently decreased with the increase of irradiation dose. The expression level of RhoC protein was consistent with that of RhoC mRNA. Conclusion:Heavy ion beam of 12 C6+ may inhibit RhoC gene expression in Tca8113 cells.
ABSTRACT
Purpose To evaluate three-dimensional strain changes of the left ventricle in patients with type 2 diabetes and poor blood glucose control using real-time three-dimensional speckle tracking imaging (RT3D-STI), and to assess the correlation between three-dimensional strains and hemoglobin A1C (HbA1c). Materials and Methods Sixty-nine patients with type 2 diabetes and forty-two control subjects were recruited in this study. The patients were divided into DM1 group (patients with well blood glucose control, HbA1c0.05). LVM of DM2 group was higher than that in control group (P<0.01), but GAS and GLS of DM2 group were lower than those in control group (P<0.05). LVM of DM2 group was higher than that in DM1 group (P<0.01), but GAS and GLS of DM2 group were lower than those in DM1 group (P<0.01). HbA1c was negative correlated with GAS and GLS (r= - 0.773 and 0.465, P<0.01). Conclusion The reduced GAS and GLS of the patients with type 2 diabetes and poor blood glucose control may indicate damaged myocardial function.