RÉSUMÉ
Objective To observe the effects of inverse ratio ventilation on respiratory mechanics and postoperative pulmonary com-plications in morbidly obese patients during laparoscopic sleeve gastrectomy Methods A total of 62 morbidly obese patients for a laparo-scopic sleeve gastrectomy were scheduled(18-65 years old,BMI≥35kg/m2 in combination with diabetes,hypertension,hyperlipemia,and other metabolic diseases,or BMI≥40kg/m2,ASA Ⅱ or Ⅲ).Patients were randomly assigned to two groups:inverse ratio ventilation group(IRV)and control group(PVG).Two groups were adjusted with an actual tidal volume(VT)of 7-8ml/kg,and respiratory rates of 12 breaths/min.In the IRV group,the ratio of I∶E was 2∶1;in the control group,the ratio of I∶E was 1∶2.We recorded the indexes of respiratory mechanics and the blood gas at the baseline(T0),5min after anesthesia(T,),15min after pneumoperitoneum(T2),30min after pneumoperitoneum(T3),60min after pneumoperitoneum(T4)and the end of surgery(T5),and the occurrence of pulmonary com-plications on day 1,day 2 after operation was observed,and the cumulative incidence of PPCs at 7 days was counted.Results Compared to the control group,the dynamic lung compliance(Cdyn),mean airway pressure(Pmean),positive end expiratory pressure(PEEP),and the PaO2 at T,-T5 of the inverse ventilation group were increased significantly(P＜0.05),the Ppeak、Pplat at T2-T5 and dynamic lung compliance(VD/VT)at T3-T5 were decreased significantly(P＜0.05),and no difference in the PaCO2 and PETCO2 in the two groups.Grade 1 pulmonary complications occurred in both groups,and there was no difference in the total occurrence of pulmonary com-plications at 7 days.Conclusion Inverse ventilation effectively may improve respiratory mechanics and oxygenation in morbidly obese pa-tients undergoing laparoscopic sleeve gastrectomy.
RÉSUMÉ
Objective To explore the association between dyslipidemia and the level of 8-OHdG/Cr in urine among a population exposed to chronic arsenic.Methods Four hundred and seven subjects were randomly selected in an arsenic-affected area in Inner Mongolia.After blood biochemical examination,all the subjects were divided into 4 groups based on the results of total cholesterol (TC),triglycerides (TG),high density lipoprotein cholesterol (HDL-C) and low density lipoprotein cholesterol (LDL-C).The groups consisted of hypercholesterolemia,HDL-C ratio anomaly,combined hypercholesterolemia and HDL-C ratio anomaly,as well as a normal lipid group.Urine samples were collected and 8-OHdG/Cr was measured using the ELISA method.A generalized linear mixed model was used to analyze the association between dyslipidemia and 8-OHdG/Cr.Results The levels of 8-OHdG/Cr as 55.73 (39.90-79.94) ng/mg,58.08 (44.94-69.91) ng/mg,65.28 (49.29-92.95) ng/mg and 51.43 (36.86-68.57)ng/mgin the HDL-C ratio anomaly,hypercholesterolemia,combined hypercholesterolemia and HDL-C ratio anomaly groups and the control group,respectively,which showed significant differences on the levels of 8-OHdG/Cr in the four groups (P=0.006).From the linear regression analysis results showed that the 8-OHdG/Cr level incombined hypercholesterolemia and HDL-C ratio anomaly group was higher (4.25 ± 0.55 ng/mg) than in the control group (3.96 ± 0.55 ng/mg) (P=0.018).After adjusting for important covariates,there was a linear trend between the levels of 8-OHdG/Cr and dyslipidemia (P=0.016).Conclusion Data from our study showed a linear relation between hypercholesterolemia,HDL-C ratio anomaly and the 8-OHdG/Cr level,suggesting that dyslipidemia was associated with oxidative DNA damage among those arsenic-affected people.