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The present study aimed to investigate bariatric surgery's effects on pregnancy in obese women.

The source of the data was the Taiwan National Health Insurance Research Database. We extracted female patients aged 18 to 45years who had been diagnosed with obesity from 2005 to 2010. Two groups were formed based on bariatric surgery, according to the medical procedure codes of ICD-9-2001. The propensity score match of 11 was coordinated, based on the age, previous delivery, and the existence of comorbidities in patients. The primary endpoint was regarded as a pregnancy, including abortion, ectopic pregnancy, and delivery. The follow-up was performed until the end of 2013, or death.

There were 689 patients placed in each group, with a median of 64.8 follow-up months. Following multivariate analysis of the data, bariatric surgery resulted in significantly higher chances for pregnancy (aHR 2.886, p < 0.001) and resulted in a higher chance of successful delivery (aHR 2.775, p < 0.001) and vaginal delivery (aHR = 6.426, p < 0.001) compared with NS group. Moreover, we identified BS has a significantly higher proportion of vaginal delivery (BS 44.74% vs. NS 20%, p = 0.025) with significantly lower overall complications during labor (BS 9.21% vs. NS 33.3%, p = 0.006).

Patients suffering from obesity who undergo bariatric surgery have higher chances of pregnancy, successful delivery, vaginal delivery, and lower maternal complications during labor. Bariatric surgery did increase the possibility of pregnancy in obese patients.
Patients suffering from obesity who undergo bariatric surgery have higher chances of pregnancy, successful delivery, vaginal delivery, and lower maternal complications during labor. KI696 Bariatric surgery did increase the possibility of pregnancy in obese patients.
Intrapartum fever occurs frequently during labor. The purpose of this study was to investigate the effects of epidural dexmedetomidine on maternal temperature, pain score and adverse effects during labor analgesia.

A total of 600 full-term primiparous parturients were randomly divided into two groups. The dexmedetomidine group (Group Dex, n = 300) received 0.1% ropivacaine with 0.5µg/mL dexmedetomidine for epidural analgesia during labor, while the control group (Group C, n = 300) received 0.1% ropivacaine alone. The maternal temperature, visual analogue scale (VAS) and Ramsay sedation score (RSS) were recorded, and the systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were monitored. Side effects, if any, were also recorded.

The incidence of intrapartum fever was lower in Group Dex than in Group C (4.1% vs. 8.7%, χ
 = 5.07, P = 0.024). VAS values from the time of 3cm cervical dilatation to 10cm cervical dilatation were also lower in Group Dex than in Group C (1.0 ± 0.9 vs. 1.3 ± 0.7, t = 3.62, P < 0.001; 2.8 ± 0.8 vs. 3.3 ± 0.8, t = 8.09, P < 0.001; 3.1 ± 0.9 vs. 3.3 ± 0.8, t = 3.88, P < 0.001; 3.6 ± 0.8 vs. 4.1 ± 1.0, t = 5.86, P < 0.001, respectively). HR from the time of 3cm cervical dilatation to 10cm cervical dilatation was lower during labor in Group Dex than in Group C (80.0 ± 4.3 vs. 83.1 ± 5.4 beats/min, t = 7.58, P < 0.001; 81.1 ± 4.0 vs. 83.7 ± 5.5 beats/min, t = 6.48, P < 0.001; 78.9 ± 5.4 vs. 81.5 ± 6.3 beats/min, t = 5.41, P < 0.001; 83.1 ± 5.3 vs. 84.8 ± 5.6 beats/min, t = 3.75, P < 0.001, respectively), while SBP and DBP were similar between the two groups. The incidence of adverse events during labor was also similar between the two groups.

The present study showed that dexmedetomidine could reduce the incidence of intrapartum fever and relieve pain during labor without increasing adverse events.

ChiCTR-OPC-16008548.
ChiCTR-OPC-16008548.Many organic pollutants attract public health concern due to their genotoxicity. To investigate the genotoxicity of organic matter in surface water of the Pearl River Delta (PRD). Organic substances of 24 samples (dry and wet season) from North River, West River and East River were extracted from 60 L source water by XAD-2 macroporous resin. DNA damage effect of organic extracts was tested in human derived liver cells (HL-7702), using single cell gel electrophoresis (SCGE) assay. The results showed that 100% organic extracts (24/24) could induce DNA damage in HL-7702 cells when the concentration was above 1.0 L surface water/ml culture, no significant difference of DNA damage between dry and wet seasons was observed. The organic substance-induced DNA damage in HL-7702 cells was significantly (P  less then  0.05) correlated with the contents of Dissolved Organic Carbon in both seasons and Total Suspended Solids in dry season. In conclusion, organic extracts induced genetic damage in HL-7702 cells, indicating potential genotoxicity of organic pollutants of surface water from PRD, South China.
With improvements in cardiovascular care, and routine percutaneous coronary intervention for ST elevation myocardial infarction, more patients are surviving following acute coronary syndromes. However, a minority of patients develop cardiogenic shock which results in approximately 50% 30-day mortality. There are various ways to classify cardiogenic shock, and much has been written about this topic in recent years. This review will examine recent developments and put them in context.

The large randomized trials of cardiogenic shock treatments such as the IABP-SHOCK II trial used a clinical definition of shock including hypotension (systolic blood pressure of 90mmHg or less, or requirement of vasopressors to maintain such a blood pressure), as well as hypoperfusion. However, while this defines a minimum standard to define cardiogenic shock, it does not distinguish between a patient on a single vasoconstrictor and one who is on multiple high dose infusions or one on extracorporeal membrane oxygenation. The Sin a multicenter shock collaborative, Classification is fundamental to understanding a disease state, and crafting solutions to improve outcomes. The last 20 years has witnessed an explosion of percutaneous mechanical circulatory support devices of increasing sophistication and capability, and yet there has been little progress in improving outcomes of cardiogenic shock. Hopefully, the next 20 years will see massive advances in understanding of the complexities of the various stages of cardiogenic shock. With such knowledge, it is likely that targeted treatments will be developed and the mortality of this disease will finally plummet.
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