Background/ObjectiveInadvertent intraoperative hypothermia (core temperature <360 C) is a recognized risk in surgery and has adverse consequences. However, no data about this complication in China are available. Our study aimed to determine the incidence of inadvertent intraoperative hypothermia and its associated risk factors in a sample of Chinese patients.MethodsWe conducted a regional cross-sectional survey in Beijing from August through December, 2013. Eight hundred thirty patients who underwent various operations under general anesthesia were randomly selected from 24 hospitals through a multistage probability sampling. Multivariate logistic regression analyses were applied to explore the risk factors of developing hypothermia.ResultsThe overall incidence of intraoperative hypothermia was high, 39.9%. All patients were warmed passively with surgical sheets or cotton blankets, whereas only 10.7% of patients received active warming with space heaters or electric blankets. Pre-warmed intravenous fluid were administered to 16.9% of patients, and 34.6% of patients had irrigation of wounds with pre-warmed fluid. Active warming (OR = 0.46, 95% CI 0.26–0.81), overweight or obesity (OR = 0.39, 95% CI 0.28–0.56), high baseline core temperature before anesthesia (OR = 0.08, 95% CI 0.04–0.13), and high ambient temperature (OR = 0.89, 95% CI 0.79–0.98) were significant protective factors for hypothermia. In contrast, major-plus operations (OR = 2.00, 95% CI 1.32–3.04), duration of anesthesia (1–2 h) (OR = 3.23, 95% CI 2.19–4.78) and >2 h (OR = 3.44, 95% CI 1.90–6.22,), and intravenous un-warmed fluid (OR = 2.45, 95% CI 1.45–4.12) significantly increased the risk of hypothermia.ConclusionsThe incidence of inadvertent intraoperative hypothermia in Beijing is high, and the rate of active warming of patients during operation is low. Concern for the development of intraoperative hypothermia should be especially high in patients undergoing major operations, requiring long periods of anesthesia, and receiving un-warmed intravenous fluids.

Lumbar decompressive surgery is the gold standard treatment for lumbar spinal stenosis. Minimally invasive surgical techniques have been introduced with the aim of reducing the morbidity associated with open surgery. The purpose of the present study was to systematically search the literature and perform a meta-analysis of studies comparing the outcomes between biportal endoscopic technique and microscopic technique for lumbar canal stenosis decompression. A comprehensive search of the PubMed, Google Scholar, Web of Science, Embase and the Cochrane Library databases was performed to identify relevant articles up to 15th of December 2019. Eligible studies were retrieved, data were extracted by two authors independently and risks of bias were assessed. A total of six studies involving 438 patients were selected for review. The results of the pooled analysis indicated similar operative times [mean difference (MD),-3.41; 95% CI,-10.78-3.96; P<0.36], similar complications (MD, 0.70; 95% CI, 0.33-1.46; P=0.34), similar visual analogue scale scores for back and leg pain at the time of the final follow-up and similar Oswestry disability indexes (MD,-0.28; 95% CI,-1.25-0.69; P=0.58) for the two procedures. In conclusion, biportal endoscopic technique is a viable alternative to microscopic technique for lumbar canal stenosis decompression with similar operative time, clinical outcomes and complications.

The purpose of this study was to evaluate related risk factors for gallstone disease in Shanghai. We analyzed successive physical examinations of 2288 adults who were recruited at the Jinshan Branch of the Sixth People's Hospital of Shanghai and Jinshan Hospital Affiliated to Fudan University Hospital from July 2010 to December 2012. The odds ratios (ORs) with 95% confidence intervals (CIs) were used to measure the influence factors on the risks of gallstone development. The incidence of gallstone disease was 4.11% (94/2,288). Older age (OR: 1.02; 95% CI: 1.00–1.03; P = .039), higher body weight (OR: 1.02; 95% CI: 1.00–1.04; P = .021), alanine transaminase activity (ALT) (OR: 1.02; 95% CI: 1.01–1.03; P = .001), total standard bicarbonate (SB) (OR: 1.04; 95% CI: 1.02–1.06; P < .001), free SB (OR: 1.17; 95% CI: 1.12–1.21; P < .001), and low density lipoprotein (LDL) levels (OR: 1.59; 95% CI: 1.32–1.91; P < .001) were associated with an increased risk of gallstone disease. Based on univariate logistic analysis, increased triglyceride (TG) levels were associated with a reduced risk of gallstone disease (OR: 0.76; 95% CI: 0.60–0.97; P = .024). The results of multivariable logistic regression analysis showed higher LDL levels correlated with an increased risk of gallstone disease (OR: 1.92; 95% CI: 1.31–2.81; P < .001), while age, weight, ALT, total SB, free SB, and TG levels did not affect the risk of gallstone disease. The although unadjusted results showed age, weight, ALT, total SB, free SB, TG, and LDL levels to be associated with the risk of gallstone disease, adjusting for potential factors revealed only increased LDL levels to be associated with an increased risk of gallstone disease.

Aim: To determine the change in cognitive function in very elderly men with chronic obstructive pulmonary disease (COPD) over a 3-year period relative to age- and education-matched controls. Methods: In this hospital-based, prospective case-control study, we evaluated a consecutive series of 110 very elderly men with COPD and 110 control subjects who were hospitalized between January and December 2007. All the subjects performed cognitive tests at baseline and underwent annual evaluations (for 3 years), which included the Mini-Mental State Examination, word list recall, delayed recall, animal category fluency, and the symbol digit modalities test. Results: In mixed-effects models adjusted for hypertension and coronary heart disease, COPD was associated with a more rapid rate of cognitive decline based on the Mini-Mental State Examination, word list recall, delayed recall, animal category fluency, and the symbol digit modalities test (all p < 0.01) compared to controls. Conclusion: COPD is associated with a more rapid rate of cognitive decline in very elderly persons.

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