Effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery

Objective:To study the effect of epidural anesthesia combined with total intravenous anesthesia on stress response and coagulation function in and after laparoscopic surgery. Methods: A total of 219 cases of patients who underwent laparoscopic cholecystectomy in our hospital between August 2014 and February 2017 were collected and divided into control group (n=125) who accepted total intravenous anesthesia alone and observation group (n=94) who accepted epidural anesthesia combined with total intravenous anesthesia after the anesthesia scheme was reviewed. Perioperative stress response and coagulation function were compared between two groups of patients.Results: Before operation, differences in the serum stress index contents and peripheral blood coagulation index levels were not statistically significant between two groups of patients. In operation and 2 h after operation, serum stress indexes Cor, Ang-Ⅰ, Ang-Ⅱ and NE contents of observation group were significantly lower than those of control group;peripheral blood coagulation indexes PT, TT and APTT levels were significantly higher than those of control group while TXA2, TXB2 and FBG levels were significantly lower than those of control group.Conclusions: Epidural anesthesia combined with total intravenous anesthesia can effectively alleviate the systemic stress response and reduce the hypercoagulable state in and early after laparoscopic surgery.

Interfacial Improvement of Carbon Fiber/Epoxy Composites by Incorporating Superior and Versatile Multiscale Gradient Modulus Intermediate Layer with Rigid-flexible Hierarchical Structure

In order to enhance the interfacial adhesion of carbon fiber(CF)and polymer matrix,a multiscale gradient modulus intermediate layer with rigid-flexible(GO-PA)hierarchical structure was designed and fabricated between CFs and matrix by a facile and businesslike strategy.The polarity,roughness and wettability of CFs surface as well as the thickness of intermediate layer in composite have been significantly increased after rigid-flexible hierarchical structure was constructed.The IFSS,ILSS,compression and impact toughness manifested that the hierarchical structure could bring about a fantastic improvement(76.8%,46.4%,40.7%and 37.8%)for the interfacial and mechanical properties than other previous reports.Consequently,the establishment of CF surface with gradient modulus rigid-flexible hierarchical structure via regulation of nanoparticles and polymer array would open a new,viable and promising route to obtaining high-performance composites.