Objective To investigate the clinical application effects of tracheal intubation under general anesthesia guiding by HC visual laryngoscope in combination with fiberoptic bronchoscopy via clinical studies.Methods A total of 348 patients underwent the tracheal intubation under general anesthesia in the hospital between January 2013 and January 2015 were randomly selected and Divided into three groups according to different ways of guiding tracheal intubation.The first group was a simple fiber light guide bronchoscopy to guide the general anesthesia tracheal intubation was set to F group,In the second group,the general anesthesia tracheal intubation was set to H group for the simple HC video.The third group was HC video mirror combined with fiber light guide bronchoscopy to guide the general anesthesia tracheal intubation was set to H+F group.The general condition and intubation conditions such as the time and frequencies of intubation in three groups were recorded respectively.Results The general condition,age,BMI index,thyromental distance,interincisor distance value were similar among three groups.The time needed for intubation was the longest in group F up to (41 ± 11) s.The highest frequency of intubation was in group H with 30 times,and the time of glottis exposure was the longest in group F as (21 ± 9) s.The difference among groups and intra-groups has statistical significance (P＜0.05).Conclusion HC visual laryngoscope in combination with fiberoptic bronchoscopy guiding tracheal intubation under general anesthesia has a good effect in clinical practice,and is worthy of clinical promotion.

Objective To observe the difference of efficacy of three different treatment of internal fixation of intervetebral crasis on cervical spondylosis (spinal cord) .Methods From January 2009 to January 2013 ,There are 167 cases of patients admitted to hospital from cervical spondylosis (spinal cord ) ,randomly selected different fusion fixation methods are divided into three groups :in the first group ,there were 55 patients treated with autologous iliac bone graft fusion plate fixation ;in the second group , there were 60 patients treated with zero profile material PEEK interbody fusion with autologous bone graft ;in the third group ,the 52 patients were treated with the PEEK material MC + self‐locking cervical interbody fusion with autologous bone graft .Observa‐tion and comparison indicators include :spinal cord function JOA scores before and after surgery ,surgical segment intervertebral height and cervical curvature condition .Results Follow‐up lasted from 13 to 50 months ,the average length was 26 months .The difference in operation time ,blood loss during surgery analysis ,wherein the first group and the second or third group of three groups was statistically significant (P<0 .05) ,the difference between the second group and the third group was not statistically significant (P>0 .05) .In the first group ,there were 17 patients had transient throat discomfort and symptom disappeared 48 hours later ;dysphagia relieved or disappeared in one week ;there were two cases of screws and titanium loosen one week after operation , and were treated with immediate revision surgery .In the second ,third group ,there were 19 cases and 13 cases showed temporary throat discomfort disappeared within 48 hours after surgery respectively ,there was no dysphagia .No patient experienced cerebrospi‐nal fluid leakage ,hematoma and wound infection .The postoperative JOA scores spinal cord function (17 points France) ,surgical segmental cervical intervertebral height and curvature of three groups improved significantly compared with preoperative evaluation index ,and there was no significant difference among three groups (P>0 .05) .In the last follow‐up ,the interbody fusion rates of the first ,second and third groups were 67 .1% ,66 .3% and 65 .9% ,the difference between groups was not statistically significant (P>0 .05) .Conclusion Anterior decompression and interbody fusion locking device applications showed good performance in maintai‐ning the intervertebral height segment surgery ,rehabilitation cervical curvature ,and promote bone fusion with autogenous titanium plate fixation comparison .Patients can get a good surgery ,and the former has a simpler surgical fixation method ,shorter time ,less bleeding and less complications .

Objective This study was conducted to describe job stressors of nurses employed in military hospitals and relationship between job stressors and demography characters.Method 296 employed nurses were investigated by nurse job stressor questionnaires.Result Professional and career issues were the most frequently encountered job stressor among employed nurses,the other stressors in descending order were workload and time pressure,patient care and interaction,resource and environmental problems,management issues.Job stressors of nurses could be influenced by their age,job title,et al.Conclusion The finding suggest that effective stress management strategies should be relieve job stress.

One of the most severe consequences of injury to primary teeth is the developmental disorder of permanent successor teeth.Affected permanent teeth may exhibit malformation and impaction,therefore extraction would be indicated in certain cases.In the present report,a case of primary teeth trauma followed by permanent teeth dysplasia is reported.

Objective To compare anesthetic effect and safety of general anesthesia and combined spinal and epidural anesthesia used in autonomic nervous hyperresponsive surgery for patients with paraplegia.Methods 26 paraplegic patients were randomly divided into two groups-control group and treatment group from February 2011 to November,2015,each with 13 cases.The control group used general anesthesia,while the treatment group used combined spinal and epidural anesthesia,to observe onset time,duration,intraoperative hemodynamic changes and complications,Complications,length of stay and cost,Days and costs of hospitalization,satisfaction of patients and their families,of anesthesia in two groups.Results The dosage of narcotics and the onset time of the treatment group were better than that of the control group.The difference between the two groups was significant,and had statistical significance (P＜0.05) Two groups of patients after surgery,diastolic blood pressure,systolic blood pressure and heart rate were lower in the treatment group than in the control group,and had statistically significant difference (P＜0.05);The postoperative complications of the treatment group were significantly better than those of the control group,and had statistically significant difference (P＜0.05);There were statistically significant differences in postoperative pain degree between the two groups (P＜0.05);Two groups of patients in hospital days,hospital costs,satisfaction rate had statistically significant difference,Have statistical significance (P＜0.05).Conclusion In autonomic nervous hyperresponsive surgery for patients with paraplegia,anesthetic effect and safety of combined spinal and epidural anesthesia is significantly better than that of general anesthesia,featured by the rapid onset of action,long duration,fewer complications,strong safety and patients' great satisfaction.It is worth generalizing and applying clinically.

To discuss the situation of country doctors' training in Honghe State of Yunnan Province and to search the more useful training methods, the 171 trainees were surveyed by self-designed questionnaire. It appeared that most students improved knowledge and clinical skills obviously and they wanted more knowledge and case analysis and training of clinic skills.

OBJECTIVETo determine the feasibility of water fluoridation to prevent caries in Kunming by investigating the epidemiological status of dental caries and dental fluorosis of children, and to provide the longitudinal reference data for the long-term epidemiology survey of dental caries and dental fluorosis in Kunming city.

METHODSThrough stratified cluster sampling method, 212 5-year-old children and 1149 12-year-old children were recruited in the survey. Dental caries condition of each child was clinically examined, dental fluorosis was examined in 12-year-old group.

RESULTSThe prevalence of dental caries of primary teeth in 5-year-old group was 73.6%, mean value was 4.47 +/- 4.39. The values of permanent teeth in 12-year-old group were 53.5% and 1.42 +/- 1.83. The prevalence of dental fluorosis in 12-year-old group was 4.1% and the average community fluorosis index was 0.03.

CONCLUSIONBased on the high prevalence of dental caries and the low prevalence of dental fluorosis, it is suggested that using water fluoridation to prevent caries is feasible and necessary in Kunming city.

Child ; DMF Index ; Dental Caries ; Dentition, Permanent ; Fluoridation ; Fluorosis, Dental ; Humans ; Prevalence ; Tooth, Deciduous

Objective:To explore the clinical application pathway of the CT generative adversarial networks (CTGANs) algorithm in mandibular reconstruction surgery, aiming to provide a valuable reference for this procedure.Methods:A clinical exploratory study was conducted, 27 patients who visited the Department of Oral and Maxillofacial Surgery, Xiangya Hospital of Central South University between January 2022 and January 2024 and required mandibular reconstruction were selected. The cohort included 16 males and 11 females, with the age of (46.6±11.5) years; among them, 7 cases involved mandibular defects crossing the midline. The CTGANs generator produced 100 images, and the mean squared error (MSE) was calculated for differences between any two generated images. Preoperative cone-beam CT data from 5 patients were used to construct a labeled test database, divided into groups: normal maxilla, normal mandible, diseased mandible, and noise (each group containing 70 cross-sectional images). The CTGANs discriminator was used to evaluate the loss values for each group, and one-way ANOVA and intergroup comparisons were performed. Using the self-developed KuYe multioutcome-option-network generation system (KMG) software, the three-dimensional (3D) completion area of the mandible under cone-beam CT was defined for the 27 patients. The CTGANs algorithm was applied to obtain a reference model for the mandible. Virtual surgery was then performed, utilizing the fibular segment to reconstruct the mandible and design the surgical expectation model. The second-generation combined bone-cutting and prebent reconstruction plate positioning method was used to design and 3D print surgical guides, which were subsequently applied in mandibular reconstruction surgery for the 27 patients. Postoperative cone-beam CT was used to compare the morphology of the reconstructed mandible with the surgical expectation model and the mandibular reference model to assess the three-dimensional deviation.Results:The MSE for the CTGANs generator was 2 411.9±833.6 (95% CI: 2 388.7-2 435.1). No significant difference in loss values was found between the normal mandible and diseased mandible groups ( P>0.05), while both groups demonstrated significantly lower loss values than the maxilla and noise groups ( P<0.001). All 27 patients successfully obtained mandibular reference models and surgical expectation models. In total, 14 162 negative deviation points and 15 346 positive deviation points were observed when comparing the reconstructed mandible morphology with the surgical expectation model, with mean deviations of -1.32 mm (95% CI:-1.33- -1.31 mm) and 1.90 mm (95% CI: 1.04-1.06 mm), respectively. Conclusions:The CTGANs algorithm is capable of generating diverse mandibular reference models that reflect the natural anatomical characteristics of the mandible and closely match individual patient morphology, thereby facilitating the design of surgical expectation models. This method shows promise for application in patients with mandibular defects crossing the midline.

Pancreatic ductal adenocarcinoma (PDAC) is characterized by the highest mortality among carcinomas. The pathogenesis of PDAC requires elevated autophagy, inhibition of which using hydroxychloroquine has shown promise. However, current realization is impeded by its suboptimal use and unpredictable toxicity. Attempts to identify novel autophagy-modulating agents from already approved drugs offer a rapid and accessible approach. Here, using a patient-derived organoid model, we performed a comparative analysis of therapeutic responses among various antimalarial/fungal/parasitic/viral agents, through which econazole (ECON), an antifungal compound, emerged as the top candidate. Further testing in cell-line and xenograft models of PDAC validated this activity, which occurred as a direct consequence of dysfunctional autophagy. More specifically, ECON boosted autophagy initiation but blocked lysosome biogenesis. RNA sequencing analysis revealed that this autophagic induction was largely attributed to the altered expression of activation transcription factor 3 (ATF3). Increased nuclear import of ATF3 and its transcriptional repression of inhibitor of differentiation-1 (ID-1) led to inactivation of the AKT/mammalian target of rapamycin (mTOR) pathway, thus giving rise to autophagosome accumulation in PDAC cells. The magnitude of the increase in autophagosomes was sufficient to elicit ER stress-mediated apoptosis. Furthermore, ECON, as an autophagy inhibitor, exhibited synergistic effects with trametinib on PDAC. This study provides direct preclinical and experimental evidence for the therapeutic efficacy of ECON in PDAC treatment and reveals a mechanism whereby ECON inhibits PDAC growth.