Objective To investigate the effect of nasal intubation guided by fiberoptic bronchoscope (FOB) and intubation guided by laryngoscope on hemodynamics and arterial oxygen saturation (SaO2).Methods Sixty-one patients received tracheal intubation for mechanical ventilation were divided into observation group (31 cases) and control group (30 cases) by random digits table who received FOB guided nasotracheal intubation and laryngoscope intubation respectively, the systolic blood pressure (SBP),diastolic blood pressure (DBP), heart rate (HR) and SaO2 of all patients in two groups was measured and recorded 1 min before intubation, the intubation moment and 5 min after intubation. Results Patients in two groups were successfully intubated. The average time in observation group was (35.2 ± 12.5) s and in control group was (38.7 ± 13.6) s, and there was no significant difference between two groups (P ＞ 0.05);SBP, DBP and HR of two groups at the intubation moment increased significantly than that at 1 min before intubation, while SaO2 decreased significantly, and the rangeability of above indexes in observation group were significantly lower than those in control group, there were significant differences between two groups (P ＜ 0.05). Conclusion FOB guided nasotracheal intubation has little effect on hemodynamics and blood SaO2, it is a safe method of endotracheal intubation and worthy of clinical application.

Objective To investigate the relationship between plasma level of homocysteine (Hcy) and amyotrophic lateral sclerosis (ALS).Methods The differences of Hcy,Vitamin B12,and folate levels between 150 outpatients with ALS and 137 age and sex matched controls were compared in a cross-sectional study.Results Compared with the healthy controls,patients with ALS had a higher plasma Hcy level [ ( 18.47 ± 13.09) μmol/L vs ( 11.91 ± 5.37 ) μmol/L,P ＜ 0.001 ] and a lower folate level [ ( 8.39 ±4.45) ng/ml vs (10.38 ±5.01) ng/ml,P ＜0.001].In a logistic regression model using ALS as a dependent variable,plasma level of Hcy was significantly associated with ALS.A trend for higher Hcy levels in patients with shorter interval from symptom onset to diagnosis ( ODI ) was also found [ Hcy levels (20.73 ± 15.79 ) μmol/L with ODI ＜ 19 months vs ( 16.41 ± 9.73 ) μmol/L with ODI ≥ 19 months,P =0.035 ].Conclusions Plasma Hcy level is significantly increased in patients with ALS.The individuals with shorter time to diagnosis present higher Hcy level,suggesting that it may associate with the progression pace of ALS.

Objective To establish the reference range of anti-mutated citrullinated vimentin antibody (anti-MCV ) among healthy individuals in Northeast area of Sichuan .Methods The Alegria enzyme-linked immunosorbent assay system and the matched anti-MCH reagent test kit were adopted to detect the serum anti-MCV concentration in 141 serum samples collected from healthy individuals .Results The intra-batch and inter-batch precisions and the functional sensitivity of the Alegria enzyme-linked immunosorbent assay system all met the laboratory requirements .The concentration of serum anti-MCV was 12 .10(6 .70-41 .30) U/mL in the healthy female group and 11 .10(6 .00-18 .30)U/mL in the healthy male group ,there was no statistical difference be-tween these two groups(Z= -0 .991 ,P=0 .322);the detection results of serum anti-MCV in the age groups of <50 years old and ≥50 years old had no statistical differences (Z= -0 .588 ,P= 0 .558) .The reference range of anti-MCV in the investigated healthy individuals was 0 .00-18 .14 U/mL .Conclusion The reference range of anti-MCV has no correlation with gender and age . Establishing the reference range of anti-MCV suitable for the healthy population in the local area has very important clinical applica-tion value .

Objective To explore the diagnostic value of corneal confocal microscopy in the early small fibre neuropathy (SFN).Methods A total of 45 patients with small fibre neuropathy and 50 age-matched healthy subjects undertook a neurological evaluation,neurological deficits score (NDS),sural nerve conduction velocity,contact heat evoked potential (CHEP) and corneal confocal microscopy (CCM) to quantify small nerve fibre pathology.Four parameters including nerve fiber length (NFL),nerve branch density (NBD),nerve fiber density (NFD) and nerve fibre tortuosity (NFT) were calculated from the observation of corneal confocal microscopy.Results Compared with the control group,significantly decreased NFD and NBD were found in the SFN group [(42.00 ±25.26)/mm2 vs (72.38 ± 14.09) /mm2 ;(31.93 ± 13.21)/mm2 vs (46.24 ± 11.48)/mm2 ; with all P ＜ 0.05],while NFT were significantly increased in the SFN group [(2.48 ±0.87) levels vs (0.88 ±0.56) levels,P ＜0.001].The neurological deficits score was correlated with NFT,NFD and NBD (r =0.782,-0.376,-0.504 ; with all P ＜ 0.001).Conclusion CCM is a new and sensitive noninvasive clinical technique that may be used to detect early small fibre nerve damage in patients with SFN.

Objective To investigate the relationship between alterations in the corneal innervation observed by laser confocal microscopy and peripheral neuropathy severity in the patients with impaired glucose tolerance (IGT).Methods A total of 70 patients with IGT were consecutively enrolled into the study.Among them,30 patients were diagnosed as peripheral neuropathy (IGT-PN),40 patients without peripheral neuropathy (IGT-NPN).Fifty age-matched healthy subjects were also studied.Corneal subbasal nerves were investigated by laser confocal microscopy.Results Corneal nerve fiber length (17.1 ±4.9) vs (14.0±3.8) mm/mm2; t=13.484,P＜0.05),newe branch density ((53.1 ±18.8) vs (36.2±11.5) mm/mm2 ; t =9.369,P ＜ 0.01) and nerve fibre tortuosity ((2.07 ± 0.76) vs (0.88 ± 0.55) levels,t =12.957,P ＜0.05)were significantly increased in IGT-NPN group when compared with control group,but nerve fibre density had no difference.Nerve fiber length,nerve branch density and nerve fibre density were significantly decreased in IGT-PN group compared with control group and IGT-NPN group,while NFT was significantly increased in IGT-PN group.Conclusions Patients with impaired glucose metabolism show alterations in corneal innervations before diagnosed with diabetes mellitus or peripheral neuropathy.It indicates that corneal confocal microscopy can be used for early diagnosis of diabetic peripheral neuropathy.

Objective To establish a regional medical information sharing platform used to promote the sharing of regional medical data such as electronic medical records( EMR) and medical images in order to improve medical services. Methods With reference to results and experience of the domestic and foreign research and by virtualizing re-establish-ment of the existing medical information resources,a regional medical information sharing platform was established based on cloud computing, SOA,and Web services, and then the heterogeneous information systems in different medical institutions were integrated.Results A novel cloud platform solution was proposed for clinical information exchange between medical institutions based on Web services that exchanged data and ensured the data security and privacy using XML encryption and compression.The prototype developed in a cloud environment was put into use in dozens of military hospitals to enable the sharing of clinical information.Conclusion This cloud computing platform has the advantages of dynamic scalability, distributed and ubiquitous access.It is highly feasible and practical for regional medical informatization.

Objective To investigate effect of hydroxypropyl methyl cellulose (HPMC) to in vitro release characteristics of cefaclor sustained-release tablets.Methods Collected 10 batches of HPMC from different manufacturers.Determined the viscosity, molecular weight and the distribution of molecular weight of HPMC.HPMC from different manufacturers was used as blocking agent for the preparation of cefaclor sustained-release tablets according to the same prescription.Results The molecular weight was positively related to the viscosity of HPMC.The more molecular weight was, the slower the drugs release rate was,the better controlled released.Conclusion HPMC from different manufacturers show different quality stability and effect in vitro release of cefacor sustained-release tablets.

Objective To analyze the requirements of the Chinese PLA biosecurity and disease prevention and to develop an Internet information tracking system for infectious disease surveillance .Methods A focused crawler was used to automatically collect Internet information about infectious diseases before the information could be released , automatically correlated and analyzed .Results This system could claw the Internet information of infectious disease surveillance and build an infectious disease surveillance information knowledge database .Conclusion The use of this system can not only improve the efficiency of information studies , but also meet the information requirements of infectious disease prevention in Chinese PLA.

Objective This study was aimed to investigate the methodology of radiofrequency ablation for paroxysmal atrial fibrillation (PAF) in complicated cases Methods 130 cases (87 males) with the average age of 56 years were enrolled consecutively Each patient was diagnosed PAF by Holter and ECG After routine transseptal procedure and cannulation, retrograde pulmonary venography was taken to show the anatomic morphology of all pulmonary veins (PVs) Under the guidance of Lasso circular mapping catheter, all cases underwent electrical isolation for four PVs using the saline irrigated ablation catheter Results (1) By venography,21 PVs (16 2%) were found to have enormously dilated ostia in 21 out of 130 cases 5 PVs (3 8%) had left common trunks 3 PVs (2 3%) had right common trunks In 6 cases right PVs were found to have multiple bifurcated ostia, and the prevalence rate was 4 7% (2) A total of 341 PVs were targeted for segmental ablation in 130 cases Complete isolation was failed in 29 PVs, including 11 PVs with dilated ostia Among the 29 PVs, 14 were left superior PVs (LSPVs), 8 were left inferior PVs (LIPVs), 5 were right inferior PVs (RIPVs), and 2 were right superior PVs (RSPVs) Conclusion The anatomical variants of PV was the main cause of complicating radiofrequency ablation in patients with PAF

Objective To explore the emergent measures for hematomyelia during microendoscopic discectomy (MED). Methods Different measures, such as electrocoagulation, compression, irrigation, or hemostatic administration, were directed against different types of hematomyelia during MED. Results No conversions to open surgery for hematomyelia were required in all the 287 cases in the study. A follow-up for 4~30 months (mean, 17 months) was carried out. According to the MacNab criteria, excellent results were achieved in 219 cases, good results in 59 cases, fair in 7, and poor in 2. Conclusions Measures for hematomyelia during MED include the decrease of abdominal pressure, strict hemostatic performance, keeping off varicose veins when the protruded intervertebral disc is resected, compression by using gelfoam or styptic cotton, and intravenous administration of thrombin. These measures can effectively improve the surgical safety and the curative effect.