Objective To study how to improve velopharyngeal ring ligafion procedure by using ring ligator in velopharyngeal ring ligatian procedure and settle the problem that there is no standard to measure the interspace of the cavity of pharynx.Methods Select some deft palate patients who were between 3 to 17 ages.Then made five groups according to age (3 to 5,6 to 8,9 to 11,12 to 14,15 to 17).Then made five different types of ring ligators accrding to the normal size of the cavity of pharynx of different ages.Results The ring ligators were easily used and all the patients were repaired satisfied.Conclusion The application of ring ligator in velopharyngeal ring ligation procedure is simple and feasible.

Objective To establish the reference intervals of hemoglobin A 1c( HbA1c ) and fasting plasma glucose ( FPG ) in the first and second trimester of pregnancy in Chongqing , and to evaluate the viability of the combination of HbA 1c and FPG in screening gestational diabetes mellitus (GDM).Methods The study retrospectively selected the pregnant women seen at the Department of Obstetrics and Gynecology in Daping Hospital between September 2014 and August 2015.The results of FPG during 10-13 pregnant weeks and 75 g oral glucose tolerance test ( OGTT ) and HbA1c during 24-28 pregnant weeks were available.Totally 185 cases were assigned into GDM group , and 269 cases were assigned into normal group based on the American Diabetes Association ( ADA) guidelines.Reference intervals of HbA 1c and FPG in normal pregnant woman were developed .The difference of HbA 1c , FPG and OGTT results between two groups was analyzed.T-student test, NcMemar test,signed rank sum test, ROC curve were used for statistical analysis.Results The reference intervals of HbA 1c and FPG in first and second trimester were 4.58%-5.52%,4.21-5.49 mmol/L and 4.03-5.08 mmol/L.The FPG level in first and second trimester and HbA 1c level in GDM group vs normal group were(5.06 ±0.37) vs(4.85 ±0.32)mmol/L(t=6.569,P=0.000), 5.23(5.11,5.4) vs 4.74(4.54,4.91) mmol/L(z=-14.31,P=0.000)and 5.3(5.1,5.4)% vs 5.2(5.0, 5.3)%( z=-5.79,P=0.000) respectively.The area under receiver operating characteristic curve ( ROC) of HbA1c , and FPG in first and second trimester was 0.655, 0.659 and 0.890 respectively.When the cut-off value of HbA1c was 5.35%, the AUC of the combination of HbA 1c and FPG in second trimester was 0.898, the sensitivity was 0.838,and the specificity was 0.859.The kappa coefficient for identifying GDM between OGTT and the combined method was 0.692(P=0.000).Conclusion HbA1c combined with FPG is of some value in screening GDM.

Objective To evaluate the relationship of preoperative neutrophil-lymphocyte ratio (NLR) with clinicopathological features and prognosis of colorectal cancer in middle-aged and elderly patients.Methods A retrospective analysis was performed in 212 patients with colorectal cancer in the First Affiliated Hospital of Nanjing Medical University from January 2011 to June 2013.All patients were divided into middle-aged group (46-65 year old,n=130) and old-aged group (66-89 year old,n=82),The optimal cut-off point of NLR was identified by the area under receiver operating characteristic curve,while NLR ＞ 3.13 and NLR≤3.13 were classified as high and low NLR group.The clinicopathological features and prognosis between the two groups were compared.Results There was no difference in gender,tumor growth site,depth of invasion,tumor embolus,lymphatic metastasis,distant metastasis,TNM stage between low and high NLR group (allP＞ 0.05).However,the difference between high NLR group and low NLR group in old-aged group with diabetes mellitus was statistically significant (P＜0.05).The 1-,2-,and 3-year survival rate of the overall 212 patients were 96.2％ (204/212),87.7％ (186/212) and 74.5％ (158/212) In middle-aged group,the 1-,2-,and 3-year survival rates were 98.8％ (85/86),90.7％ (78/86) and 84.9％ (73/86) respectively in low NLR group,but 95.5％ (42/44),84.1％ (37/44) and 72.7％ (32/44) respectively in high NLR group,(allP＜0.05).In old-aged group,the 1-,2-,and 3-year survival rates were 95.7％ (44/46),89.1％ (41/46) and 73.9％ (34/46) respectively in low NLR group,but 91.7％ (33/ 36),83.3％ (30/36) and 52.8％ (19/36) respectively in high NLR group (all P＜0.05).Cox regression showed that TNM stage and NLR were independent risk factors for the prognosis of the middle-aged and elderly patients with colorectal cancer (P＜0.05 or P＜0.01).Conclusions Preoperative NLR ＞ 3.13 suggest that the prognosis is poor in middle-aged and elderly patients with colorectal cancer.

Objective To investigate the differences of measurement of gross target volume (GTV)between endoscopic ultrasonography ( EUS )-based ( GTVEUS ) and computed tomography ( CT ) -based (GTVCT) method for thoracic esophageal squamous cell carcinoma. Methods EUS was performed on 36consecutive patients with thoracic squamous cell carcinoma, and the superior and inferior boarders of the tumor defined by EUS were marked with hemoclips. The CT planning scan was then performed with the patient in supine position, and the GTVCT and GTVEUS were contoured respectively. The lengths ( LCT and LEUS) and spatial locations of longitudinal GTVCT and GTVEUS were compared. Results The mean LCT and LEUS were (7. 79 ± 3. 15 ) cm and (7. 42 ± 2. 72) cm, respectively ( t = 0. 82, P ＞ 0. 05 ), with a correlation coefficient of 0. 61 (P ＜0. 001 ). Locations of longitudinal GTVCT and GTVEUS were compared in 34cases, with 2 excluded for invisualization on CT. The mean conformal index (CI) was (0. 79 ± 0. 18 ), and spatial variations were found in 71% patients, with 8 patients at proximal end and 21 others at distal end.There was no clip placement associated complication. Conclusion Endoscopic hemoclips placement is safe and reliable. EUS can provide additional information to CT in defining longitudinal GTV in thoracic esophageal squamous cell carcinoma, especially in superficial and submucosal carcinomas.

Objective To investigate the distribution and changes of microorganisms on the skin of submariners under a chronically closed environment , and provide reference for targeted medical support .Methods One hundred and twenty-two samples were collected using swab.After culture and isolation, the microbes were identified by matrix-assisted laser desorption/ionization time of flight mass spectrometry ( MALDI-TOF-MS) .Results A total of 52 types of 229 bacteria and 2 types of fungi were isolated . Major opportunistic pathogens included Acinetobacter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae, while major dwelling bacteria included Micrococcus luteus, Oslo Mora bacteria, Acinetobacter, Staphylococcus epidermidis, and Serratia marcescens.Compared with the early period of the task, major opportunistic pathogens and dwelling bacteria were significantly increased in the middle and late period of the task .Conclusion The skin microbes of the submariners are investigated , targeted drugs need to be prepared for daily medical support and war trauma .

PURPOSE: Extensive data support the influence of the upper airway on lower airway inflammation and pathophysiology in allergic disease. However, few studies have focused on allergic inflammation in the nose after an isolated lower airway allergen challenge, a situation that can exist clinically when human subjects breathe primarily through the mouth, as occurs when nasally congested. This study used a mouse model to investigate whether upper airway inflammation and hyperresponsiveness were induced by an isolated lower airway allergen challenge. METHODS: BALB/c mice were sensitized by systemic intraperitoneal injection of ovalbumin/saline and challenged with intratracheal ovalbumin/saline. Inflammation in the nose and lungs was assessed by cytology and histology of nasal tissues and bronchoalveolar lavage fluid (BALF), while nasal airway resistance and response were measured over 3 days post-challenge. RESULTS: Intratracheal application of an allergen in anaesthetized mice resulted in exclusive deposition in the lower airway. Compared to control animals, ovalbumin-sensitized mice after challenge showed bronchial hyperreactivity and increased IL-5 in the serum BALF, as well as eosinophil infiltration in the lungs. However, nasal histology of the ovalbumin-sensitized mice showed no increase in eosinophil infiltration. The nasal lavage fluid revealed no increase in eosinophils or IL-5, and the nasal airway resistance did not increase after challenge either. CONCLUSIONS: In a mouse allergy model, exclusive allergen challenge of the lower airway can elicit a pulmonary and systemic allergic response, but does not induce upper airway inflammatory or physiological responses.
Airway Resistance ; Animals ; Asthma* ; Bronchial Hyperreactivity ; Bronchoalveolar Lavage Fluid ; Eosinophils ; Estrogens, Conjugated (USP) ; Humans ; Hypersensitivity ; Inflammation* ; Injections, Intraperitoneal ; Interleukin-5 ; Lung ; Mice ; Mouth ; Nasal Lavage Fluid ; Nose* ; Rhinitis

OBJECTIVE: To explore the preventing infection measures of new coronavirus disease 2019(COVID-19) patients during mechanical ventilation, and to provide reference for the safe application of mechanical ventilation. METHODS: Retrieved from PubMed, Ovid and other databases, and combined with the application experience of mechanical ventilation were collected to explore the preventing infection measures of COVID-19 patients during mechanical ventilation. RESULTS: This paper put forward the preventing infection measures of external circuit, internal circuit, outer surface, filter and special parts in ventilator. The preventing infection measures of sputum suction and nebulization were summarized. CONCLUSIONS The preventing infection measures of COVID-19 patients during mechanical ventilation are successfully completed, which can provide suggestions for the application and maintenance of mechanical ventilation.
Betacoronavirus ; COVID-19 ; Coronavirus Infections/therapy* ; Humans ; Infection Control/methods* ; Pandemics/prevention & control* ; Pneumonia, Viral/therapy* ; Respiration, Artificial ; SARS-CoV-2 ; Ventilators, Mechanical