Objective To compare the effect of the application of tracheal intubation with SEESHEEN video intubation endoscope (ENF-20) and direct laryngoscopy in patients with missing teeth.Methods 50 patients with missing teeth were selected,and they were randomly divided into two groups, respectively after induction of general anesthesia in tracheal intubation using ENF-20 (group E) and direct laryngoscopy (SHUCMAN laryngoscopy) (group S) intubation.The time of intubation, the times of intubation and the complication of intubation were recorded.Results The success rate of intubation in group E was 92%, which was significantly higher than 64% in group S (x2=5.711,P=0.017).The intubation time of group E was (27±12)s, which was significantly shorter than (36±13)s in group S (t=-2.620,P=0.012).The total intubation complications of group E was 12%, which was significantly lower than 48% of the group S (x2=6.095,P=0.014).Conclusion The successful rate of tracheal intubation in patients with missing teeth by using video tracheal intubation (ENF-20) is higher and with less complication.

Objective To assess the efficacy and safety of smoking intervention by anesthesiol-ogists in surgical patients.Methods A total of 182 male patients,aged 18-79 years,ASA grade Ⅰ-Ⅲ,scheduled for elective noncardiovascular and nonthoracic surgery,were assessed preoperatively. Patients were randomized to either the control group or the intervention group,n =91 each.The con-trol group did not receive specific smoking cessation intervention.The intervention group received brief counseling by the anesthesiologist,leaflets on smoking cessation,including pictorial health warning labels,smoking cessation clinic’s smokers’hot line and WeChat public number.Anesthesia methods,operation time,treatment time in PACU,the rate of smoking cessation at 30 days postop-eratively,perioperative complications and smoking status at 30 days postoperatively were recorded. Results One hundred and sixty-six patients were included in the analysis finally.There was no signif-icant difference between two groups in 30 days of follow-up postoperatively.Self-reported smoking re-duction in the postoperative 30 days the intervention group was significantly lower than that in the control group (36.9% vs.22.0%,P <0.05).For smokers,there was a relationship between the lev-el of eCO and the smoking cessation rate,it was 83.3% in the intervention group and 40.0% in the control group (P <0.05).There was no significant difference of overall rate of combined intraopera-tive and immediate postoperative complications between two groups.Conclusion Smoking cessation intervention launched by anesthesiologists promotes 30 days of abstinence postoperatively.

0.05) ;TNF-? 0.5 ?g and TNF-? 1.0 ?g pretreatment groups showed reduced volume of lesion(all P

AIM: To study the expression and function of novel gene AngRem104. METHODS: Northern blot was performed to detect the distribution of AngRem104 in human multiple normal tissues as well as the effect of AngⅡ and AT1R antagonist (losartan) on AngRem104 expression. The sense and antisense eukaryotic expression vectors of AngRem104 were constructed and transfected into human mesangial cells. RT-PCR was used to detect the expression of FN when AngRem104 was over-expressed. Primary sequence and motif analysis of AngRem104 protein were performed by on-line ExPasy predictive tools. RESULTS: AngRem104 was predicted to localize at the cellular nucleus. It was widely expressed in human heart, placenta, liver, muscle, kidney and pancreas. Moreover, the up-regulated expression of AngRem104 induced by AngⅡ was inhibited by losartan in a dose-dependent manner. CONCLUSION: AngRem104 is a novel nuclear protein related to the expression of fibronectin and could be up-regulated by AngⅡ in human MC.

Objective:To investigate the effects of enteral nutrition assisted therapy in preventing postoperative anastomotic fistula in patients with esophageal cancer and its influence on immunity,healing process and nutritional recovery.Methods: The clinical data of 90 cases of patients with esophageal cancer who underwent surgical treatment were retrospectively analyzed.According to the mode of postoperative nutritional support,the patients were divided into group A(n=34),B(n=30)and C(n=26)three groups.Group A was treated by immune-enhancing enteral nutrition(Supportan)assisted therapy.Group B was treated with routine enternal nutrition(Nutrison Fibre)assisted therapy.Both of the two groups were treated with 25%,50% and 100% of the full dose on the 1st,2nd and 3rd-7th day after surgery.Later,the dose was reduced day by day till normal diet.Group C was treated by parenteral nutrition assisted therapy.Since the 1st day after surgery,patients in group C were intravenously injected with glucose,vita min and a mino acid mixed liquid calculated by 125.52 kJ/kg.8-10 d later,patients gradually transited to the normal diet.The incidence rates of anastomotic fistula,pulmonary infection and incision infection,wound healing time,total hospitalization time and initial exhaust time were observed and compared between the three groups.The changes of immune index [T lymphocytes and its subsets(CD3+,CD4+,CD8+)],inflammatory factors[C reactive protein(CRP),IL-6]and nutrition indexes[serum total protein(TP),albumin(ALB)]before surgery,on the 1st and 8th day after surgery were recorded.Results: ①There were significant differences in the incidence rates of postoperative anastomotic fistula and pulmonary infection between the three groups(P<0.05),and the incidence rates in group C were significantly higher than those in the other two groups(P<0.05).②There were significant differences in wound healing time,total hospitalization time and initial exhaust time between the three groups(P<0.05)and that of group C group was longer than that of the other two groups(P<0.05).③On the 1st day after surgery,the levels of immune indexes such as CD3+,CD4+,CD4+/CD8+ and nutrition indexes such as TP and ALB in the three groups were significantly lower than those before surgery.CD8+ levels and levels of inflammatory indexes such as CRP and IL-6 were significantly higher than those before surgery(P<0.05).However,there was no significant difference between the groups(P>0.05).On the 8th day after surgery,the nutrition indexes in the three groups were still significantly lower than those before surgery.However,those in group A and B were significantly higher than those in group C(P<0.05);the inflammatory factors were still significantly higher than those before surgery(P<0.05)but those in group A and B were significantly lower than those in group C(P<0.05).Among the three groups,there was no statistical significance in comparing the immune indexes with those in group A(P>0.05).The levels of CD3+,CD4+,CD4+/CD8+ in the other two groups were lower than those before surgery while CD8+ level was higher than that before surgery(P<0.05).Conclusion: To apply enteral nutrition assisted therapy in patients with esophageal cancer after surgery can effectively improve the prognosis.It has positive effects on shortening the healing process,improving the immune function and improving the nutritional status.

Objective To screen the genes related to novel gene AngReml04. Methods Gene chip was employed to detect the genes related to AngRem104 by its over-expressed constructs, which was produced by transfection of the sense- and antisense-AngReml04 into human mesangial cells, and then RT-PCR was used to confirm the up-regulated expression of related genes. Results There were 94 genes up-regulated and 2 genes down-regulated when AngRem104 was over-expression. The different expression genes were cataloged as extracellular matrix and receptor protein, DNA-binding and transcription-related protein, immune-related protein, cytoskeletal and dynamic protein, synthesis and metabolism related protein. Fibronectin (FN) and integrin beta 1 (fibronectin receptor) were dramatically over-expressed in the top of all up-regulated genes. Furthermore, the correlative expression between AngReml04 and FN was detected by RT-PCR. Conclusion Gene chip not only demonstrates the clues for further investigation of novel gene AngRem 104, but also reveals the co-expression of AngRem104 and fibronectin.

In the perspective of medical ethics,doctor-patient relationship is a particular kind of social relations that contains a combination of factors such as biological,psychological and social basis,including certain moral standards and ethical norms formed.Ethical property is a fundamental property of the doctor-patient relationship.In current medical practice,doctor-patient relationship unprecedented tensions,conflicts between doctors and patients,the frequent occurrence of medical trouble,has become the social factors of disharmony and highly attention.In order to make the medical humanity regression and construct a new doctor-patient relationship reflecting equality and cooperation,with medical ethics as the angle of view,the author the author has discussed and demonstrated how to improve doctor-patient ethics accomplishment,rebuild the doctor-patient relationship of trust,reshape the respect for life and personality of medical humanism spirit,safeguard the equality of the subject position of both doctors and patients,and how to provide humane medical services etc.in order to indicate the direction for the deepening of China's reform of the medical system and provides theoretical support.

OBJECTIVE:To analyze the constituents of volatile oil in Artemisia indica from different area of Guangxi, and to compared which with those in Artemisia argyi. METHODS: The volatile oil was extracted from Artemisia indica and Artemisia argyi respectively by steam distillation. The constituents of the volatile oil were identified by GC-MS technology. RESULTS: The yield of the collected volatile oil of Artemisia indica from different area of Guangxi was 0.32%～0.67%, and compared with Artemisia argyi, both were found to contain the following main constituents: eucalyptol, camphor, borneol, germacrene D, caryophyllene, caryophyllene oxide, terpineol, azulene etc. But the content of the same constituents in Artemisia indica varied with different producing area and there was also difference for a certain constituent of the volatile oil. CONCLUSION: The study results serve as a scientific basis for rational use of Artemisia indica from Guangxi.

BACKGROUND: Some studies suggest that pre-injection of tumor necrosis factor-α (TNF-α)can protect focal cerebral ischemia in mice. Cerebral ischemia tolerance is related to the increase of TNF-α level; on the other hand, TNF-α is an injurious cytokine associated with stroke. Circulating antibody against anti-TNF-α can protect reperfused injury.OBJECTIVE: To study the effects of TNF-α pretreatment and post-treatment on cerebral ischemia-reperfusion injury and explore possible mechanism.DESIGN: Randomized controlled study.SETTING: Neurological Department, the Second Hospital Affiliated to Harbin Medical University.MATERIALS: The experiment was conducted at the Animal Experiment Center of Harbin Medical University from January to April 2002. Totally 120 healthy adult male Wistar rats were randomly divided into the following 8 groups: TNF-α 0.05 μg, 0.5 μg and 1.0 μg pretreatment groups and PBS group, TNF-α 0.05 μg, 0.5 μg and 1.0 μg post-treatment groups and PBS group with 15 in each group.METHODS: The focal brain ischemia model of middle cerebral artery occlusion (MCAO) was made using inserting thread method. TNF-α of different doses (0.05 μg, 0.5 μg or 1.0 μg) or PBS was injected intracisternally and 22-hour reperfusion, 8 rats from each group were killed. Then the perhour reperfusion, 7 rats from each group were killed. Then pathological changes were observed, glial fibrillary acidic protein (GFAP) and intercellular adhesion molecule-1 (ICAM-1) expression were inspected by immunohistochemical method. Histopathological and immunohistochemical evaluation was made with the computer-assisted image analyzing system,and the number of GFAP positive cells and ICAM-1 positive vessels in each hemisphere was counted.riliary acidic protein and ICAM-1.infarct volume: TNF-α 0.5 μg and TNF-α 1.0 μg pretreatment groups showed reduced volume of lesion; infarct volume reduced by 70.9% in TNF-α 0.5 μg pretreatment rats and 66.5% in TNF-α 1.0 μg pretreatment rats. TNF-α 0.5 μg and TNF-α 1.0 μg post-treatment groups showed increased volume of lesion; infarct volume increased by 22.3% in TNF-α 0.5 μg post-treatment rats and 46.7% in TNF-α 1.0 μg post-treatment rats.TNF-α 0.05 μg and 1.0 μg pretreatment groups did not differ significantly (P ＞ 0.05), but there was an obvious difference between TNF-α 0.5 μg and pared with PBS pretreatment group, TNF-α 0.5 μg and 1.0 μg pretreatment groups showed lessened tissue damage and edema. Compared with PBS post-treatment group, TNF-α 0.5 μg and TNF-α 1.0 μg post-treatment fibriliary acidic protein and ICAM-1: TNF-α 0.5 μg and TNF-α 1.0 μg pretreatment groups showed reduced volume of glial fibriliary acidic protein and ICAM-1 (P ＜ 0.05); but TNF-α 0.5 μg and TNF-α 1.0 μg posttreatment groups showed increased volume of glial fibriliary acidic protein and ICAM-1 (P ＜ 0.05). TNF-α 0.05 μg and 1.0 μg pretreatment groups did not differ significantly (P ＞ 0.05); but there was an obvious difference between TNF-α 0.5 μg and 1.0 μg post-treatment groups (P ＜ 0.05).cerebral ischemia reperfusion injury. This effect is not related to the repair given after cerebral ischemia reperfusion, ischemia exacerbates, which is α are determined by whether TNF-αis given before or after cerebral ischemia in a dose-dependent manner.

Objective To analysis the risk factors in ventilator-associated pneumonia (VAP) in mechanically ventilated patients.Methods Seventy-eight adult inpatients on mechanical ventilation (MV) through oral endotracheal intubation were studied prospectively by observation between June,2007 and May,2010.Clinical associated factors including patients'predisposition related,medical personnel or device related and nutritional state related factors,etc.were recorded and analyzed.Results In 78 ventilated patients,the incidence of VAP was 23.1％,the fatality rate was 22.2％.Preventive antibiotic treatment (OR=6.038; 95％ CI:1.319-27.641; P =0.021),applying glucocorticoid (OR =5.385; 95％ CI:1.191-24.346; P =0.029) and prealbumin (PA) ≤ 69.7 mg/L (OR =0.975; 95％ CI:0.956-0.995 ; P =0.013) were risk factors in VAP.Conclusions The risk factors in VAP were PA ≤ 69.7mg/L,preventive antibiotic treatment and employment of glucocorticoid.