ObjectiveTo compare and evaluate the effectiveness of Airtraq laryngoscope combined with a Bougie and Airtraq laryngoscope alone for tracheal intubation in simulated difficult airway.Methods Four anesthetists and 4 clinical physicians of standardized training were enrolled in the study.The participants intubated the trachea of the ALS simulator manikin in 5 tongue edema scenarios simulating modified Cormack-Lehane grade 1,2a,2b,3,and 4 views and 1 cervical immobilization scenario.Results No significant difference in the rate of successful intubation was detected between two techniques(P＞ 0.05 ).In Cormack-Lehane grade 1,2a views,the duration of successful intubation in Airtraq laryngoscope alone [ ( 14.3 ± 1.3),( 17.1 ± 2.9) s] was shorter than that in Airtraq laryngoscope combined with a Bougie [ (26.6 ± 3.8),(36.4 ± 3.6) s ] with significant difference (P ＜ 0.01 ).Cormack-Lehane grade 2b,3,4 views,the duration of successful intubation in Airtraq laryngoscope alone[ (74.5 ± 6.5 ),(116.3 ± 9.8),(53.0 ± 6.1 )s] was longer than that in Airtraq laryngoscope combined with a Bougie [ (35.4 ± 4.3 ),(52.3 ± 5.0),(40.4 ± 3.8 ) s ] with significant difference (P ＜ 0.05).ConclusionAirtraq laryngoscope combined with a Bougie can be quickly intubated in simulated difficult airway compared with Airtraq laryngoscope alone.

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Objective To investigate the clinical effect of selective laparoscopic cholecystectomy (LC) after percutaneous transhepatic gallbladder drainage (PTGD) in the treatment of elderly patients with acute severe cholecystitis,as well as the most appropriate timing for selective operation.Methods A total of 90 patients with acute severe cholecystitis aged above 60 years who were admitted to Department of Hepatobiliary Surgery in The First Hospital of Jilin University from January 2015 to June 2016 were enrolled,and according to the time of selective LC,they were divided into group A (with 2 months),group B (2-4 months),and group C (＞4 months),with 30 patients in each group.The clinical effects of PTGD and selective LC were observed.The t-test was used for comparison of continuous data between two groups,an analysis of variance was used for comparison between three groups,and LSD-t test was used for comparison between any two groups;the chi-square test was used for comparison of categorical data between groups.Results All the patients underwent successful PTGD,and the time to abdominal pain remission was 2.52 ± 0.76 hours.Body temperature returned to normal with 24-72 hours after surgery,and there were significant improvements in laboratory markers (white blood cell count,neutrophil count,and liver function) (all P ＜ 0.05).No patient experienced complications such as bile leakage,hematobilia,pneumothorax,and colon perforation caused by puncture,and there was no case of PTGD after the tube was detached.There were significant differences between the three groups in gallbladder wall thickness before LC (F =8.029,P ＜ 0.001),time of operation (F =24.674,P ＜ 0.001),intraoperative blood loss (F =12.864,P ＜ 0.001),length of hospital stay (F =22.844,P ＜ 0.001),rate of conversion to laparotomy (x2 =12.345,P =0.002),and incidence rate of complications (x2 =8.750,P =0.013).Compared with group A,groups B and C had significantly lower gallbladder wall thickness before LC,intraoperative blood loss,length of hospital stay,rate of conversion to laparotomy,and incidence rate of complications (all P ＜ 0.05),and group B had significantly lower time of operation,intraoperative blood loss,and length of hospital stay than group C (all P ＜ 0.05).Conclusion Selective LC with 2-4 months after PTGD has a marked clinical effect and high safety in the treatment of elderly patients with acute severe cholecystitis.

Objective To determine whether the use of 18F-FDG PET/CT alters staging and management of nasopharyngeal carcinoma (NPC) when compared with MRI staging practice;and to explore the relation of standard uptake value (SUV) of 18F-FDG PET/CT and the pathological classification and T staging of NPC. Methods The study was performed retrospectively on a group of 41 patients with a new diagnosis of NPC. All the patients underwent whole body PET/CT scanning and head & neck MRI scanning within 3 weeks of each other. The AJCC protocol was introduced to stage NPC and the results of the PET/CT were compared with MRI based on pathologic diagnosis. Results ①Primary tumor:the accuracy of T staging of PET/CT was significantly higher than MRI (85.37% vs 60.98%,U=2.49,P

Objective To study the in vitro culture condition for melanoblasts from human foreskin tissue. Methods The skin tissue taken from foreskin of children was treated with 0.5% dispase Ⅱ to separate epidermis from dermis, then with trypsin to obtain single cell suspension, which was cultured in modified medium for melanoblasts, i.e., MCDB254 medium supplied with several cell growth factors. Finally, melanoblasts were obtained based on the difference of adhesion speed. The morphology and proliferation of cultured melanoblasts were observed under a light microscope. DOPA staining, immunostaining with anti- S-100 and -tyrosinase related protein 2 (TRP2) antibodies, and transmission electron microscopy were per- formed to identify the cultured melanoblasts. Results The cultured human melanocytes displayed a match-like shape, scattered arrangement, syrmnetric double poles, slim cell body, highly refractive nuclei; meanwhile, the melanoblasts exhibited plentiful cytoplasm, large volume, bipolar or irregular shape and clonal growth. Additionally, the melanocytes were positive for TRP2, S-100 and Dopa staining, while the melanoblasts were positive only for TRP2. Electron microscopy revealed the presence of mature melanin granules (stage Ⅲ-Ⅳ ) in melanocytes but immature melanin granules (stage Ⅰ ) in melanoblasts. Conclu- sion Stable pure culture of melanoblasts has been realized with the reformed medium, which may lay a foundation for the investigation into the mechanism of epidermal pigmentation.

Objective To evaluate the radioprotective effects of Quercetin (QN) on 6 Gy X-ray irradiation-induced immune dysfunction and toxicity in hepatic tissue in rats. Methods 40 adult rats were randomly divided into 4 groups. Group Ⅰ was injected intraperitoneally with saline solution for 7 consecutive day sand served as control group. Group Ⅱ was daily injected with QN (40 mg/kg) for 7 consecutive days. Group Ⅲ was irradiated with a single dose of 6 Gy X-ray. Group Ⅳ received a daily injection of QN (40 mg/kg) for 7 consecutive days, and 1 h after the last injection rats were irradiated with a single dose (6 Gy) X-ray irradiation.The animals were sacrificed after 24 h. Lymphocyte transforming rate was measured with MTT method, and CD+4 T, CD+4 T and CD+8/CD+8 T were measured with flow cytometry method. Oxidative conditions in liver were measured with malondialdehyde (MDA), reduced glutathione hormone (GSH), supernxide dismutase (SOD) andglutathione peroxidase (GSH-Px) activities kits. HE staining was used to observe the general condition of rat's liver. Results Lymphocyte transforming rate, CD+4 T, CD+8 T and CD+8/CD+8 T in rats of Group Ⅳ were all higher than those in rats of Group Ⅲ ( F = 8.455,22.644, 18.911, P < 0.01 ). MDA content in the Group Ⅳ rat's liver was lower than that in the Group Ⅲ ( F = 10.059, P < 0.01 ) and antioxidant enzymes SOD, GSH-Px activities were higher than those in Group Ⅲ (F = 23.688,186.046,19.788, P < 0.01 ). The capillary of the hepatic lobules dilated and congested obviously in portal area, involving infiltration of polymorphonuclear leukocytes in the Group Ⅲ, while QN improved this change apparendy. Conclusions Pretreatment with Quercetin improved the irradiated rat's immune functions and protected the irradiated rats from oxidative stress to some extent.

Objective To investigate the phenotype,number and distribution of inflammatory cells in early and late stages of spontaneous regression of halo nevi,and to elucidate the immunological mechanisms for spontaneous regression of these nevi.Methods Halo nevi,their surrounding non-lesional skin,and normal control skin were examined by immunohistochemical staining with monoclonal antibodies to CD3,CD4,CD8,CD20,CD1a,CD56 and CD68.Staining results were observed and analyzed by the computer image analysis system,image-pro plus 6.0.Results The number of CD4+,CD8+,CD20+,CD1a+cells,along with the diameter of CD1a+and CD68+ cells was significantly increased in the lesions of early and late stage of spontaneous regression of halo nevi than in non-lesional skin and normal control skin(both P＜0.01).The ratio of CD8+/CD4+ cells in the lesions of late stage of spontaneous regression was also higher than that in the lesions of early stage (2.05∶1 VS 1.82∶1).A massive infiltrate of CD8+ cells was observed in the nests of nevus cells.ConclusionsCD4,CD8,CD20,CD1a,CD56 and CD68 positive cells are all involved in the spontaneous regression of halo nevi,and CD8+ cells may play a predominant role in this process.

Objective Electronic portal imaging devices (EPIDs) are widely used as a replacement of portal films for patient position verification, but the image quality is not always optimal. Because of very low density resolution, the portal imaging is difficult to be used clinically. In this study, several transforming models and the optimization exposure or acquisition conditions were studied for optimization portal imaging, which based on DicomRT platform built by ourselves. Methods 6 MV X-ray from Varian 21EX linac was used to generate portal images by Portal Vision aSiS00 amorphous silicon detector image acquisition system. The density resolution study was based on the number of the lines which could be seen in the image of a special Las Vegas image quality test board. The optimization calculating models were focused on equalization after stretch transforming discrete wavelet transform (DWT) and Butterworth high pass filters. The calculation was performed in Matlab language. Results The optimal numbers of MU, average frames and reset number were 4 - 5,3 - 4 and 2 - 3, respectively. The density resolution of optimized imaging via equalization after stretch transforming, DWT and Butterworth high pass filter transforming was markedly improved. The bone structure could be definitely distinguished. The number of lines distinguished in Las Vegas image via equalization after stretch transforming, DWT and Betterworth high pass filter transforming was 3, 4 and 5, respectivly. Conclusions The proposed transforming systems, including DWT edge detection and Butterworth high pass filter transform, are suitable for improving density resolving power of MV X-ray portal image.

Objective:To evaluate the value of adenosine triphophate (ATP)stress/rest nuclide myocardial perfusion imaging (MPI)in the diagnosis of female patients with coronary heart disease (CHD).Methods:The clinical materials of 47 female suspected CHD patients were retrospectively analyzed,aged from 39 to 74 years,and the average age was (53.7±6.3)years old.All patients were hospitalized and underwent two-day ATP stress and rest nuclide MPI and coronary angiography (CAG)in two weeks. The results and images of MPI and CAG were evaluated by more than 2 attending physicians. Using CAG as the “gold standard”, the diagnostic efficiency (sensitivity, specificity and accuracy) of MPI for CHD was evaluated. Results:Compared with CAG, the sensitivity,specificity and accuracy of ATP stress MPI in diagnosing the female CHD patients were 81.3% (13/16),77.4% (24/31)and 78.7% (37/47)individually;the positive predictive value and negative predictive value were 65.0% (13/20)and 88.9% (24/27).There were no severe adverse effects in the ATP stress test and the incidence of adverse effects was 85.1%.Conclusion:There is a highly diagnostic efficiency of ATP stress MPI in the CHD patients.It can be the first choice of examination methods for screening without injury and diagnosing the myocardial ischemia in the female patients.

Objective To explore the appearances of DSA and therapeutic methods of tanscatheter hepatic artery chomoembolization (THACE) of hepatic carcinoma with arteriovenous fistula(avf).Methods The indirect hepatic portal vein angiography (Superior mesenteric artery angiography) and celiac trunk angiography (common hepatic artery) were performed in 673 cases with hepatic carcinoma confirmed by pathology,then hepatic artery infusion-chemotherapy and/or embolizations were done. Results Heptic carcinoma to be accompanied with arteriovenous fistula(AVF) 151 was totally cases(22.4%),including artery-portal vein fistula 127 cases,artery-vein fistula 15 cases, mixed 9 cases.Of them, hepatic artery embolizations in 131 cases with artery-vein fistula(86.6%) were performed once or more times, in 20 cases due to the embolization of artery-vein fistula couldn’t be performed and/or with tumor embolus inside common portal vein while only arterial infusion-chemotherapy were performed.Conclusion DSA is accurate and direct diagnostic method in hepatic carcinoma with artery-vein fistula. Hepatic artery embolization and infusion-chemotherapy is an effective way for the patients with artery-vein fistula.