Objective To observe the effect of different doses of sufentanil on intubation guided by fiber bronchoscope in diffi‐cult airways .Methods One hundred and eighteen patients with difficult airways who underwent tracheal intubation were randomly divided into 3 groups [groupⅠ(n=40) ,groupⅡ (n=42) ,and groupⅢ (n=36)] .First all group received 1 μg/kg dexmedetomi‐dine ,then groupⅠ ,groupⅡ and group Ⅲ received sufentanil 0 .1μg/kg ,0 .2 μg/kg ,0 .3μg/kg infusion in bolus respectively .Heart rate(HR) ,mean arterial pressure(MAP)and saturation of pulse oximetry(SpO2 )were recorded at 5 min after patients arriving at operation room (T0 ) ,after drug infusion(T1 ) ,the time of intubation and seeing the epiglottis (T2 ) ,1 min(T3 )and 5 min(T4 )after intubation .side effect was recorded throughout the process .Results HR at T2 and T3 in groupⅡ and group Ⅲ were significantly lower than those in group Ⅰ(P<0 .05) .MAP at T2 and T3 in groupⅡ and group Ⅲ were significantly lower than those in groupⅠ(P<0 .05) .SpO2 at T2 in group Ⅲ was significantly lower than those of groupⅠ and groupⅡ(P<0 .05) .Cough reflex in groupⅠwas much frequent than others .Only group Ⅲ had respiratory inhibition .Conclusion Intravenous sufentanil (0 .2 μg/kg)could in‐hibit effectively stress reaction from endotracheal intubation ,in which less side effects such as haemodynamic changes and respirato‐ry depression occur .

ObjectiveTo investgate the effects of pyruvate sodium on energy metabolism of erythrocytes in dog blood during circulation in cardiopulmonary bypass machine.MethodsTen healthy adult mongrel dogs of both sexes weighing 12-18 kg were anesthetized with intraperitoneal 2.5％ pentobarbital 25 mg/kg.Femoral artery was cannulated and 500 ml of blood was collected from femoral artery in each dog.Blood samples from the 10 dogs were divided into 2 equal parts (250 ml each).Each part was mixed with 250 ml lactated Ringer's solution (group C) or 250 ml pyruvate sodium (group P).Flow rate of 4 L/min was employed and blood temperature was kept at 30-32 ℃ during circulation in cardiopulmonary bypass machine.The blood sanples were collected before (baseline value,T1 ) and at 30,60,90,120 min of circulation (T2-5) for determination of ATP,ADP and AMP concentrations in RBC.ResultsThe ATP and AMP concentrations were significantly higher at T2-5,while ADP concentration was higher in group P than in group C.ConclusionPyruvate sodium can improve energy metabolism of erythrocytes in dog blood druing circulation in cardiopulmary bypass machine.

Objective To investigate whether the defective interfering(DI) particles of Paramyxovirus, Tianjin strain could be used as a candidate adjuvant. Methods DI particles were separated and purified. After being identified, it was equally mixed with the inactivated poliovirus (PV) vaccine. Kunming mice were administered subcutaneously with the mixture, besides we set groups of inactivated PV vaccine containing Al(OH) 3 as an adjuvant, inactivated PV vaccine of which the dose was doubled without any adjuvant, and negative control. Sera were collected in the 14th day after immunization, and the specific antibodies of PV were detected. T/B lymphocyte stimulation indexes(SI) were counted through the lymphocyte proliferation tests. The quantities of IFN-γ/IL-4 produced by the splenocytes which were stimulated again by PV antigen were detected. Results The SI and the quantity of IFN-γof the mice in the group of inactivated PV vaccine combining with DI particles of Paramyxovirus, Tianjin strain were more than other groups. Conclusion DI particles of Paramyxovirus, Tianjin strain could enhance the immune response of inactivated poliovirus, especially the cellullar immunologic response of Th1 type.

Objective To investigate clinical value of Xpert M TB/RIF assay on rapid detection of M TB and rifampin‐resistant . Methods 408 cases of tuberculosis were detected by acid‐fast stain ,Solid culture and Xpert MTB/RIF ,the results were compared . Results All the samples were detected by acid‐fast stain ,culture and Xpert MTB/RIF assay ,the positive rates were 25 .00% (102/408) ,42 .16% (172/408) and 58 .09% (237/408) ,respectively .The positive rates of Xpert MTB/RIF assay were higher than acid‐fast stain and culture method ,and the difference is statistically significant(P<0 .05) .There are 168 cases of specimen which were tested positively by both culture and Xpert M TB/RIF ,the RIF resistance rates from standard drug susceptibility testing and Xpert MTB/RIF assay respectively were 26 .19% (44/168) and 27 .38% (46/168) ,and had no statistical significance(P>0 .05) .Accord‐ing to the result of drug susceptibility with proportion method ,the sensitivity and specificity of Xpert MTB/RIF in detecting RIF resistance were 97 .73% (43/44) and 97 .58% (121/124) .Conclusion Xpert MTB /RIF can quickly and accurately detect MTB and RIF resistance ,it has important clinical significance .

Objective To investigate the apoptosis of rat glioma C 6 cells induced by defective in-terfering( DI) particles of Sendai virus strain Tianjin .Methods Rat glioma C6 cells were treated with dif-ferent titers of DI particles of Sendai virus strain Tianjin in vitro with culture media as negative control and intact virus as positive control .At different time point , cells were collected and their apoptosis was detected by DNA gel electrophorsis , TUNEL assay and AnnexinⅤ/PI double-labeled flow cytometry .The C6 glioma-bearing rat model was established and then treated with three intratumoral injections of DI particles , intact virus or saline three times at interval of two days .The antitumor effects of ID particles were evaluated through daily measuring of the tumor size .Hematoxylin-eosin( HE) staining was used to observe the patho-logical changes in tumor tissues .TUNEL assay was performed to detect the apoptosis of tumor tissues .Re-sults Rat glioma C6 cells treated with DI particles or intact virus in vitro showed typical DNA ladder pattern in agarose gel electrophoresis in a time-and dose-dependent manner .With the intervention of DI particles , the apoptosis rate of C6 cells showed a time-and dose-dependent manner and was significantly higher than that of the control group (P<0.01) as indicated by flow cytometry assay and TUNEL assay .In vivo, DI par-ticles could markedly inhibit the growth of the tumors in comparison with saline control group .There were fe-wer tumor cells in tumor nodules in DI particles group or intact virus group as shown by histological examina -tion.The TUNEL assay showed that the apoptosis rate of tumor tissues injected with DI particles or intact vi -rus was much higher than that of the saline group (P<0.01), but there was no significant difference between the DI particles group and the intact virus group (P>0.05).Conclusion The DI particles of Sendai virus strain Tianjin could induce apoptosis of rat glioma C 6 cells in a time-and dose-dependent manner both in vitro and in vivo, suggesting that the DI particles might be applicable for the treatment of neurogliocytoma in the future.

Objective:To investigate the clinical characteristics of idiopathic hypereosinophilic syndrome (IHES) with gastrointestinal manifestations,and to improve the level of diagnosis and treatment of IHES. Methods:The clinical materials, process of diagnosis and treatment and prognosis of 9 patients diagnosed as IHES with gastrointestinal manifestations were retrospectively analyzed. Results:The average age of 9 patients was (22.66± 12.86)years old,and the ratio of male and female was about 1.25∶ 1. The main clinical manifestations included abdominal pain,diarrhea and abdominal distension.The eosinophil percentages in peripheral blood and bone marrow of the patients were (42.66 ± 19.88 )% and (39.33 + 15.99 )%, respectively.The ascites exudate cytology examination showed eosinophil infiltrated.The results of gastroscope or colonoscope showed mucosal hyperemia and edema,scattered bleeding spots, and dark red granular hyperplasia; the colon was affected frecuently.The histological biopsy confirmed that the mucosal was infiltrated by eosinophils.The abdominal CT of 6 patients showed that the walls of stomach or bowel were thickened.The abdominal symptoms disappeared,and the ascites was absorpted in 9 patients after the treatment of glucocorticoid.After 2 years of follow up,2 patients had relapse, others had no recurrence.Conclusion:Performing the routine diagnosis and treatment of gastrointestinal diseases, the clinicians should consider the possibility of IHES in order to avoid the misdiagnosis and delayed treatment. When IHES is diagnosed,steroid treatment should be performed in preference.

Aiming at the shortcomings of traditional medical device tracking and supervision mode, such as delayed feedback of medical device positioning information, poor visual tracking effect of medical device, and missing early warning of medical device working state supervision, a medical device visual tracking and supervision system based on wireless Local Area Network (LAN) real-time positioning system is developed. Introduction of wireless LAN real-time positioning system, using standard coding algorithm generating device object ID tags, with the only attribute based on RFID read-write terminal complete physical mapping of medical equipment and material ID label, we realize a real-time positioning and traceability of medical equipment, with the help of active warning algorithm based on depth of learning medical equipment working state supervision for early warning, with the help of indoor map generation and trajectory playback medical equipment to realize visualization back regulation. Choose equipment of hospital of Linyi Central Hospital for performance evaluation of the carrier, the evaluation model of engineering practice and clinical statistical analysis, the results show that the system has a complete real-time positioning, visible trace, abnormal warning function. In medical equipment real-time positioning information visual tracing feedback, abnormal state warning etc, medical equipment has obvious advantages.
Algorithms ; Local Area Networks

OBJECTIVETo assess clinical and pathological features of ovarian transitional cell tumors.

METHODSFourteen cases of ovarian transitional cell carcinoma (TCC) were selected and investigated for their clinical and pathological features. Their immunohistochemical profiles were compared with 12 cases of serous adenocarcinoma (SC) admixed with TCC and 4 cases of EC admixed with TCC 20 cases of pure high-grade serous adenocarcinoma (HG-SC), 15 cases of endometrioid adenocarcinoma (EC), 6 cases of Brenner tumor (BT, 2 cases of malignant BT and 4 cases of benign BT).

RESULTSThe patients' age ranged from 36-63 years (mean, 56 years). All cases underwent surgery and postoperative chemotherapy with TP or CAP program. Clinical follow-up was available in 9 cases, of which 2 patients died. Histologically, all cases showed features of transitional cell carcinoma without BT component. Immunohistochemically, 13 of 14 TCCs were positive for WT-1 and all were positive for CK7, ER, PR and CA125, but negative for Uroplakin III and CK20.Similar immunohistochemical staining patterns were seen in SC admixed with TCC and pure HG-SC. Percentage of the 14 TCC cases were also diffusely positive for BRCA1. All SCs admixed with TCC and pure HG-SCs were diffusely or heterogeneously positive for WT-1, with a sharp contrast and mottled distribution pattern in the heterogeneous cases. All TCCs were diffusely and strongly positive for p53, while 16 of 20 cases of pure HG-SC were positive. The positive ratio of p53 in SCs admixed with TCC cases was 11/12.WT-1 expression in TCCs was significantly higher than BTs, ECs and ECs admixed with TCC (P < 0.01), while no obvious difference was seen when compared with SCs admixed with TCC and pure HG-SCs.SCs admixed with TCC, TCCs and EC were positive for BRCA1 except pure ECs and BTs. The positive rate of Ki-67 of BTs was low, while it was higher in TCCs, SCs admixed with TCC and pure HG-SCs. Only BTs expressed Uroplakin III.

CONCLUSIONSOvarian TCC has characteristic morphological and immunohistochemical features, similar to SC but different from BT. Therefore, TCC should be considered as a morphological variant of HG-SC.

Adult ; Brenner Tumor ; metabolism ; pathology ; CA-125 Antigen ; metabolism ; Carcinoma, Endometrioid ; pathology ; Carcinoma, Transitional Cell ; pathology ; Cystadenocarcinoma, Serous ; pathology ; Female ; Humans ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasms, Glandular and Epithelial ; pathology ; Ovarian Neoplasms ; metabolism ; pathology ; Uroplakin III ; metabolism

Objective To study the effect of artesunate on inflammatory responses to severe pneumonia by regulating macrophage migration inhibitory factor (MIF) in rats.Methods Total of 100 SD by random (random number) assigned,20 rats were control group,80 SD rats with severe pneumonia were caused by Klebsiella pneumoniae,60 SD rats were treated with different concentrations (20,40,80 mk/kg) of artesunate after modeling.The pathological changes of lung tissue,the level of MIF myeloperoxidase activity and inflammatory cell infiltration in lung tissue of rats were evaluated.Results After treatment with artesunate,the severity of inflammation was significantly alleviated in rats with severe pneumonia evidenced by decrease in myeloperoxidase activity [severe pneumonia:(17.5 ± 1.5) vs.treatment group:(7.5 ±2.0)] and reduction in inflammatory cell infiltration (severe pneumonia:27 × 106 vs.treatment group:12.5 × 106).Similarly,the artesunate also reduced the production of inflammatory cytokines significantly in bronchoalveolar lavage fluid (IL-1 in severe pneumonia group:(1 100 ± 50) pg/ml vs.treatment group:(400 ± 60) pg/ml;IL-6 in severe pneumonia group:(700-± 30) pg/ml vs.treatment group:(200 ±40) pg/ml;IL-10 in severe pneumonia group:(500 ± 70) pg/ml vs.treatment group:(200 ± 40) pg/ml;TNF-αin severe pneumonia group:(500 ± 80) pg/ml vs.treatment group:(150 ± 50) pg/ml.In addition,artesunate inhibited the level and production of MIF,thus inhibiting the inflammatory responses mediated by MIF.Conclusions Artesunate had a protective effect on pneumonia caused by Klebsiella pneumoniae in rats via inhibiting the inflammation responses mediated by MIF.This study provided a molecular basis for newly developed drugs applied to the treatment of pneumonia caused by Klebsiella pneumoniae in rats.