Objective To evaluate the feasibility of tracheal intubation without muscle relaxant after induction of anesthesia with propofol-remifentanil given by target controlled infusion (TCI) .Methods Twenty-eight ASA Ⅰ or Ⅱ patients of both sexes (15 males, 13 females) aged 18-67 yrs weighing 43-89 kg scheduled for elective operation under general anesthesia were studied. Midazolam 0.03 mg?kg-1 was given i. v. as premedication. Anesthesia was induced with propofol and remifentanil and both of them were given by TCI. The target effect site concentration of propofol was set at 3 ?g?ml-1 and that of remifentanil at 4 ng?ml-1. BP, HR and bispectral index (BIS) were monitored during induction and intubation. The results of tracheal intubation were graded as satisfactory, average and poor baaed on intubation conditions and intubation response including easiness of ventilating the patients via face mask, jaw relaxation, easiness of inserting laryngoscope and visualization of larynx, the vocal cord position and patients response to intubation such as cough, limb movement and response to cuff inflation.Results HR and BP were significantly increased within 1 min after intubation as compared to the baseline values before intubation ( P

Esophageal carcinoma(EC) is one of the most common malignancies,which is difficult to cure.The median overall survival is less than 1 year,and the 5-year survival rate is less than 10％.Previous reports cited the incidence of brain metastasis (BM) from esophageal cancer to be approximately 0.4％ ～ 5.1％,and most of the reports come from America and Japan.The incidence of BM from EC is increased.However,because of the rarity of BM from EC,there are no established treatment guidelines.This report provides a comprehensive view of the clinical characteristics,treatment and prognosis of brain metastasis from esophageal carcinoma.

Herpes simplex virus type Ⅰ(HSV-1) is a common pathogen, and human is the only natural host of it.Following a period of lytic replication in epithelial cells, HSV-1 enters axon terminals of sensory neurons and then travels via retrograde transport to the sensory ganglia where latency can be established.Upon the stimulation of some stressors, the latent virus can reactivate, leading to recurrent diseases.Therefore, to clarify the mechanism of HSV-1 latent infection and stress-induced reactivation will offer new insights into the prevention, treatment and control of HSV-1 infection.In this review, we describes the mechanisms underlying HSV-1 latent infection and stress-induced reactivation.

Objective To explore and assess the reasonable application of integrated collaborative service mode in obstetrics and gynecology clinical service.Methods 152 pregnant women admitted in obstetric outpatient from March 2016 to May 2016 were randomly assigned into observation group and control group,76 cases in each group.The control group received obstetric traditional outpatient treatment and hospitalization mode,while the observation group implemented the integrated collaborative service mode.It was a integrated mode based on the traditional mode and multidisciplinary professionals integrated into groups for synergistic services,from the beginning of pregnancy to discharge.Results The number of cases who were knowledged maternal diseases,intraoperative coordination,reasonable diet and breastfeeding of the observation group (69,70,69,66) were superior to those of the control group (51,40,54,50) (x2=17.56,52.58,12.44,11.11,all P<0.001).The incidence rate of maternal and neonatal complications of the observation group were significantly lower than those of the control group(t=12.04,6.49,2.87,9.26,-7.14,all P<0.005).And patients satisfaction survey was improved,the number of satisfaction and complaint in the observation group was 70 persons,1 person,which of the control group was 70 persons,6 persons (x2=7.65,P<0.01).Conclusion Integrated collaborative service mode can improve the quality of medical service and patients' satisfaction,while reduce cesarean section rate,postpartum hemorrhage and maternal complications.Integrated collaborative service mode is an effective method to promote the development of perinatal medicine.

Objective To evaluate the clinical value and the early therapeutic efficacy of hysteromyomas treated with the radiofrequency ablation (RFA) by two-dimensional contrast-enhanced ultrasound(2D-CEUS) and three-dimensional contrast-enhanced ultrasound(3D-CEUS). Methods A total of 90 patients with 150 hysteromyomas were treated with RFA, including 138 intramural myomas and 12 submucous myomas (in which 5 had micr-pedicles). 2D-CEUS and 3D-CEUS were performed within one day before and after RFA treatment, respectively. The blood supply of focal zone(FZ) was observed by 2D-CEUS and 3D-CEUS. The volume of hysteromyomas and the coagulation necrosis range were measured by 3D-CEUS. The average necrotic rates of hysteromyoma were calculated. Results The 5 submucous myomas with micr-pedicles were removed completely after the RFA treatment. The 2D-CEUS appearances of other 145 hysteromyomas were diverse after the RFA treatment, in which 137 FZs had no contrast infusion,indicating complete ablation, 8 FZs appeared peripheral linear or small flaky enhancement, considering incomplete treatment. The 3D-CEUS performances were variant too, in which 132 FZs vascular network displayed as a "cavity", indicating complete tumor necrosis, the other 7 FZs appeared "branch shape" low enhancement and another 6 FZs showed nonuniform low enhancement, considering residual tumor tissue. The average necrotic rate of the 139 hysteromyomas was (97.1 ± 12. 9)% ,another 6 hysteromyomas was only (46. 4 ± 7. 0) %. Conclusions 3D-CEUS can display vascular structure and spatial relationship of the hysteromyomas, which can be used as the complement of 2D-CEUS. The combination of the two techniques can evaluate the earlier therapeutic efficacy of hysteromyomas by RFA more timely, intuitively and accurately.

Objective To investigate the expression of blood CD +4 CD +25 Treg GITR,CD +4 T cell GITRL in children with asthma,and the role of them in asthmatic inflammation.Methods 50 cases of severe asthma were selected,and were controlled with thirty two healthy children.The venous blood was collected both in the period of acute episode and clinic remission.The mean fluorescence intensity of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL was detected by flow cytometry.Results The expression of CD +4 CD +25 Treg GITR in the asthma acute period group was (24.2 ±8.2)MFI,which was significantly lower than (28.5 ±6.0)MFI in the control group(t =2.5,P <0.05).While there was no significant difference of CD +4 T cell GITRL expression between the asthma acute period group[(5.2 ±3.6)MFI]and the control group[(4.6 ±1.0)MFI](t =1.1,P >0.05).Moreover,the expression of CD +4 CD +25 Treg GITR in the asthma in remission group after treatment was (29.5 ±8.3)MFI,which was significantly higher than that in acute period group before treatment(t =-9.9,P <0.01 ).Whereas,there was no significant difference of CD +4 T cell GITRL expression in asthma group between in remission after treatment[(5.7 ±3.6)MFI] and in acute period before treatment(t =-1.6,P >0.05).Furthermore,there was no significant correlation between levels of CD +4 CD +25 Treg GITR and CD +4 T cell GITRL.Conclusion The level of CD +4 CD +25 Treg GITR in acute period asthmatic patients was decreased,but it was increased in remission,but no changes of CD +4 T cell GITRL expression were observed.GITR/GITRL signal system might be involved in the asthmatic inflammation procession.

ObjectiveTo explore the epidemiologic features and distribution pattems of hepatitis C virus (HCV) genotype infection among HIV positive former blood donors (FBDs) and transfusion recipients in Hubei province.Methods597 serum samples from HIV-positive patients in Hubei were collected and examined for anti-HCV by enzyme-linked immunosorbent assay ( ELISA ).Reverse transcription nested polymerase chain reaction (RT-nested PCR) amplification and DNA sequencing were used to evaluate the HCV core regions.ResultsThe prevalence rates of HCV in HIV positive FBDs and transfusion recipients were 76.5％ (205/268) and 57.4％ (189/329) respectively.HCV genotypes 1b (92.8％,90/97) and 2a (7.2％,7/97 ) were detected.ConclusionsBlood donation and blood transfusion are the major modes of HIV-HCV co-infection in Hubei province.The prevalence of HCV in HIV positive transfusion recipients is lower than that in HIV positive FBDs.HCV genotypes 1b and 2a are the predominant strains among HIV-positive FBDs and transfusion recipients.

Objective: To investigate the current prevalence of latent tuberculosis infection (LTBI) among residents living in Nanchuan District, Chongqing Municipality, so as to provide the evidence for formulating LTBI control measures. Methods: The residents living in one street and one township from Nanchuan District were randomly selected using the multistage cluster sampling method during the period between January and April, 2020, and their demographic information, smoking history, history of alcohol consumption, history of contacts with tuberculosis patients and Bacillus Calmette-Guérin ( BCG ) vaccination scars were collected. The infection of Mycobacterium tuberculosis was detected using interferon gamma release assay ( IGRA ), and a positive IGRA test and exclusion of active tuberculosis was defined as LTBI. The prevalence of LTBI was descriptively analyzed among the study subjects. Results: Totally 1 000 residents were recruited, including 381 males and 619 females, with a male to female ratio of 0.62∶1. The mean age was ( 45.87±18.40 ) years. Among all participants, there were 222 smokers ( 22.20% ), 247 subjects consuming alcohol (24.70%), 62 subjects with a history of contacts with tuberculosis patients ( 6.20% ) and 904 subjects with BCG scars ( 90.40% ). A total of 198 residents were diagnosed with LTBI (19.80% prevalence), and a higher prevalence rate of LTBI was seen in men than in women ( 23.36% vs. 17.61%; χ2=4.911, P=0.027 ). The prevalence of LTBI was significantly higher in married/divorced/widowed residents than in unmarried residents ( 24.22% vs. 2.01%; χ2=49.514, P<0.001 ), and significantly greater prevalence was found in smokers than in non-smokers ( 27.93% vs. 17.48%; χ2=11.871, P=0.001 ). The prevalence of LTBI appeared a tendency towards a rise with age ( χ2trend=59.100, P<0.001 ) and body mass index ( χ2trend=9.479, P=0.002 ). Conclusions The prevalence of LTBI is high among residents living in Nanchuan District, notably among elder, male smokers with high body mass index. Risk monitoring and timely interventions are required.

Objective To investigate the effect of allgeneic hematopoietic stem cell transplantation (allo-HSCT) for β-thalassemia major. Methods Twenty-four β-thalassemia major patients with median age of 4 years (range: 2～15 years), 18 boys and 6 girls, received allo-HSCT.They were classified into class Ⅱ-Ⅲ according to Pesaro thalassemia classification. Twenty-three transplantations were from sibling donor and 1 was from mother, either HLA-identical (n = 23) or HLA-mismatched (5/6) (n = 1). Fifteen patients received bone marrow transplantation (BMT) plus peripheral blood stem cell transplantation (PBSCT), and 9 were subjected to umbilical cord blood transplantation (UCBT). The conditioning regimen consisted of busalphan, cyclophosphamide,fludarabine, plus hydroxyurea before transplantation. Graft-versus-host disease (GVHD) prophylaxis included CsA, methotrexate, antilymphpcute globulin, and mycophenolate mofetil. The median follow-up period was 13 months (range: 3～69). Results Of 24 patients, there were 21 cases (87. 5 %) of disease-free survival, 1 (4. 2 %) transplantation-related death, and 2 cases (8. 3 %) of rejection. Three-year overall survival and disease-free survival rate was 91.7 % and 87. 5 %respectively. The cumulative incidence of grade Ⅱ -Ⅳ acute GVHD and chronic GVHD was 16. 7 %and 20. 3 %, particularly cumulative extensive chronic GVHD was 5. 0 %. Conclusion The sibling donor BMT plus PBSCT is an effective and safe way to treat β-thalassemia major. Cord blood is an important source of hematopoietic stem cells for HSCT. The protocol GVHD prophylaxis of CsA,MTX, ATG with a low-dose and short course of MMF can effectively reduce the incidence of severe acute GVHD, improve the outcome of thalassemia transplantation.

Objective To study the effects of the rehabilitation robot-assisted task-oriented training on the hand function in patients after stroke. Methods From June, 2015 to September, 2016, 35 inpatients suffering from stroke were randomly allocated to control group (n=17) and trial group (n=18). Based on the routine rehabilitation, the trial group accepted robot-assisted task-oriented training, while the control group accepted therapist-assisted task-oriented training, for two weeks. They were measured the active range of motion (AROM) of fingers, assessed with fingers motor of Fugl-Meyer Assessment (FMA) and modified Barthel Index (MBI) invovled with hands before and after train-ing. Results The inpatients dropped three in the control group, two in the trial group. AROM of extension and flexion of all the fingers, the AROM of extension and total of three fingers of thumb, index and middle, and the total AROM of each finger improved in the trial group af-ter training (t>2.937, P<0.05), while the AROM of extension and flexion of all the fingers, AROM of extension, flexion and total of the fin-gers of thumb, index and middle, total AROM of the fingers of thumb, index and little improved in the control group after training (t>2.528, P<0.05);the AROM of extension and total of the fingers of thumb, index and middle, and the total AROM of fingers of thumb and index im-proved more in the trial group than in the control group (t>2.535, P<0.05). The scores of mass flexion, mass extension, opposition, cylinder grip, spherical grip and total score of FMA improved in the trial group after training (Z>2.000, P<0.05), while the scores of mass extension, opposition and the total score of FMA improved in the control group after training (Z>2.000, P<0.05). There was no significant difference between the two groups on the items and total scores after training (P>0.05). The scores of feeding, dressing, toilet transfers, bathing, groom-ing of MBI and the total score of them improved in the trial group after training (Z>2.041, P<0.05), while the total score of MBI improved in the control group after training (Z=-2.527, P<0.05). There was no significant difference between the two groups in the items and total scores after training (P>0.05). Conclusion The rehabilitation robot-assisted task-oriented training can improve AROM of hemiplegic fingers and grip function.