Objective: To observe the feasibility of dexmedetomidine sedation application in light of the difficult airway intubation assisted. Methods: Selecting pseudo operation under general anesthesia, is expected to 60 cases of difficult airway patients, randomly divided into dexmedetomidine combined bar adjuvant therapy group(group A, n=20) and dexmedetomidine treatment group(group B, n=20), the general status of the two groups were observed and recorded the intubation time, intubation times and success rate, of the patients, and postoperative complications. Results:The results of dexmedetomidine combined with light auxiliary treatment group first intubation success rate is higher than the single use of dexmedetomidine treatment group, no significant difference;the intubation time than group B(t=63.18, P<0.05), in A group before and after intubation, HR MAP had no obvious change before and after MAP, B group, HR intubation, there was statistically significant difference. A group complications of lower than B group. Conclusion:Dexmedetomidine sedation application can improve the success rate of intubation in difficult airway intubation in light assisted, little side effects on patients, and reduce its complications.

Objective To evaluate the influence of tracheal intubation guided with light wand on hemodynamics in patients with obstructive sleep apnea syndrome.Methods Seventy-four patients with obstructive sleep apnea syndrome were randomly divided into light wand group (n =37) and laryngoscope group (n =37).The time to successful intubation,rate of successful intubation,changes of heart rate (HR),systolic blood pressure (SBP),diastolic blood pressure (DBP) and complications were compared in two groups.Results The time to successful intubation of light wand group was significantly shorter than that of laryngoscope group,while the rate of successful intubation in light wand group was significantly higher than that in laryngoscope group (P＜0.05).The HR,SBP and DBP at T1 were significantly lower than those at T0 in two groups (P＜0.05).The HR,SBP and DBP in two groups at T2,T3 were significantly higher than those at T1 (P＜0.05),and those indexes of light wand group were significantly lower than laryngoscope group at T2 and T3 (P＜0.05).The incidence rates of complications in light wand group were significantly lower than those in laryngoscope group (P＜0.05).Conclusion With the advantage of higher success rate,shorter time to successful intubation,more stable hemodynamics and fewer complications,tracheal intubation guided with light wand is worthy of popularization and application in clinical.

Objective To verify the possibility and exactly of ultrasound diagnosing peripheral nerve injection injury,by high-frequency ultrund observing the rabbits' injection injured sciatic nerve and contrasting with pathology.Methods Twenty-two rabbits were enrolled in this study,anesthetized by injected phenobarbital sodium through the ear edge vein.The rabbits' left sciatic nerve were punctured and cidomycin was injected by ultrasound guided.Ultrasound examination on the left sciatic nerve was performed at different time.After each examination 2 rabbits were killed and dissected the affected limb.The sciatic nerve was observed by eyes and under microscope.Results After injection,the sciatic nerves' outer diameter,inner diameter,thickness of the epineurium,the proportion of epineurium was increased (P ＜ 0.05),internal echo of the nerves was reduced (P ＜ 0.05),epineurium became rough (P ＜ 0.05),demarcation with surrounding tissue became gradually fuzzy (P ＜ 0.05),the nerves became rigid (P ＜ 0.05).Observed by microcrope,after injection,hyperemia and hemorrhage of endoneurium and epineurium,inflammatory cell infiltration,damaged nerve fiber structures,desmoplasia inside and outside nerve can be seen.Conclusions The sonogram of injection injured nerve vary in different periods,and related with pathological changes.High-frequency ultrasound is a reliable imaging method of diagnosing sciatic nerve injection injury.

Objective To investigate the effect of obesity on the early complications after esophageal cancer operation.Methods Clinical data of 327 patients who had esophageal cancer operation in our hospital from August 2012 to September 2015 were retrospectively analyzed.The patients were divided into 4 groups:lean group(n =75), normal group(n =120),overweight group(n =103)and obesity group(n =29)by body mass index(BMI).The impact of obesity on early complications of esophageal carcinoma after surgery was analyzed.Results The operation time of the lean group,normal group,overweight group and obesity group were (257.8 ±52.6 )min,(289.3 ± 48.7)min,(321.5 ±55.9)min,(367.9 ±50.2)min respectively.The operation time was increased with the increase of BMI (F =13.397,P =0.000).The incidence rates of incision infection,empyema,hoarseness,diaphragmatic hernia,postoperative bleeding,chylous fistula,pulmonary complication were 5.3%,1.3%,1.3%,1.3%,2.7%, 2.7%,16.0% in the lean group,5.0%,1.6%,1.6%,1.3%,1.6%,1.6%,17.5% in the normal group,5.8%, 1.9%,0.9%,1.9%,1.9%,1.9%,1.9% in the overweight group,10.3%,3.4%,0.0%,3.4%,3.4%,0.0%, 13.8% in the obesity group.No significant differences were found about the hospital days,wound infection,empyema, hoarseness,diaphragmatic hernia,operation hemorrhage,chylous fistula,pulmonary complications among the 4 groups (all P >0.05 ).The incidence rates of cardiovascular complications and anastomotic leakage after operation were 0.0%,4.0% in the lean group,1.9%,5.0% in the normal group,6.8%,9.7% in the overweight group,13.8%, 17.2% in the obesity group.The incidence of cardiovascular complications,postoperative anastomotic leakage increased with the increase of BMI.The differences of the four groups were statistically significant(F =1.675,1.054, all P <0.05).Conclusion Obesity can increase the incidence of early postoperative complications in patients with esophageal cancer.But obesity is not a contraindication of surgery for esophageal cancer,but obese patients should be more carefully treated in the perioperative period.

The effects of MC903, a novel 1,25-dihydroxyvitamin D3 [1,25(OH)2 D3] analogue, on proliferation and differentiation of a human megakaryoblastic leukemia cell line (HIMeg) were investigated. MC903 was found to inhibit cell proliferation and induce cell differentiation of HIMeg cells. Colony formation assay showed that MC903 (10-10 to 10-6mol/L) almost completely inhibited the colony-forming ability of HIMeg cells. Cell cycle analysis demonstrated that MC903 altered the cell cycle distribution; the fraction of cells in G0 + G1 increased while those in S and G2 + M decreased after treatment with MC903 for 4d. The effect of MC903 on proliferation and differentiation of HIMeg cells was in a dose- and time-dependent manner and was more active than that of 1, 25(OH)2, D3,. The results of the present study suggested that 1,25(OH)2 D3 as well as its novel analogue MC903 might play an important role in modulating the proliferation and differentiation of megakaryocytic lineage.

The cellular effects of glucocorticoids on proliferation and differentiation of a human inegakaryoblastic leukemia cell line (HIMeg) were studied in comparison with sex steroid hormones. In both liquid and methylcellulose culture systems, glucocorticoids suppressed the proliferate of HIMeg cells in a dose-dependent manner. In contrast, sex steroid hormones except progesterone had little effects on the proliferation of HIMeg cells. In liquid culture systems, morphological changes were not evident, and the percentage of cells with multilobular nuclei increased slightly from 2% to 8% after glucocorticoid treatment. Similarly, only 2% of HIMeg cells expressed glycoprotein Ⅱb/Ⅲa (GP Ⅱb/Ⅲa) antigen without hormone, whereas 30% of the cells expressed GP Ⅱb/Ⅲa with the addition of glucocorticoids. These data indicated that glucocorticoids could induce differentiation of HIMeg cells. To clarify the molecular mechanisms, glucocorticoid receptor (GR) expression was examind by Scatchard analysis, and it was found that there was a saturable, high affinity GR in HIMeg cells. Furthermore, the cellular effects of glucocorticoids on HIMeg cells could be reversed by RU486, a potent glucocorticoid antagonist. These observations suggest that the cellular effects of glucocorticoids on HIMeg cells were mediated by GR.

OBJECTIVE: The latency-intensity function (LIF) of wave V from click ABR of some deaf children showed great variation. We attempted to find out the intrinsic reasons. METHOD: The children recieved tone-burst ABR test. RESULT: Frequencies from 0.5-4.0 kHz have been tested and the thresholds of tone-burst ABR were recorded. The average thresholds of steeply LIF children at 0.5-4.0 kHz were (93.13 ± 7.04), (79.37 ± 7.72), (69.38 ± 8.54) (66.25 ± 8.06) dB respectively, while the average thresholds of shallower LIF children at these 4 frequencies were (65.00 ± 7.32) (68.13 ± 6.55) (70.63 ± 6.80) (78.12 ± 8.34) dB respectively. CONCLUSION The results imply that the child with steeply LIF may have more hearing loss at frequencies 0.5 and 1 kHz than those with shallower LIF. LIF may predict the audiogram configuration.
Audiometry, Pure-Tone ; Auditory Threshold ; Child ; Evoked Potentials, Auditory, Brain Stem ; Hearing Loss ; diagnosis ; Humans

Islet transplantation is an effective method treating insulin-dependent diabetes mellitus, which is apt to supersede pancreas transplantation currently. Although human islet transplantation has already performed successfully, its long-term effect is still unsatisfying. Reasons causing loss of islet function is still not fully understood to date. Thus, deep research of factors influencing transplanted islet survival is of importance to improve long-term effect of islet transplantation. Patient selection and tissue matching, collection, preservation and transport of pancreatic organ, isolation and purification of islet cells, implement of islet transplantation, blood glucose control and immunosuppressive drug application during islet transplantation period, functional assessment after islet transplantation, etc. completion quality of each of these technical links is the factor influencing islet transplantation.

In the light of sociological and psychological theories, the authors reflect from the perspectives of social politics, economy, culture, psychology and law on the current situation of the physician-patient relationship, the causes and lessonss. They argue that the current situation of the worsening physician-patient relationship is worrisome, its causes are multifarious, and channels for improvement ought to be as wide as possible. They hold that there is still a long way to go to improve the situation, efforts ought to be made by the whole society and humane medical services are indispensable.

Child ; Child, Preschool ; Humans ; Infant ; Smith-Lemli-Opitz Syndrome