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.

A number of compounds extracted from plants have cert ain physiological and pharmacological activity.Some of these compounds had been proved to have the ability to induce tumor cell apoptosis and demonstrated antitumor activity depending on their chemical structures.This review focuses on recent progress in the studies about the mechanism of tumor cell apoptosis induced by plant extracts including alkaloids,terpenes and lignans.

Objective To investigate effect of transforming growth factor β3(TGFβ3)on expression of MMP-9,MMP-2,TIMP-1 and collagen I in rats with liver fibrosis through transduction by recombinant adeno-associated virus 2(rAAV2).Methods Rats were randomly divided into 4 groups:normal control group,model group,negative control group and TGFβ3 group.Liver fibrosis model was induced by hypodermic injection of 40% CCl4.rAAV2-TGFβ3,was injected via vena caudalis of the rats one week before CCl4 Was given.All rats were sacrificed and the liver tissues were taken 8 weeks afler injection of CCl4.The histopathological changes were observed on HE sections;the expressions of MMP-9,MMP-2,TIMP-1 and collagen I were examined by histochemistry and the positive area rates were semi-quantitatively analyzed.Results Compared with the model group and negative control group,the decreases of inflammatory infiltration and collagen fibers hyperplasia were observed in the TGFβ3 group,and the expression of MMP-9 increased(q=23.664,27.746,P<0.01),the expression of collagen I(q=5.503,5.251,P<0.01)and TIMP-1(q=5.800,8.608,P<0.01)decreased,but that of MMP-2 was not changed(q=2.1 08,0.996,P>0.05).Conclusion rAAV2-TGFβ3 can reduce the histological damage and degree of liver fibrosis in rats by inhibiting expression of TIMP-1 and collagen I,and upregulating expression of MMP-9.

Aim Organotin compounds are important organometallic chemicals with a variety of technical applications.Of these compounds,the trialkyltins,especially tributyltin,triphenyltin and trimethyltin,have been proved to have the distinct ability to induce tumor cell apoptosis and significant antitumor activity.They can induce tumor cell apoptosis through Fas receptor,mitochondrial,Ca 2+,MAPKs,p53,NF-?B and caspase/p38/ROS pathway.This paper reviewed recent progress in the studies on signal transduction in tumor cell apoptosis induced by trialkyltin compounds.

AIM To explore the inhibition in in vitro p roliferation human prostate cancer PC 3 cells induced by melatonin and the effe ct of combination of melatonin and 5-Fu. METHODS Cell growth cu rve, MTT assay, and acid phosphatase(ACP)activity were used to determine cell proliferation. Coomassie brillient blue assay and modified diphenylamine assay w ere used to measure the content of protein and DNA in PC 3 cells. ACP activity was measured by modified phenyl phosphat e method of kind and king and modified method of lowry. Co-administration effec t of MLT and 5-fluorouracil(5-Fu)on PC 3 cell proliferation was determined by MTT assay. RESULTS The IC 50 of MLT for inhibiting PC 3, CoLo205, K562, and HeLa cell proliferation was(1 20?0 30),(1 27?0 12) ,(1 60?0 16)and(2 25?0 11)mmol?L -1 , respectively. And MLT inhib ited all above cells proliferation in a concentration-dependent manner. The protein and DNA content and ACP activity in PC 3 cell treated with 2 mmol?L -1 MLT for 96 h were redu ced 58 77%, 54 97% and 89 24%, respectively. When PC 3 cells were treated wi th MLT in combination with 5-Fu 0 5 mg?L -1 , the inhibition rate enhance d. CONCLUSION MLT inhibited PC 3, CoLo205, K562, and HeLa cell p roliferation, and reduced the content of protein and DNA and ACP activity in PC 3 cell. MLT and 5-Fu co-administration enhanced the inhibition rate of PC 3.er.TheproteinandDNAcontentandACPactivityinPC3 celltreatedwith 2mmol?L-1MLTfor 96hwerereduced5 8 77% ,5 4 97%and 89 2 4% ,respectively .WhenPC3 cellsweretreatedwithMLTincombinationwith5 Fu 0 5mg?L-1,theinhibitionrateenhanced .CONCLUSION　MLTinhibitedPC3 ,CoLo2 0 5 ,K5 62 ,

Objective:To analyze the drug resistance of Pseudomonas aeruginosa( PA) isolated from clinical specimen to provide the guidance for the clinical treatment. Methods:The infection status of PA from January 2012 to December 2012 was reviewed retro-spectively, and the results of susceptibility test for 448 PA strains were analyzed. Results:The antibiotic susceptibility of the PA strains to cefoperazone sodium and sulbac, ampicillin aodium and aulbacta,aiprofloxacin,cefepime,piperacillin/ sulbactam,amikacin, ceftazi-dime,meropenem, imipenem, minocycline, selectrin and aefuroxime was 100%, 76%, 72. 8%, 69. 4%, 66. 3%, 65. 6%, 64. 8%, 59. 9%,28. 9%,2. 4% and 0%,respectively. Conclusion:PA is one of the main pathogenic bacteria for nosocomial infection. It is necessary to strengthen the drug resistance test and standardize the application of antibiotics in order to provide the reference for clinical rational use of antibacterial drugs.

Objective To investigate the expression of integrin β1 and VEGF in gastric carcinoma and evaluate its correlation with invasion and metastasis.Methods Immunohistochemistry techniques were used to study the expression of integrin β1 and VEGF in 63 gastric carcinoma specimens.We analyzed the variance with histological grade and stage and classification of clinical date.Results No significant relationship was observed among age,sex and histological classification of the expression of integrin β1 in the gastric cancer group (P>0.05).With the depth of invasion and lymphatic metastasis increasing,integrin β1 expression improved.The positive rate of integrin β1 among tubular adenocarcinoma,papillary carcinoma,mucinous carcinoma and undifferentiated carcinoma was 70.00 %,55.56 %,57.14 % and 64.86 %.No significant relationship was observed in it.Integrin β1 in cases with lymphnode metastasis was significantly higher than those without lymph node metastasis (P<0.05).No significant relationship was observed among VEGF expression and age,sex,histological classification and depth of invasion (P>0.05).Significant relationship was observed among VEGF expression and lymphatic metastasis.VECF in cases with lymph node metastasis was significantly higher than those without lymph node metastasis (P<0.05).Conclusion Immunohistochemistry techniques indicated that integrin β1 participated in the procession of invasion and metastasis.The expression of integrin β1 and VEGF are important factor,forecasting the invasion and metastasis.VEGF is an important factor for lymphnade metastasis of gastric carcinoma.VEGF in cases with lymphnode metastasis was significantly higher than those without lymphnode metastasis(P<0.05).The usage of integrin β1 and VEGF will improve the rightness in forecasting the invasion and lymph node metastasis of gastric carcinoma.

Objective:To provide some thoughts for pharmaceutical treatment and care for the patients with pulmonary infection af-ter renal transplantation. Methods:Clinical pharmacists participated the whole treatment process of one case of pulmonary infection af-ter renal transplantation. According to the literatures combined with medical history, clinical symptoms and lab results, the drug treat-ment process of the patient was analyzed, and the key points of the optimized pharmaceutical care were summarized. Results: The pharmaceutical care included the dose adjustment of immunosuppressants at the early phase of the disease and after the improvement of clinical symptoms, attention paid to the interactions between multiple anti-infective drugs and immunosuppressive agents, dosage ad-justment based on the renal function of the patient, monitoring adverse drug reactions and drawing up personalized regimen. Conclu-sion:Through comprehensive medication monitoring, clinical pharmacists can help physicians develop timely and effective treatment programs and provide professional and effective pharmaceutical care for patients.

BACKGROUND:Femoral offset reconstruction is significant for recovering strength of abductor and the balance of soft tissue tension surrounding hip joint, maintaining joint stabilization, restoring joint function, reducing limping after replacement, decreasing prosthetic abrasion, and the incidence of joint prosthesis dislocation.
OBJECTIVE:To discuss effect of femoral offset reconstruction on hip joint function in total hip arthroplasty.
METHODS:We comparatively analyzed 20 patients (20 hips) undergoing the modular prosthesis (S-ROM) total hip arthroplasty and 19 patients (20 hips) undergoing the one modular prosthesis (Corail) total hip arthroplasty at the same time. According to Harris hip score and radiography results, hip joint function and femoral offset reconstruction rate were comparatively studied in both groups.
RESULTS AND CONCLUSION:No infection, fracture, dislocation, deep venous thrombosis or neurovascular injury occurred in either group. Clinical fol ow-up results:In the modular prosthesis and one modular prosthesis groups, there was no significant difference in preoperative Harris hip score between the femoral offset reconstruction and non-reconstruction groups (P>0.05). At 12 months and the latest fol ow-up, the Harris hip score was higher in the patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). The range of abduction of hip joint was larger in patients with femoral offset reconstruction than those with femoral offset non-reconstruction (P<0.05). Radiographic fol ow-up results:significant differences in the rate of femoral offset reconstruction were detected between the modular prosthesis and one modular prosthesis groups (χ2=3.956, P<0.05). 39 (98%) femoral stems were in neutral position and one (2.5%) was in mild valgus. There was no significant difference in the abduction angle and the anteversion angle between patients with and without femoral offset reconstruction (P>0.05). These results indicated that functional recovery and the range of abduction were better in patients with femoral offset reconstruction than those without femoral offset reconstruction. Modular prosthesis has a high rate of femoral offset reconstruction.

Objective:To summarize the clinical experience of changing the membranous pulmonary system during extracorporeal membrane oxygenation(ECMO) in infants after congenital heart disease opration with cardiopulmonary bypass.Methods:From January to September in 2019, 6 cases of congenital heart disease with cardio-pulmonary bypass in our hospital were analyzed retrospectively, whose membrane obstruction occurred during ECMO treatment and replaced successfully.The hemodynamics and blood gas before and after replacement of ECMO system were observed, and the experience was summarized.Results:Six patients(3 males and 3 females), aging from 1 to 3 months and weighing from 3.0 to 4.9 kg, were received VA-ECMO adjuvant therapy.The ECMO system replacement process was smooth and took 175-209 s. The hemodynamic of the children was stable.The ECMO support time was 134-249 h. After the improvement of cardiac systolic function, all children were successfully withdrawn and survived.Conclusion:The improved method of liquid replacement in ECMO system can make full use of the blood components in the original system and avoid the loss of blood tangible components.According to the plan of rapid replacement, the risk of replacement will not be increased.