Acute laryngeal obstruction is one of the most common diseases in Department of ENT, and it can cause suffocation without prompt treatment. Methods by using Nasopharyngofiberoscope guided tracheal intubation treatment of a case of acute laryngeal obstruction patients in a timely manner. This method is well tolerated, less trauma, high success rate, in the shortest time to improve the patient's ventilation, for the next step of the treatment to win the time.
Airway Obstruction ; surgery ; Humans ; Intubation, Intratracheal ; Larynx ; physiopathology

BACKGROUND: Propranolol is a nonselective competitive adrenergic β-receptor blocker capable of suppressing sympathetic nerve excitation. Postmenstrual osteoporosis may be associated with the changes of sympathetic nerve activity.OBJECTIVE: To observe the effect of propranolol on tibial morphology in ovariectomized rats, and compare it with that of estrogen medication.DESIGN: Completely randomized design and controlled experiment.SETTING: End ocrinology Department, General Hospital of Beijing Military Area Command of Chinese PLA.MATERIALS: This experiment was conducted at the animal laboratory of the Institute of Basic Theory Research of Traditional Chinese Medicine between March 2002 and April 2003. Forty female unmated SD rats aged 6 months were included and randomized into 4 groups with 10 rats in each group: sham-operation group, estrogen medication group, propranolol treatment group, and placebo group.METHODS: ① Rats in estrogen group, propranolol treatment group and placebo group were anesthetized before the abdomen was opened and bilateral ovaries were excised. Rats in sham-operation group had their abdominal cavity opened and a piece of ovary surrounding fattytissue excised before closing the abdomen. ② Estrogen medication group: Rats were given hypodermic injection of grain oil dissolved 17 β-estradiol at a dose of 20 μg/(kg·d). Propranolol treatment group: Propranolol was used for gastric infusion at a dose of 18 mg/(kg·d). Placebo group and sham-op-eration group: The same volume of grain oil and/or distilled water was used instead of hypodermic injection or gastric infusion. Two treatment groups were given the same intervention as placebo group and sham-operation group during treatment; medication was carried out from postoperative week 1 for altogether 12 weeks. ③ Leica Qwin imaging analysis system was used for morphological measurement of bone tissues so as to calculate the volume percentage, active-surface formation percentage, mineralization rate, and formation rate of bone trabecula. ④ t-test was used for comparing the differences.MAIN OUTCOME MEASURES: Comparison of rat tibial morphological parameters between groups.RESULTS: Forty rats were divided into four groups with 10 rats in each and all entered the result analysis. ① Left tibial active-surface formation percentage and mineralization rate of bone trabecula: They were obviously lower in sham-operation group and estrogen group than in placebo group (P ＜ 0.01), but obviously higher in propranolol treatment group than placebo group (P ＜ 0.05). ② Formation rate of left tibial trabecula: It was obviously higher in propranolol treatment group than in placebo group (P ＜ 0.05). ③ The volume percentage of left tibial bone trabecula: It was obviously higher in sham-operation group and propranolol treat ment group than in placebo group (P ＜ 0.01), but obviously lower in pro pranolol treatment group than in sham-operation group and estrogen group (P ＜ 0.01). CONCLUSION: Propranolol can increase bone mass, reduce bone loss, and promote bone formation in osteoporotic rats following ovariectomy, thus displaying obvious preventive and therapeutic effects on osteoperesis in rats.

OBJECTIVE To investigate(meticillin-resistant Staphylococcus aureus MRSA) the antibiotics resistance and curative effect of herbal Tanreqing-injection combined with vancomycin in the treatment of MRSA pneumonia.METHODS All data of microbiology about sputum culture between 2001-2007 were statistically analyzed with a retrospective method in a hospital,in order to understand the MRSA prevalence trends and their resistance.From 100 cases of MRSA pneumonia,50 cases were treated by vancomycin alone,another 50 cases were treated by Tanreqing injection plus vancomycin.RESULTS There were 3082 MRSA strains and 162(meticillin-sensitive S.aureus MSSA) strains in 3244 S.aureus strains;nosocomial infection cases accounted for 78.07% in MRSA-positive sputum samples;MRSA wasn't resistant to vancomycin,but resistant to other antibiotics.Resistance rates had a significant difference between MRSA and MSSA(P

Objective To investigate the efficacy and safety of modified endoscopic submucosal dissection (ESD) and rubber band ligation assisted endoscopic dissection for treatment of small gastric submucosal tumors (SMT) originating from the muscularis propria layer. Methods A total of ninety-two patients diagnosed as gastric SMT (6 mm≤diameter≤13 mm) originating from the muscularis propria layer by EUS in our hospital were enrolled in this study. With intravenous anesthesia and tracheal intubation in all patients, modified ESD was performed firstly to stripe the small tumors. After being exposed to a certain extent, the tumors were ligated by rubber band and snared for endoscopic dissection. The situation of bleeding, perforation in both intraoperative and postoperative, the integrity and size of the resected specimens were observed and recorded. The resected specimens were identified with histopathological detection and immunohistochemistry assay. At the 6-month and 12-month after the operation, all patients were reviewed by gastroscopy and EUS in our hospital. Results All the 92 tumors were resected completely and successfully. The mean operating time was (19.2±2.3) min and the mean blood loss in operation was (2.6±0.5) mL. Perforation after resection occurred in 3 cases, which were closed with metal hemostatic clips and nylon ropes. No delayed bleeding and perforation occurred in one week after the operation. The tumor sizes ranged from 6 mm × 5 mm to 13 mm × 12 mm. Seventy-three gastric stromal tumors (risk classification:all were very low risk), 18 gastric leiomyomas and 1 gastric neurofibroma were identified. There were no residue or recurrence in all cases during the 12-month follow-up period. Conclusion The modified ESD and rubber band ligation assisted endoscopic dissection are effective and safe for treatment of small gastric submucosal tumors originating from the muscularis propria layer. The tumors are resected completely and successfully, showing certain significance to assess the nature, degree of malignancy of the tumor and prognosis of the patients.

The gammac cytokines play an important role in proliferation and survival of T cells. Blocking the gammac signals can cause the activated donor-reactive T cells losing the ability to proliferate, and getting into apoptosis pathway, which contributes to induction of the peripheral tolerance. In this study, we induced the transplant tolerance through blocking the gammac in combination with donor-specific transfusion (DST) in the cardiac transplantation. Following DST, on the day 2, 4 and 6, C57BL/6 recipients received anti-gammac monoclonal antibodies (mAbs) injection, and those in control group were not given anti-gammac mAbs. On the day 7, Balb/c cardiac allografts were transplanted. All recipients in experimental group accepted cardiac allografts over 30 days, and two of them accepted allografts without rejection until sacrifice on the 120 day. Animals only receiving DST rejected grafts within 5 days, and the mice receiving cardiac transplantation alone rejected grafts within 9 days. Our study showed that blockade of gammac signaling combined with DST significantly prolonged allograft survival, which was probably associated with inhibition of antigen-specific T-cell proliferation and induction of apoptosis.

Objective To study the changes of plasma endotoxin and procalcitonin in patients with esophagogastric varices and provide a theoretical basis for prophylactic antibiotics after endoscopic treatment. Methods Fifty cases of patients with esophageal and gastric varices accepted the endoscopic treatment.The patients were divided into antibiotic group (32 cases)and non-antibiotic group (18 cases).The plasma endotoxin and procalcitonin were measured before and on the first day and 7th day after endoscopic treatment.Results The plasma levels of endotoxin and procalcitonin were not significantly different on the first and 7th day after endoscopic treatment compared with preoperative levels in antibiotic group.But in non-antibiotic group,the levels significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.05).And in patients of Child-Pugh A grade,the level of plasma procalcitonin significantly increased on 7th day after endoscopic treatment compared with preoperative levels (P <0.01), but the procalcitonin was not significantly different on the first and 7th day after operation.And in patients of Child-Pugh B and C grades,the levels of plasma endotoxin and procalcitonin significantly increased on the 7th day(P <0.01).Conclusion The levels of plasma endotoxin and procalcitonin in non-antibiotic group increase after endoscopic treatment,which suggests the risk of infection.Prophylactic antibiotics after endo-scopic treatment should be considered for the patients of Child-Pugh B and C grades.

Objective:To investigate the effect of HLA-DRB1*07,13 allelic genes on the immune response to hepatitis B vaccination.Methods:896 healthy college students of Han nationality from Guangxi province,who had received standard courses of vaccination with recombinant hepatitis B virus vaccine,were tested the level of anti-HBs with ELISA method at the sixth month after their last vaccination.The non- or hypo-responders were selected to receive another 20 μg doses of recombinant vaccine and were examined anti-HBs once more four weeks later.99 non- or hypo-responders and 136 medium or hyper-responders were selected for the study subjects.HLA-DRB1*07,13 allelic genes of the subjects were detected by polymerase chain reaction using sequence specific primer (PCR-SSP) method.Results:The frequencies of HLA-DRB1*07 gene in the non- or hypo-responders group were significantly higher than that in the medium or hyper-responder group (16.16% vs 4.41%,P＜0.05). No significant difference of HLA-DRB1*13 gene between the two groups (1.01% vs 3.68%,P=0.389).Conclusion:There is a close relationship between the expression of HLA-DRB1*07 gene and the non- or hypo-response to HB vaccine;No relationship between HLA-DRB1*13 gene expression and the response to HB vaccine is found.

In order to obtain glucagon-like peptide-1(GLP-1)analogs which can sustainedly control the levels of glucose, 12 derivatives were designed and synthesized by coupling monomethoxy polyethylene glycol(mPEG, with average molecular weights of 350, 550 and 750)to GLP-1 analogs. Preliminary pharmacological activities showed that all compounds retained GLP-1 receptor agonist activities, and the hypoglycemic activity of compound I-12 was similar to those of Ex-4 and Liraglutide, suggesting I-12 could be a potential long-acting GLP-1 receptor agonist.