Objective To evaluate the value of TruviewTM EVO2 optical laryngoscope for emergency endotracheal intubation in the clinical application.Methods Forty-four patients in need for emergency endotracheal intubation were randomly (random number) divided into two groups:the observation group (TruviewTM EVO2 optical laryngoscope for tracheal intubation,n =22) and the control group (ordinary laryngoscope for tracheal intubation,n =22).Parameters recordered included C/L (Cormack-Lehane)grade,the time taken for successful intubation,tracheal intubation times,lowerest SpO2 during the intubation and the incidences of complications after intubation.IDS (intubation difficulty scale) scores were calculated and the total effective rates were compared.Results The data showed that there were no significant differences in the duration of the successful endotracheal intubation attempts between the two groups,respectively (24.04 ±6.56) s and (21.97 ±8.92) s,P ＞0.05.The C/L grade with the observation group was 10∶ 9∶ 3∶0 (Ⅰ ∶ Ⅱ ∶ Ⅲ∶ Ⅳ),which was significantly better than that with the control group (3∶ 7∶ 9∶ 3,P ＜0.01).The tracheal intubation times of the observation group was 17∶ 5∶0 (one time∶ two times∶ three times),which was significantly better than that of the control group (9∶ 8∶ 5,P ＜0.01).The minimum of SpO2 in the observation group (97.31 ± 1.64)％ was significantly higher than that in the control group (92.03 ± 5.39)％,(P ＜ 0.01).The incidence of complications after intubation was lower in the observation group.The IDS score in the observation group (0.68 ± 0.38) was much lower than those in the control group (2.54 ± 1.49),(P ＜ 0.01).In addition,the total effective rate of the observation group (86.36％) was significantly higer than that in the control group (45.45％),(P ＜0.01).Conclusions Using optical laryngoscope for emergency endotracheal intubation could facilitate the glottis exposure and reduce C/L grade effectively.It could lead to lower the incidence of complications and increase the success rate of tracheal intubation.

[Objective] To explore the characteristics of the plantar pressure data of the patients with adolescent idiopathic scoliosis (AIS).[Methods] 56 AIS patients who were diagnosed from October 2015 to March 2017 in the East branch of the First Affiliated Hospital of Sun Yat-sen University divided into 3 groups,18 cases in spinal lateral bending to right,18 cases in spinal lateral bending to left,20 cases in type S who were thoracolumbar scoliosis.Another 19 healthy persons were as the control group.The left and right foot pressure,half foot pressure and other biomechanical data were compared.The changes of the plantar pressure and the Cobb angle were analyzed with the patients who wore orthopedic insoles.[Results] Compared with the control group,the mean pressure of the left foot and the pressure of the left anterior half of the right bending group were less than those of the control group,and the right half foot pressure were greater than those of the control group (P ＜ 0.017).To the left bending group,the mean pressure of right anterior half foot were less than those of the control group,and the right rear half foot pressure was greater than that of the control group (P ＜ 0.017).The pressure of the left anterior half foot of the S type scoliosis group was less than that of the control group.To the right bending group,the left foot average pressure (44.7％±6.0％) was significantly less than the average pressure of right foot (55.4％ ± 6.0％).There was no difference in bilateral plantar pressure of the left bending group,S type group and control group.There was difference with the plantar pressure distribution in patients with only one curve after they wore orthotic insoles,but there was no difference in patients with type S.There was no significant difference in the Cobb angle after the patients wearing the orthotic insoles (P =0.102).[Conclusions] The right and left foot pressure symmetry of the right bending patients is poor,but the left and right plantar pressure in the patients with type S is symmetrical.The orthotic insole can be used to adjust the plantar pressure distribution in patients with a single curved scoliosis (left or right),but their effect on the patient's spinal lateral curvature should be further observed.

Objective To investigate the first medical contact to balloon ( FMC2B) time in our center and to identify the influencing factors .Methods This is a retrospective study conducted in the heart center of Beijing Luhe Hospital . A total of 140 patients undergoing primary percutaneous coronary intervention ( PCI) were enrolled between July 2013 to September 2014.Demographic data , clinical risk factors and the emergency process were evaluated .All the patients were categorized into 2 groups including:the conformed group ( patients with FMC2B<120 min for non-PCI-capable hospital and <90 min for direct arrival at Luhe hospital, n=59) and the unconformed group (n=81).Multivariant regression aralysis was done to analyse factors influencing FMC 2B time.Results Among the enrolled 140 patients, 58 patients were initially seen in a non-PCI-capable hospital , 31 patients were directly sent to Luhe hospital by ambulance and 51 patients arrived by themselves.The median FMC2B time was 106.16 min (interquartile range [ IQR ]: 77.37 -165.52 min ) and 42.1% ( 59/140 ) of the patients achieved the current recommended FMC2B time.In a multivariate logistic analysis , FMC to electrocardiographic ( ECG) within 10 min ( OR=5.61 , 95% CI 1.91-16.88 ) , admission during normal working hours ( OR=5.11 , 95%CI 1.88-13.85 ) , patient′s education level of high school or above ( OR=4.16 , 95%CI 1.53-11.34 ) , awareness of heart diseases ( OR =2.58, 95% CI 1.13 -5.91 ) were predictors of improving FMC2B. Transfer for primary PCI (OR=0.37, 95% CI 0.15-0.92) increased FMC2B.Conclusions Less than half of the patients with primary PCI achieved the goal of guidelines′recommended FMC2B time.Initial ECG, admission during normal working hours , patient′s education level and awareness of heart diseases and transfer for primary PCI are the independent predictors of FMC 2B time.

A high sensitive and rapid method was developed for the analysis of lappaconitine in mouse plasma using liquid chromatography coupled to mass spectrometry (LC-MS). Detection was performed by positive ion electrospray ionization (ESI) in multiple reaction monitoring (MRM) mode, monitoring the transitions m/z 585 --> m/z 535 and m/z 356 --> m/z 192, for the quantification of lappaconitine and tetrahydropalmatine (internal standard, IS), respectively. The method was linear over the concentration range of 3.0-2000.0 ng x mL(-1). The lower limit of quantification was 3.0 ng x mL(-1). Intra- and inter-run precisions (RSD) were both less than 9.9% and accuracy (RE) within +/- 4.8%. After single intravenous injections of lappaconitine hydrobromide at 1.0, 2.0 and 4.0 mg x kg(-1), the elimination half-lives (t(1/2)) were 0.47, 0.48 and 0.49 h, and the areas under the curve (AUC(0-t)) were 55.5, 110.5 and 402.9 ng x h x mL(-1), separately. The pharmacokinetic profile of lappaconitine was linear at relatively lower dose levels (1.0-2.0 mg x kg(-1)). When the dose increased farther to 4.0 mg x kg(-1), the Vz and CL decreased, and the increase fold of the AUC was much larger than that of the dose.

Objective To investigate lymph node metastases in distal gastric cancer and its clinical significance. Methods From June 2006 to December 2007, 129 distal gastric cancer patients underwent radical gastrectomy with lymphadenectomy. Dissected lymph nodes were collected in groups, and histopathological studies were performed to detect lymph node metastasis. The relationship between lymph node metastasis and tumor parameters such as diameter, location, infiltrating depth, histological category,Borrmann typing was evaluated. Results Lymph node metastases was found in 80 out of 129 patients (62%). A total of 3295 lymph nodes were harvested with an average of 25.54 lymph nodes per patient,among those 889 lymph nodes were identified with metastasis. The metastasis rate was 18.60%, 48. 84%,37. 98%, 38. 76%, 44. 19%, 31.01%, 10. 85%, 14. 73%, 4. 65%, 1.55% and 0. 78% respectively in No. 1, No. 3, No. 4d, No. 5, No. 6, No. 7, No. 8a, No. 9, No. 11 p, No. 12a, No. 14v lymph node group.No. 3 and No. 6 group nodes were moat frequently invaded by metastasis. Conclusion This study provides the regular pattern of lymph node metastasis in distal gastric carcinoma patients undergoing radical gastrectomy and perigastric lymphadectomy which helps to guide lymphadectomy in terms of less trauma and favorite prognosis.

Objective To investigate the prevalence and distribution of pre-diabetes and diabetes mellitus in Han population aged over 60 years in Urumqi. Methods The physical examination and 75 g oral glucose tolerance test (OGTT) were performed in 2210 people, including 1231 elderly people aged over 60 years (old age group) and 951 people aged 40-59 years (middle age group). The diagnosis of diabetes mellitus was established according to WHO criteria in 1999. Results In Han ethnic people, the prevalence rates of diabetes mellitus and pre-diabetes were 32.2% and 29.0% respectively in old age group, and were significantly higher than in middle age group ( 12.3% and 20.9%,x2= 192.62, P＜0.05). The prevalence rates of impaired glucose tolerance (IGT) were higher in old age group than in middle age people (21.6% vs. 13.9%, x2 = 20.97, P＜0.05), but there was no significant difference in the prevalence rate of impaired fasting glucose (IFG) between the two groups. The prevalence rate of metabolism syndrome (MS) was higher in old age group than in middle age group (52.2% vs. 33.7%, x2 =73.77, P＜0.05). The multivariable analysis showed that hypertriglyceridemia, hypertension, family history of diabetes mellitus were risk factors for development of diabetes mellitus in elderly Han population (x2 =44.34, P＜0.05). Conclusions The prevalence rates of diabetes and pre-diabetes are considerably high in the current state. It should be strengthened to prevent and treat diabetes mellitus and pre-diabetes in Urumqi Han population,especially in residents aged over 60 years.

BACKGROUND:Nickel-titanium memory-shape compression anastomosis clip (Ni-Ti CAC) has been used in gastrointestinal anastomosis, but its efficacy and safety still remain controversial.OBJECTIVE:To evaluate the efficacy and safety of Ni-Ti CAC in gastrointestinal anastomosis.METHODS:A computer-based online research of PubMed, EMbase, Cochrane Library, CBM, CNKI, and VIP databases was performed for articles published before January 15th, 2017 using the keywords of nickel-titanium, compression anastomosis clip, anastomosis, gastric, jejunum, ileum, small intestine, colon, rectum, and large intestine in English and Chinese, respectively. The randomized controled trials about Ni-Ti CACversus conventional methods for gastrointestinal anastomosis were included. Meta-analysis of the anastomosis time, time of exsufflation, and hospitalization time was performed, and sequential analysis was conducted on TSA v0.9 software.RESULTS AND CONCLUSION:A total of 18 eligible randomized controlled trials were enroled, involving 1860 patients. Ni-Ti CAC could reduce the anastomosis time [MD=-3.83, 95%CI(-6.48,-1.19),P=0.004] and time of exsufflation [MD=-0.14, 95%CI(-0.22,-0.05),P=0.002], but there was no significant difference in the hospitalization time [MD=-0.83, 95%CI(-1.82, 0.16), P=0.10]. The quality was ranked as low level based on GRADE system. The time of exsufflation of Ni-Ti CAC was superior to that of conventional method, which was confirmed by sequential analysis. One case of death was reported and incision infection was the most common adverse effects; additionaly, pulmonary embolism and abdominal pain occurred. To conclude, Ni-Ti CAC can facilitate gastrointestinal anastomosis, accelerate the time of exsufflation, and holds a good safety. However, more multicenter and high-quality randomized controlled trials are needed.

Objective To investigate the characteristics and the frequencies of B cell subsets in peripheral blood of rheumatoid arthritis (RA) patients,and to study the correlation between B cell subsets and clinical indices and influence of different therapies on B cell subsets to deeply understand the pathogenesis of RA.Methods Peripheral blood witched memory B cells,non-switched memory B cells,naive B cells,and double negative B cells of 141 patients and 33 healthy controls were measured by flow cytometry.Patients were divided into three groups based on their therapeutic regimen,including tumor necrosis factor-or (TNF-α) inhibitors combined with disease modifying antirheumatic drugs (DMARDs),DMARDs only and patients without any therapy.The relevance between B cells subsets and clinical manifestations,lab test results exemption were assessed as well as the influence of different therapies.All data were were analyzed by Statistical product and service solutions (SPSS) 23.0 statistical analysis for unpaired t test,analysis of variance and Spearman's correlations analysis.Results ① New-onset RA patients with less than 12 weeks disease duration and never accepted any drugs had a significantly lower frequency of peripheral blood memory B cells,including non-switched memory B cells [(8 ±4)％ vs (13 ±4)％,P＜0.05,t =3.3)] and switched memory B cells [(18±10)％ vs (23±7)％,P＜0.05,t=2.2)],than healthy individuals.② There was a negative association between non-switched memory B cells and disease activity score in 28 joints (r=-0.23,P＜0.05).③ Negative association between non-switched memory B cells and erythrocyte sedimentation rate (ESR),lgG was found,while therewas no association between pre-switched B cells and other laboratory test results.④ Non-switched memory B cells and switched memory B cells increased after TNF-α arntagonist or DMARDs therapy.Conclusion The results of this study suggest that B cell abnormalities in new-onset RA patients with short disease duration are reduced non-switched memory B cells and switched memory B cells.A negative correlation has been found between non-switched memory B cells and ESR and lgG.B cells subsets frequency are changed by TNF-α antagonist and DMARDs,which suggests that changes of B cell subsets may contribute to the occurrence and development of RA.

Objective:To evaluate the efficacy and safety of Tuina(Chinese therapeutic massage)in the treatment of functional dyspepsia(FD)in children and adults. Methods:Related articles in PubMed,Excerpta Medica Database(EMBASE),Cochrane Library,Web of Science,China Biology Medicine Disc(CBM),Wanfang Academic Journal Full-text Database(Wanfang),China National Knowledge Infrastructure(CNKI),and Chongqing VIP Database(CQVIP)were collected.The retrieval time was from each database's start to March 2022.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included studies.A meta-analysis was then performed using the RevMan 5.4 software. Results:A total of 19 clinical trials were included,9 of which encompassed studies on adults while 10 were on children with FD,comprising a total of 1961 patients.The findings of the meta-analysis showed that the effective rate of FD in children and adults treated with Tuina was significantly higher than that in the control group[risk ratio(RR)=1.15,95%confidence interval(CI)(1.09,1.21),P<0.001],[RR=1.13,95%CI(1.06,1.21),P<0.001].In addition,the effective rate of FD in children and adults treated with Tuina combined with other treatments was significantly higher than that in the control group[RR=1.14,95%CI(1.07,1.21),P<0.001],[RR=1.12,95%CI(1.02,1.24),P=0.02].In terms of single symptoms,Tuina improved epigastric burning sensation score in adults[standardized mean difference(SMD)=-0.41;95%CI(-0.79,-0.02);Z=2.08;P=0.04]compared with that of the Western medicine group.Compared with children treated with oral Chinese medications(CM)or Chinese patent medicine(CPM),children with FD demonstrated lower scores of epigastric pain[SMD=-0.38,95%CI(-0.56,-0.19);Z=3.96;P<0.001],postprandial fullness[SMD=-0.30,95%CI(-0.50,-0.10);Z=2.88;P=0.004],and early satiety[SMD=-0.26,95%CI(-0.47,-0.06);Z=2.54;P=0.01]after receiving Tuina combined with CM or CPM treatment.No adverse events were reported in the Tuina treatment group,and the follow-up indicated that the symptom scores in the Tuina group improved. Conclusion:Compared with the control group,both Tuina and Tuina combined with other treatments are shown to have better effective rates,lower incidence of adverse events,and better follow-up outcomes.The study results suggest that Tuina may be a clinically viable complementary therapy.However,due to limitations in the number and quality of the included studies,the above conclusions should be verified by further high-quality studies.

Objective:To explore the impact of domestic bivalirudin on platelet function during emergency percutane-ous coronary intervention (PCI) .Methods :A total of 100 patients with acute ST segment elevation myocardial in-farction who recieved emergency PCI were randomly divided into unfractionated heparin group (UFH group ,n=53) and bivalirudin group (n=47) .Adenyl diphosphoric acid (ADP)-induced platelet aggregation rate was meas-ured and statistically compared between two groups before and after PCI .Results:Before emergency PCI ,there was no significant difference in ADP-induced platelet aggregation rate between two groups (P=0.99) .After emergency PCI ,ADP-induced platelet aggregation rate in bivalirudin group was significantly lower than that of UFH group [ (16.46 ± 10.23)% vs .(25.21 ± 15.91) % , P<0.01] .Conclusion:During percutaneous coronary intervention , compared with routine heparin anticoagulation , bivalirudin , as an anticoagulant , can more significantly inhibit platelet aggregation and possess antiplatelet effect .