Objective To assess the efficacy of laryngeal mask airway Supreme (LMA Supreme) used in patients undergoing laparoscopic surgery. Methods One hundred and twenty ASA I or Ⅱ patients of both sexes aged 35-60 yr weighing 48-85 kg undergoing elective laparoscopic surgery were randomized to 2 groups ( n = 60 each): LMA Supreme group (group S) and tracheal intubation group (group T). Mallampati test was performed before operation in both groups. The patients were classified as I - Ⅲ . In group S the LMA Supreme was inserted after induction of anesthesia with sufentanil 0.2 fig/kg, propofol 2-3 mg/kg and vecuronium 0.1 mg/kg. A gastric tube was inserted through the drain tube of the LMA Supreme. In group T the patients were intubated under direct laryngoscopy. The success rate, LMA placement/intubation time, success rate of gastric tube placement, airway seal pressure, SpO2, PETCO2 , peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The duration of surgery, anesthesia time, extubation time and emergence time were also recorded. Results There was no significant difference in the success rate between the two groups. The placement and removal time and recovery time were significantly shorter in group S than in group T. The airway seal pressure was (25 ±4) cm H2O in group S. SpO2, PETCO2 and peak pressure were within normal range in both groups. The incidence of postoperative hypoxemia, choking and sore throat were significantly lower in group S than in group T. Conclusion LMA Supreme can provide adequate ventilation during operation with less complications and can be used effectively for laparoscopic surgery.

Objective To investigate the data of outpatient children,survey on the clinical characteristics of vertigo and provide baseline information for clinical diagnosis and treatment.Methods The questionnaires and clinical tests data of 553 children with vertigo were retrospectively analyzed.Results All the children and their parents received interviews,otological examinations and clinical audiological tests. Their ages were between 4 and 15,with the average at 9.51?2.83. ①The males were 341(61.66%) and female 212 (38.34%),with the gender ratio of male to female as 1.61:1. ②The peak of the age curves of treatment and the first onset of vertigo was 9.51 and 8.62-year-old,respectively. ③20.98% of children with vertigo had normal results with peripheral vertigo more common in the rest.④The semicircular canals were more likely to dysfunction if their relatives had vertigo or car sickness.Conclusion The age of children mostly with vertigo is between 6 and 11 years with more males than females. Vertigo itself can be a symptom but on the other hand,some show no positive signs even with vertigo.

Objective To assess the efficacy of the laryngeal mask airway i-gel (LMA i-gel) in patients umdergoing laparoscopic cholecystectomy. Methods One hundred and twenty ASA Ⅰ or Ⅱ patients of both sexes,aged 34-62 yr, weighing 45-90 kg, undergoing elective cholecystectomy using fiberoptic laparoscope, were randomized into 2 groups (n =60 each): LMA i-gel group (group I) and LMA ProSeal group (group P). After induction of anesthesia with sufentanil 0.2 μg/kg, propofol 2.5 mg/kg and vecuronium 0.1 mg/kg, LMA i-gel and LMA ProSeal were inserted in group I and P respectively. A gastric tube was inserted through the drain tube of the LMAs. The number of attempts, success rate, success rate of gastric tube placement, airway seal pressure, SpO2 ,PETCO2, peak airway pressure and complications (hypoxemia, nausea and vomiting, choking hoarseness, sore throat and regurgitation of gastric contents) were recorded. The fiberoptic laryngoscope scores were assessed after sccessful LMA placement. The anesthesia time, duration of surgery, extubation time and emergence time were also recorded. Results There was no significant difference in the anesthesia time, duration of surgery, extubation time and emergence time between the two groups ( P ＞ 0.05). The SpO2, PETCO2 and peak airway pressure were within the normal range during operation in both groups. The first attempt success rate of LMA placement and fiberoptic bronchoscopic scores were significantly higher, and the LMA placement time was significantly shorter in group Ⅰ than in group P (P ＜ 0.05). The success rate of LMA and gastric tube placement was 100% in both groups. The incidence of sore throat was significantly lower in group I than in group P ( P ＜ 0.05). Conclusion LMA i-gel can provide adequate ventilation during operation with less complications and can be used effectively for cholecystic laparoscopic surgery.

Objective To know about the influences of KTH integrated intervention on the blood pressure and quality of life of elderly patients with essential hypertension so as to explore the effective model of health education suitable for them. Methods 120 elderly hypertensive patients recruited from the community in Hengyang city were randomly divided into the experimental group and the control group, each group had 60 patients. The experimental group accepted KTH integrated intervention weekly, and control group was accepted routine hypertension education monthly. The blood pressure was taken before, during and after intervention. Meantime the quality of life was surveyed with WHOQOL- 100 questionnaires before and after the intervention. Results The systolic pressure and diastolic pressure in the experimental group were more lower than those before intervention and those of the control group after intervention. The hypertension of the experimental group was more stable as the time passed. There were distinguished differences between two groups in the quality of life, physical, psychological, social relationships, environmental and spirituality domain. However, there was no distinguished differences between two groups in the domain of independence. Conclusions KTH integrated intervention can make elderly hypertensive patients to keep blood pressure stable and improve their quality of life.

Objective To evaluate the efficacy of streamline liner of pharyngeal airway ( SLIPA) in airway management of general anesthesia. Methods Sixty ASA Ⅰ -Ⅱ patients undergoing elective breast surgery were randomized into 2 groups (30 cases each): SLIPA group (group S) and laryngeal mask airway (LMA) classic group (group L). Anesthesia was induced with propofol 2 mg/kg, sufentanil 0.15 μ g/kg and vecurium 0.08 mg/kg. SLIPA or LMA was inserted with digital manipulation. Anesthesia was maintained with 1% - 2% sevofluran and 50% N2O in 50% oxygen. The parameters of controlled ventilation were same in both groups. The attempt times, seal pressure and grade of fiberoptic (FOB ) laryngoscopy were measured. SpO2, PErCO2 and peak airway pressure were monitored every 15 minutes after successful laryngeal mask insertion. The complications such as regurgitation of gastric contents and sore throat were assessed by anesthesiologist after surgery. Surgery time, anesthesia time, extubation time and emergence time were recorded. Results Success rate of LMA insertion in both groups were 100%. The first attempt success rates were 90%( 27/30) in group S and 60%( 18/30) in group L (P< 0.05), the FOB grade 4 were 67%(20/30) in group S and 37% (ll/30)in group L(P< 0.05), the maximum seal pressures were (23.6 ± 4.7)cmH2O (1 cm H2O = 0.098 kPa) in group S and (18.8 ± 4.5) cm H2O in group L (P<0.05). SpO2, PErCO2 and peak airway pressure were within normal ranges. The occurrence of sore throat was similar in group S and group L (7 cases vs 6 cases). No signs of regurgitation were detected. Conclusion The SLIPA proved to be a simple, safe and effective airway instrument with little complications during the course of general anesthesia.

The clinical practice is a very important link for medical students to relate theory with practice and to be trained comprehensively.Stomatology is an applied science,so clinical practice is more outstanding and important during the stomatological education.This thesis discusses how to improve stomatological students' comprehensive skill in the clinical practice.

Objective To investigate of effect and mechanism of honokiol against acute lung injury (ALI) induced by lipopolysaccharide (LPS).Methods Forty SPF BALB/c mice were randomly divided into 5 groups (N =8),normal control group,LPS group,low-and high-dose magnolol groups,and dexamethasone group.The mouse model of ALI was induced by LPS.After intraperitoneal injection of honokiol,we detected neutrophil count,concentration of albumin,and pulmonary myeloperoxidase (MPO) activity in bronchoalveolar lavage fluid (BALF)as well as alveolar permeability.We also detected the levels of malondialdehyde (MDA),protein carbonyl content(PCC),reactive oxygen species (ROS) and glutathione(CAT),and the activities of superoxide dismutase (SOD),catalase,glutathione peroxidase (GPx),and glutathione-S-transferase(GST) in lung tissue of mice.Results In the LPS group,the neutrophil count,albumin concentration,MPO activity and Evans blue (EB)content were increased (P ＜ 0.05),and anti-oxidase activity was decreased significantly (P ＜ 0.05).After treatment with honokiol,the neutrophil count,albumin concentration,MPO activity,EB content,and lipid peroxidation level were decreased significantly,and the activities of antioxidant enzymes were increased significantly (P ＜ 0.05).Conclusion Honokiol has protective effects against LPS-induced acute lung injury through inhibiting oxidative stress.

OBJECTIVE:To establish the quality standard of Jingyuan capsule. METHODS:TLC was used for qualitative iden-tification of Epimedium brevicornu,Pseudostellaria heterophylla and Fallopia multiflora in the preparation. HPLC method was used to determine the content of icariin. The determination was performed on Odyssil C18 column with mobile phase consisting of acetoni-trile-water(28:72,V/V)at the flow rate of 1.0 mL/min. The detection wavelength was set at 270 nm,and the column temperature was 30 ℃. The sample size was 10 μL. The contents of polysaccharides was determined by phenol-sulfuric method. RESULTS:TCL spots of E. brevicornu,P. heterophylla and F. multiflora were clear and well separated without interference from negative con-trol. The linear range of icariin ranged 0.027-0.135 mg/mL(r=0.9999);RSDs of precision,stability and repeatability test were all lower than 2.0%. The recoveries were 97.87%-101.94%(RSD=1.47%,n=9). The linear range of glucose ranged 0.056-0.121 mg/mL(r=0.9995),and RSDs of precision,stability and repeatability tests were all lower than 2.0%. The recoveries were 99.37%-100.38%(RSD=0.36%,n=6). CONCLUSIONS:The established standard can be used for the quality control of Jingyuan capsule.

Objective To investigate the current situation and related risk factors of healthcare-associated infection (HAI),so as to provide evidence for making prevention and control measures of HAI.Methods On November 26, 2014,a combination method of bedside visiting and medical record reviewing was adopted to survey HAI status, pathogen examination,and antimicrobial application in all hospitalized patients in a tertiary first class military hospi-tal.Results A total of 1 657 hospitalized patients were investigated,66 patients developed 71 times of HAI,HAI rate and HAI case rate were 3.98% and 4.28% respectively.The top 4 departments with HAI prevalence rates were departments of neurosurgery (24.49%),hematology(19.05%),cadre ward(13.73%),and burn surgery (10.91 %).The top 5 HAI sites were lower respiratory tract (40.85%),urinary tract(23.94%),upper respirato-ry tract(12.68%),surgical site(9.86%),and gastrointestinal tract(5.63%).Of 66 cases of HAI,39 (59.09%) patients sent specimens for culture,a total of 48 pathogens were cultured,the major isolated bacteria was Esche-richia coli (n = 10,20.84%),followed by Staphylococcus aureus ,Klebsiella pneumoniae ,and Pseudomonas aeruginosa ,each was 7 (14.58 %)respectively.The usage rate of antimicrobial agents was 34.40%,specimen de-tection rate in patients receiving therapeutic and therapeutic+prophylactic antimicrobial agents was 59.28%.Risk factors for HAI were age <2 years old or >60 years,with respirator,tracheotomy,urinary tract catheterization, arteriovenous catheterization,hemodialysis,and surgery,difference was significant(all P <0.05).Conclusion Mo-nitoring on key departments and key sites of HAI should be strengthened,antimicrobial agents should be used rationally based on pathogenic detection results,specimen pathogenic detection rate should be improved,and effective prevention and control measures needs to be taken according to the risk factors of HAI.