Objective To research the most commonly used five method to evaluated the difficulty airway , and compare which methods were more suited for the pregnant woman in general anesthesia. Methods 214 patients with full-term pregnancy who requested emergency or elective caesarean-section were assigned. During the pre-anesthetic visit,we evaluated patients from Mallampati score, thyromental distance, body mass index (BMI), inter-incisor gap, and upper lip bite test. After endotracheal intubation ,patients were divided into 2 groups based on Cormack classification. Results Five ways sensitivity descending order were upper lip bite test (79.5%)、Mallampati score (76.9%)、BMI (56.4%)、inter-incisor gap (51.3%)、thyromental distance (35.9%); specificity descending order were upper lip bite test (93.1%)、Mallampati scores (86.3%)、inter-incisor gap (85.1%)、thyromental distance (76.6%)、BMI (62.3%). Conclusions In pregnant women ,Mallampati score and the upper lip bite test are the better indicators to predict difficult airway.

BACKGROUND: Severe acute respiratory syndrome (SARS) is caused by a genetically novel coronavirus that is caused by acute infectious disease. It is not yet clear for the immunology function of SARS patients in their convalescent stage.OBJECTIVE: To study the effects on T lymphocyte, and the titer profiling of 24 T cell receptor (TCR) V β subfamilies expressions in SARS convalescent patients.DESIGN: A self-control observation.SETTING: Central Laboratory, Guangdong Provincial Hospital of Traditional Chinese Medicine.PARTICIPANTS: Seventy-six cured SARS patients who received treatment in the Second Hospital Affiliated to Guangzhou University of Traditional Chinese Medicine between January and April 2003. All the patients corresponded to "clinical diagnostic criteria of atypical pneumonia", " diagnostic criteria of severe atypical pneumonia and discharge criteria" and "clinical diagnostic criteria and discharge criteria of severe acute respiratory syndrome". The involved patients, 30 male and 46 female, averaged (32±11 (years old. Another 10 subjects who simultaneously received health examination in the same hospital, 5 male and 5 female, aged (32±7(years, were involved in the study. Informed consents of detected items were obtained from all the subjects.METHODS：①Detecting the expression of 24 T cell receptor(TCR)V β subfamilies in SARS convalescent patients：Peripheral blood(2 mL) was collected from the healthy convalescent subjects,and EDTA-K2 was used as anticoagulant．In the flow cytometry delection tubes．10 μL various fluorescein-labeled mAb，such as anti-CD3,anti-CD4，anti-CD8,anti-CD25，anti-CD28，anti-HLA-DR，anti-CD3mAb conjugated with PC5，TCR Vβ1(PE+FITC)．Vβ2(PE+FITC)。Vβ3 (FITC)，Vβ4(PE+FITC)，Vβ5．1(PE+FITC),Vβ5．2(PE),Vβ5．3(PE)，Vβ7．1(PE+FITC)，Vβ7．2(FITC),Vβ8(FITC),Vβ9 (PE)，Vβ11(PE)，Vβ12(FITC)，Vβ13．1(PE),Vβ13．2(PE),Vβ13．6(PE+FITC)，Vβ14(FITC),Vβ16(FITC),Vβ17 (PE+FITC)，Vβ18(PE)，Vβ20(FITC)，Vβ21．3(FITC),Vβ22(PE+FITC)and Vβ23(PE)，was added in special flow tubes,and then 50 μL whole blood was added．The mixed solution was incubated away from light for 15 minutes．After erythrocytolysin being added，mixed solution was washed．Finally．cell deposit was dissolved in 300 μl phosphate buffer solution (PBS)．Coulter ESP flow cytometer was used for detection．For the analysis of TCR expression,an electronic gate was set on these cells and at least 5000 events per sample were collected．Three-color cytofluodmetric analysis was performed using a Coulter ESP flow cytometer．②Detecting the T cell subset,activated T and B cells,and the percentage of Ts and Tc cells：5000 cells were collected and used to calculate the expression of T cells (CD3,CD4 and CD8),the activated T and B cells(CD3+／CD25+,CD3+/HLA-DR+ and CD3-／HLA-DR+),as well as the percentage of Ts and Tc cells by Coulter ESP flow cytometer and its software．MAIN OUTCOME MEASURES：①The change of T cell subset(CD3，CD4，and CD8)from SARS convalescent patients．②The change of activated T and B cells(CD3+／CD25+，CD3+／HLA-DR+ and CD3-／HLA-DR+)．③The percentage of Ts and Tc cells(CD8+／CD28+，CD8+/CD28-)in convalescent patients．④Analysis of the 24 TCR V β subfamilies from SARS patients in convalescence．RESULTS：All data were explored to analyze the expression profiling of 24 TCR Vβ subfamilies,the data from 74 SARSpatients and 10 healthy controls were explored to other result analysis．①The detecting results of T celI subset：The percentage of CD4+T cell mean value was lower than the reference value[(33．33±6．64)％ vs．(43±9)％，P＜0．01]．The percentage of CD8+T cell mean value was higher than the refefence value[(34．07±6．40)％ vs．(30±9)％,P＜0．01]．② The expression of activated T and B cells：Percentage of HLA-DR+ T and B cell was Increased while the percentage of CD25+ T-cell was decreased compared with reference values．In 53 out of 74 patients,the percentage of CD25+ T cells was lower than the reference value,and 64 patients had a lower percentage in CD3+/CD25+ T cells．The percentages of CD3+/HLA-DR+ and CD3-／HLA-DR+ cells were higher than the normal reference value．T cells expressing higher CD3+／HLA-DR+ were found in 36 patients，and T cells expressing higher CD3-/HLA-DR+ were found in 30 patients．③The ratios of Ts and Tc cells：The percentage of Ts cells which expressed CD8+／CD28- was increased compared with reference value [(28．75±7．31)％ vs．(15．99±5．1)％，P＜0．01],while the percentage of Tc cells which expressed CD8+／CD28+ was decreased [(5．99±3．60)％ vs．(13．2±4．1)％，P＜0．01]．Thirty-nine patients were found to possess the lower Tc cells and forty-eight patients were found to possess the higher Ts cells．The ratios of both CD4+ and CD8+ T cells were in the normal reference value．④24 TCR Vβ subfamilies expressions in T cells：It was noteworthy that Vβ14 had a highest percentage in all 24 Subfamilies,and followed by Vβ 5．3,and Vβ 23 in the convalescent patients．The percentage of Vβ 14 was the highest in the normal controls,which was consistent with the results of SARS patients．But the other subfamilies expression patterns were different．There were significant differences between Vβ1,Vβ5．2,Vβ5．3,Vβ7．2，Vβ9，Vβ11,Vβ13．1,Vv13．2，Vβ17,Vβ18，Vβ22 and Vβ23．In the convalescent period，each TCR Vβ expression of SARS patients was higher than that of controls(P＜0．05-0．01)．CONCLUSION:In SARS convalescent patients,the increased CD8+CD28- T cell may elevate CD8+ T cell number;Meanwhile.the reduced CD3+ and CD4+ T cell number may be corresponding to the increased Ts cell number．For some inhibiting factor secreted by Ts cell was also increased．The usage pattern of 24 TCR Vβ subfamilies in SARS patients is different from that of control group．The increase of percentage of CD3+／HLA-DR+ and CD3-／HLA-DR+ T cell may be related to the late response of activated T and B cells.

Objective To establish a guinea pig model for diagnostic reagent of tuberculosis.Methods By single or multiple subcutaneous injection of heat-killed H37 Rv in different doses in the groin of guinea pigs to establish a model of positive response to 0.1 mL (5 IU) standard tuberculin ( TB-PPD) skin test.Results Three doses of heat-killed H37 Rv ( 0.2 mg/mL, 0.3 mg/mL and 0.5 mg/mL ) could be used to generate the model of biological diagnosis of tuberculosis.After 24 and 48 hours, the diameter of red spot by TB-PPD skin test was 15.4 ±2.3 mm when a dose of 0.2 mg/mL heat-killed H37 Rv was administered for immunizing and allergizing the guinea pigs.The biggest red spot was induced at doses of 0.3 mg/mL and 0.5 mg/mL.The test results showed that the immune response induced by multiple njection to immunizing and allergizing guinea pigs was not significantly different than that induced by single immunizing injection, and the first skin test was better than the second, third and fourth skin test (P≤0.05).In addition, the body weight of the guinea pigs was still increasing after infection with heat-killed H37 Rv, and ulcers occurred in the injection sites in some guinea pigs.Conclusions A single subcutaneous injection of 0.2 mg/mL heat-killed H37 Rv in guinea pigs can be used well to establish a reliable model for biological diagnostic reagent of tuberculosis.Increasing the sensitizing dose and multiple sensitization can not increase the intensity of the delayed-type hypersensitivity ( DTH) response.

This article elaborated the connotation of public hospital medical insurance payment system and the importance of reform,summarizing and analyzing the practical exploration of promoting medical insurance payment system reform in the localities.Then it moved on to introduce new progress of medical insurance payment system reform abroad and the emerging mode of medical insurance payment, such as pay for performance,payment by results,and bundled payment.In the end,the authors put forward policy suggestions to improve medical insurance payment system at public hospitals in China, namely to build a modern healthcare payment system in line with the needs of medical service system.Such a system should be guided by comprehensive performance,restrained by cost budgeting, based on a diversified payment mode,and supported by information technology.In addition,it should have scientific payment standard and modern governance mechanism,and keep interactive development with commercial health insurance.

Objective To explore the effects of coincident infection on treatment response and coronary artery lesion (CAL) outcome in children with Kawasaki disease(KD).Methods A retrospective study of 141 children diagnosed on KD between Jul.2005 and Dec.2006 were performed.Standardized clinical assessments,laboratory examinations microbiology test results plus treatment regimens were reviewed.CAL were visualized by using echocardiography.Infectious agents positive (INF+) and negative (INF-) groups were identified,and clinical assessments,laboratory and treatment data were analyzed.Results 1.Concurrent infections:41%(58/141) of children had one of above confirmed infection at KD diagnosis.2.Treatment response:the presence of infection did not alter the response to treatment with intravenous immunoglobulin (IVIG),with resolution of fever within 72 h in 85% (120/141) children after 1 dose of IVIG (2 g/kg) together with aspirin administration regardless of present or absent infection.3.CAL outcome:in total,56.0% (79/141) of children developed CAL at the time of diagnosis,involving dilatation (91.1%,72/79 cases) and aneurysm (8.9%,7/79 cases),and no giant aneurysm was found.Most CAL were recovered within 1 year after treatment.Incidence of aneurysm in INF+ group was significantly higher than that in INF-group (P=0.019).Conclusions Coincident infection would not affect on the clinical assessment,laboratory test results and treatment response to IVIG in children with KD,but would result in higher risk of serious CAL.Therefore,children with infection at diagnosis on KD will not only accept active treatment in acute phase,but also insist on convalescent care and follow-up visit.

Cultivation of Medical Humanism Spirit has special value in the teaching of psychiatry,but which was ignored in the teaching. This paper explored the way to integrate humanistic spirit education into the teaching process of psychiatry.

Objective To investigate the clinical efficacy and safety of double filtration plasmapheresis (DFPP) pretreatment combined with CD25 monoclonal antibody inducible therapy for sensitized recipients of cadaver kidney transplantation.Method The clinical data of 45 sensitized recipients who received the pretreatment with DFPP and CD25 monoclonal antibody from November 2011 to January 2012 were retrospectively analyzed.Panel reactive antibody (PRA) was examined by using ELISA.Before the DFPP combined with CD25 monoclonal antibody,the PRA was (56.5 ± 19.9) ％ (＞ 20％),and after the pretreatment,the PRA level was decreased to (18.9 ± 19.1)％.HLA mismatch of recipients and donators was (2.1 ± 0.7),and the lymphocytotoxic crossmatch tests before operation were negative.The incidence of patient/kidney survival,transplantation rejection and pulmonary infection were observed.All the patients were followed up for 12 months.Result During the follow-up period,no patient died,and transplanted kidney dysfunction occurred in 2/45 recipients.Twelve months after months,the survival rate was 100％ and transplanted kidney survival rate was 95.6％ (43/45).One (2.2％) of 45 recipients had hyperacute rejection during the operation,and was given plasmapheresis after the resection of the transplanted kidney.Twelve (26.7％) of 45 recipients had acute rejection:11 recipients completely recovered after methylprednisolone and ATG therapy,and 1 recipient given plasmapheresis for kidney dysfunction.Four (8.9％) had the pulmonary infection after operation,and all of them recovered after antiinflammation treatment.Conclusion DFPP pretreatment before kidney transplantation combined with CD25 monoclonal antibody inducible therapy is safe and effective,specially for sensitized recipients.

Objective To analyze the effects and experience of ideological and political education through inquiring students' satisfaction on it,and to strengthen innovation and efficiency. Methods Five hundred and fifty university students were chosen by random.Through anonymous questionnaires,information on attention and satisfaction of ideological and political education about educate by all staff,campus culture,psychological status,and extracurricular activities were acquired.Results More than 56% of the students thought who impressed them most were the professional teachers;and 75.64% of them would ask friends for help when they were facing difficulties.And 44.91% considered study as the main resource of pressure,although the other 39.09% chose the career perspective.Then,57.45% were willing to take part in the meaningful activities after class,though the study was tough.And 45.45% hoped it would be a great progress on extracurricular activities;74% would take part in entertainment,and on the other hand 68.55% chose volunteer;and 87.72% interested in learning psychological knowledge. Conclusion It is important to strengthen and develop ideological and political education among students in the university.And attention should be paid to the innovation and efficiency of the education.

Objective To detect the regulation of CXCL16 synthesis and shedding in first-trimester human trophoblasts. Methods Firstly, we analyzed the expression and secretion of chemokine CXCL16 in primary cultured trophoblasts by immunochemical staining and ELISA. Then we determined the soluble and cell-associated CXCLI6 respectively with and without treatments of cytokine IFN-γ, TNF-α, IL-4 and ADAM10 by ELISA. Results Trophoblast expressed and secreted CXCL16 in a stable level. Cytokine IFN-γ induced both synthesis and secretion of CXCL16 significantly ( P <0. 01 ) in trophoblasts. ADAM10 increased the shedding of chemokine domain of CXCL16 from trophoblasts but didn't influence the synthesis of CXCL16 protein in trophoblast. Conclusion IFN-γ and ADAM10 play important roles in production and shedding of transmembrane CXCL16 in first-trimester trophublasts.

OBJECTIVETo investigate the antithrombotic effects and its molecular mechanisms of prazosin combined with anisodamine (Ani).

METHODSIsolated rat tail artery rings model was employed to evaluate the vasodilative effects of drugs, mice tail thrombosis model induced by carrageenan was used to study the antithrombotic effects and its molecular mechanisms of the drug composition.

RESULTSAmong alpha1-adrenoreceptor antagonists, prazosin(Pra) had the greatest relaxation rate, which was (82.6 +/- 8.9)%, and the EC50 value was 0.44 micromol/L. The drug composition of anisodamine and prazosin of different doses could decrease the length of the tail thrombosis from (24.6 +/- 4.6)mm to (6.9 +/- 2.7)mm, and the rate of thrombosis was decreased from 86.6% to 50.0%. The drug composition could prolong the prothrombin time (PT) distinctively, but it had no effect on the activated partial thromboplastin time (APTT). It also could restrain the decrease of serum levels of tissue plasminogen activator (t-PA) and 6- Keto -PGF1alpha as well as the increase of type-1 plasminogen activator inhibitor (PAI-1) and thromboxane B2 (TXB2) in the mice.

CONCLUSIONThe drug composition formed by anisodamine and prazosin has good effects of relaxing extremities tiny blood vessels and it can fight against thrombosis, its antithrombotic mechanisms may be related to the influence of the extrinsic coagulation pathway, inhibition of platelet activation functions and the promotion of fibrinolysis function.

Adrenergic alpha-1 Receptor Antagonists ; pharmacology ; Animals ; Disease Models, Animal ; In Vitro Techniques ; Male ; Prazosin ; pharmacology ; Rats ; Rats, Wistar ; Solanaceous Alkaloids ; pharmacology ; Thrombosis ; drug therapy