Objective To compare the hemodynamic responses to orotracheal intubation with GlideScope video laryngoscope (GSVL), Macintosh laryngoscope (MDLS) and fiberoptic bronchoscope (FOB) .Methods Sixty ASAⅠorⅡpatients (21 male, 39 female) aged 18-50 yrs weighing 45-90 kg scheduled for elective plastic surgery under general anesthesia with tracheal intubation and mechanical ventilation were randomly divided into 3 groups ( n = 20 each): GSVL group; MDLS group and FOB group. The patients were premedicated with intramuscular scopolamine 0.3 mg. Anesthesia was induced with midazolam 0.05 mg?kg-1 , fentanyl 2?g?kg-1 , propofol 2 mg?kg-1 and vecuronium 0.1 mg?kg-1 and maintained with 1% isoflurane and 60% N2O-40% O2 . Orotracheal intubation was performed at 2 min after intravenous vecuronium. Noninvasive BP and HR were recorded before and after induction of anesthesia, during tracheal intubation and at 1, 2, 3, 4, 5 min after tracheal intubation was completed. The HR and SBP product (RPP) was calculated. Results The intubation time was significantly longer in FOB group than in MDLS group (P

Objective To compare the effects of small dose remifentanil and fentanyl on hemodynamic responses to orotracheal intubation in children.Methods Ninety ASAⅠorⅡchildren (57 males, 33 females) aged 3-9 yrs weighing 17-34 kg scheduled for elective plastic surgery under general anesthesia were randomly allocated to one of 3 groups (n = 30 each): groupⅠcontrol (C); groupⅡfentanyl (F) and groupⅢremifentanil (R) . The children were premedicated with intramuscular scopolamine 0.01 mg?kg-1(the maximum dose 0.3 mg) and midazolam 0.1 mg?kg-1.Anesthesia was induced with propofol 2.5 mg?kg-1 and vecuronium 0.1 mg?kg-1. In group F fentanyl 2?g?kg-1 was injectedⅣ5 min before intubation while in group R remifentanil 1?g?kg-1 was injectedⅣover 30 seconds immediately after vecuronium. Tracheal intubation was performed at 2 min after vecuronium injection. Noninvasive BP and HR were recorded and RPP (SBP?HR) was calculated before (baseline) and immediately after induction (T1),during intubation (T2) and at 1,2,3,4, 5 min after intubation.Results BP was significantly decreased after induction of anesthesia (T1) as compared to the baseline values in all 3 groups (P

Objective To investigate the impact of metal plate on radiation dose distribution in surrounding tissues in cadaver specimens.Methods Stainless steel plate, titanium plate, and muscle strip were implanted into the left thigh of a corpse, respectively.All the specimens were irradiated with 6 MV X-ray , SSD = 100 cm.The absorbed dose of surface was measured by thermoluminiscent elements.Results Surface dose distributions differed significantly among the three different materials (F = 57.35, P < 0.01),with the amounts of 1.18 Gy ± 0.04 Gy (stainless steel plate), 1.12 Gy ± 0.04 Gy (titanium plate) and 0.97 Gy ±0.03 Gy (muscle strip), respectively.The surface absorbed doses on incident plane of stainless steel plate and titanium plate were significantly increased by 21.65% and 15.46% respectively as compared with that of muscle strip.The absorbed doses on the exit surface of stainless steel plate, titanium plate and muscle strip were 0.87 Gy ± 0.03 Gy, 0.90 Gy ± 0.02 Gy and 0.95 Gy ± 0.04 Gy, respectively (F =13.37, P <0.01).The doses on the exit surface of stainless steel plate and titanium plate were significantly lowered by 8.42% and 5.26% when compared with that of muscle strip.Using treatment planning system,the differences between dose distribution with and without metal plate were compared.Within 1 cm away from the incident plate, there was an obvious increase in the absorbed dose, while the influence was less than 5% 1cm outside the surface.The effect of dose distribution on exit surface was less than 2%.Conclusions The influence of metal plate on the radiotherapy dose distribution is significant.The deviations ranges from 5% to 29%.Under the same condition, the impact of stainless steel plate is much more than that of titanium alloy plate.

OBJECTIVE: To investigate the feasibility of introducing self-assembling peptides as protein drug carrier.METHODS: By using RAD16-Ⅰ as a model of self-assembling peptides,lysozyme as the model of protein drug,the property of self-assembling peptide solution containing protein to form hydrogel in-situ were characterized by rheology,and the property of protein release in vitro from self-assembling peptide in-situ hydrogel was studied.RESULTS: The self-assembling peptide RAD16-Ⅰ can form hydrogel with certain mechanical intensity rapidly after its solution contained protein being mixed with PBS.Proteins can release easily from RAD16-Ⅰ hydrogel in a sustained-release manner to some extent.About 80% of proteins can be released from the hydrogel within 8 hours and the cumulative protein release from 1.5% hydrogel was less than 90%.The bio-activity of lysozyme released from RAD16-Ⅰ hydrogel was well preserved as 98% to 115%.CONCLUSION: Self-assembling peptide can be employed as potential in-situ hydrogel carrier for protein drugs.

OBJECTIVE To analyze the superinfection and multidrug resistance of patients in ICU.METHODS(Isolation),cultivation,and identification of ESBLs and drug-sensitivity tests to 17 antibiotics in 219 clinical(specimens) from ICU were conducted.Susceptibility testing was performed by disk diffusion(KB) method,(according) the NCCLs standard to manipulate and judge the results.interim sensitivity was ascribed to resistance.RESULTS Totally 219 cases of patients with bacterial infection in ICU,in which there were 132 cases of patients with superinfection(60.3%),in the same time,100 cases of patients with bacterial infection in general wards,in which there were only 11 cases of patients with superinfection(11%),the superinfection in ICU and general wards had significant deference(P(

Objective To study the set-up accuracy in radiotherapy of thoracic neoplasms by improving the body immobilization method.Methods Fifty patients with thoracic neoplasms were randomly divided into conventional group (without electrode paste) and improved group (with electrode paste).Using simulator for position calibration and center field digital image reconstruction from treatment planning system.Then compare the set-up accuracy of two groups with different body methods by grouped t-test.Results Set-up error in the left-right,superior-inferior,anterior-posterior direction were 2.5 ± 1.5 and 2.4 ± 1.4(P =0.010),4.4 ± 2.0 and 2.2 ± 1.2 (P =0.000),2.2 ± 1.3 and 2.1 ± 1.0 (P =0.100) in conventional group and improved group,respectively.Conclusions The improved body immobilization method improves setup accuracy in radiotherapy for thoracic neoplasms which also will be effective for clinical treatment.

Objective To investigate the setup errors of super chest segment of esophageal cancer patients before radiotherapy delivery by KV cone beam CT,and evaluate the margin from CTV to PTV.Methods From 2010 to 2012,13 patients with super chest segment of esophageal cancer whose IMRT planning CT images were included in this study.Delineate target on the CT images of treatment planning and enlarge the margin of CTV to form ITV,then enlarge the margin of ITV gradually 10 times by 1 mm each time to form varied PTV,and create the plan according to the size of the PTV,simulate setup errors in the new plan to obtain the simulation of the actual exposure curve and find a suitable PTV to assure 95％ ITV volume as ever to approach the prescription dose,obtained the outside enlarge distance of CTV → PTV.Results The maximum setup errors in the direction of the anterior and posterior positioning was (3.42 ±2.19) mm.The margin of ITV→PTV is 5 mm which was figured out by PTN enlarging method.Compared to the original plan that under the condition of draw up the radiotherapy plan that based on the method of PTV enlarging obtained the CTV→PTV and simulate the actual dose distribution according to the setup errors:total lung V5,spinal cord D1cm3,increased by about 0.87％,4.95 Gy,heart V40,PTV D95,PTV V100,ITV D95,ITV V100 were reduced about 0.62％,4.95 Gy,8.38％,1.84 Gy,1.87％,all of them have statistically difference.Conclusions Range of external expansion of the left to right,superior to inferior and anterior to posterior is 7 mm,8 mm and 7 mm respectively,according to the method of PTV enlarging obtained the margin of CTV→PTV of super chest segment of esophageal cancer patients.

ObjectiveTo investigate the effects of postconditioning with electric vagal stimulation on myocardial ischemia-reperfusion (I/R) injury in rats.MethodsSixty male SD rats weighing 250-350 g were randomly divided into 3 groups (n ＝ 20 each):group sham operation (group S); group myocardial I/R (group I/R) and group electric vagal stimulation postconditioning (group POES).Myocardial I/R was induced by occlusion of left anterior descending branch of coronary artery for 30 min followed by 120 min reperfusion in groups I/R and POES.In group POES right cervical vagus nerve trunk was stimulated for 30 min with continuous electric rectangular pulses (2 ms,10 Hz) starting from 15 min of myocardial ischemia.The voltage of the pulses was adjusted to decrease HR by 10％ of the baseline HR before stimulation.MAP,HR and RPP (MAP× HR) were recorded before (baseline) and at 1 and 10 min of ischemia and 30,60 and 120 min of reperfusion.Arterial blood samples were collected from 10 rats in each group at 120 min of reperfusion for determination of serum concentrations of cTnI,CK-MB,TNF-a,high mobility group box 1 protein (HMGB1),ICAM-1,IL-1,IL-6 and IL-10 (by ELISA).The animals were then sacrificed and myocardial infarct size was measured by Evans blue and TTC staining.Another 10 rats were sacrificed at 120 min of reperfusion for determination of myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 (by ELISA).ResultsI/R induced myocardial infarct,significantly increased serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 and significantly increased myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1,IL-6 and IL-10 in both ischemic and non-ischemic regions in group I/R as compared with group S.Electric vagal stimulation significantly decreased myocardial infarct size and serum concentrations of cTnI,CK-MB,TNF-α,HMGB1,1CAM-1,IL-1 and IL-6 in group POES compared with group I/R.Myocardial contents of TNF-α,HMGB1,ICAM-1,IL-1 and IL-6 were significantly decreased while myocardial IL-10 content was increased in both ischemic and non-isehemic regions in groups POES compared with group I/R.ConclusionPostconditioning with electric vagal stimulation can attenuate myocardial I/R injury by inhibiting inflammatory response in rats.

Objective To evaluate the influence of head anteflexion on airway sealing pressure during intermittent positive pressure ventilation(IPPV) with ProSeal laryngeal mask airway (PLMA) with an esophageal vent.Methods Fifty ASA Ⅰ or Ⅱ patients (20 males and 30 females), aged 18-51 ye are, weighing 50-70 kg and scheduled for elective plastic surgery under general anesthesia, were enrolled in this study. Anesthesia was induced with fentanyl 2 μg/kg, propofol 2 μg/kg and vecuromium 0.1 mg/kg. PLMA with an esophageal vent was inserted at 2 min after intravenous vecuronium injection.The airway sealing pressure, the anatomic position of the cuff and the efficacy of positive pressure ventilation were checked in the neutral and anteflexed head positions with the cuff deflated and inflated to an intracuff pressure of 60 cm H2 O, respectively.Results The lungs were better ventilated in the head anteflexion position than in the head neutral position whether the cuff was deflated or inflated. There was no significant difference in the volume of air required to achieve an intracuff pressure of 60 cm H2O between the two head positions ( P＞ 0.05). The airway seating pressure increased from (27 ± 6) cm H2O in the head neutral position to (33 ± 6) cm H2O in the head anteflexion position, with no significant difference between them ( P＞ 0.05). The expired tidal volume and the peak inspiratory pressure during IPPV were (496 ± 81 ) ml and (14.3 ± 1.9) cm H2O respectively in the head neutral position and (496 ± 81 ) ml and ( 14.5 ± 2.1 )cm H2O respectively in the head anteflexion position.Conclusion Head anteflexion can significantly improve airway sealing but does not affect the anatomic position of the cuff.Appropriate head anteflexion is a simple and effective way to improve IPPV when the airway sealing pressure is inadequate in the head neutral position.

Objective To investigate the effects of postconditioning with α7 nicotinic acetylcholine receptor (α7nAChR) agonist and ischemia on myocardial ischemia-reperfusion (IR) injury in rats. Methods Fifty adult male SD rats weighing 290-320 g were randomly divided into 5 groups ( n = 10 each): Ⅰ sham operation group, Ⅱ IR group, Ⅲ ischemic postconditioning group, Ⅳ α7nAChR agonist postconditioning group and Ⅴpostconditioning with α7nAChR agonist and ischemia group. Myocardial I/R was induced by ligation of anterior descending branch of left coronary artery for 30 min followed by 1 80 min of reperfusion. In group] the anterior descending branch was only exposed but not ligated. In group Ⅲ the hearts were subjected to 3 episodes of 10 second ischemia at 10 second intervals at the end of 30 min ischemia before 180 min reperfusion, Intraperitoneal PNU282987 2.4 mg/kg was injected at the end of 30 min ischemia before 180 min reperfusion in group Ⅳ and Ⅴ .Blood samples were taken from right internal jugular vein at 180 min of reperfusion. Then the rats were killed and hearts removed to determine the concentrations of serum cardiac troponin-I (cTnI), TNF-α and high-mobility group box 1 (HMGB1) by ELISA. The infarction size was measured by Evans blue and triphenyltetrazolium chloride staining. Results The infarction size was significantly larger in the other groups and concentrations of serum cTrI, TNF-α and HMGB1 were significantly higher in group Ⅱ than in group Ⅰ ( P ＜ 0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGBI were significantly lower in group Ⅲ, Ⅴ than in group Ⅱ (P ＜ 0.05). The infarction size was significantly smaller in group Ⅴ and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅳ and Ⅴ than in group Ⅲ (P ＜0.05). The infarction size was significantly smaller and concentrations of serum cTnI, TNF-α and HMGB1 were significantly lower in group Ⅴ than in group Ⅳ ( P ＜ 0.05 ). Conclusion Postconditioning with α7nAChR agonist and ischemia can reduce myocardial I/R injury and the efficacy is better than that of α7nAChR agonist postconditioning or ischemic postconditioning alone.