OBJECTIVETo compare the clinical effectiveness of blind intubation through the Cookgas intubating laryngeal airway(CILA) or Fastrach intubating laryngeal mask airway(FT-LMA) for anticipated difficult tracheal intubation.

METHODSEighty-six patients with anticipated difficult tracheal intubation who were undergoing elective plastic surgery under general anesthesia were randomly allocated into CILA group(n=43) and FT-LMA group(n=43) . After general anesthesia being induced and CILA or FT-LMA being inserted, the patients were treated with blind intubation through CILA or FT-LMA. In each case, the number and the time of intubating laryngeal airway(ILA) insertion and blind intubation attempts and ILA removal were recorded. The view of glottis under fiberoptic bronchoscope(FOB) via CILA or FT-LMA was recorded. In addition, noninvasive blood pressure and heart rate were recorded before and after intravenous anesthetic induction, at ILA insertion, at intubation, at ILA removal and every minute thereafter for 5 minutes.

RESULTSCILA or FT-LMA was inserted successfully in all 86 patients. The rate of the first successful insertion was not significantly different between two groups(P>0.05) . In CILA group, the first intubation attempt succeeded in 35 patients;5 and 2 cases were intubated blindly at the second and the third attempt, one patient failed who was intubated successfully by FOB via CILA. In FT-LMA group, 32 patients were intubated successfully at the first attempt, 4 at the second attempt, 3 at the third attempt, and 4 cases failed, three of them were intubated smoothly with FOB through FT-LMA, one failed patient was intubated by FOB. The time of FT-LMA insertion(34.2∓13.9) s was significantly longer when compared with CILA(22.4∓18.9) s (P<0.05) . However, the time of blind intubation through CILA and FT-LMA [(46.0∓26.7) s vs.(51.8∓41.1) s]and the time of ILA removal[(39.3∓11.9) s vs.(35.3∓10.4) s] were not significantly different between groups(P>0.05) . Hemodynamic changes during blind intubation in the two groups showed no significant differences(P>0.05) .

CONCLUSIONSBlind intubation via CILA or FT-LMA is safe and effective for anticipated difficult tracheal intubation. Nevertheless, CILA is easier to be inserted, with relatively higher success rate of blind intubation.

Adolescent ; Adult ; Anesthesia, General ; Bronchoscopy ; Humans ; Intubation, Intratracheal ; instrumentation ; Laryngeal Masks ; Middle Aged ; Young Adult

OBJECTIVEThe purpose of this article is to examine the effect of curcumin on the proliferation and metastasis of human tongue squamous cell carcinoma and analyze its mechanism.

METHODSSCC-4 were treated with curcumin of 0, 5, 10, 20, 30, 60, 100 micromol x L(-1) in 24 h. MTT assay, Matrigel invasion assay, flow cytometry and fluorescence microscopy were used to examine the effect of curcumin on the growth and metastasis of SCC-4. cDNA microarray and RT-PCR were employed to analyze the expression of genes treated by curcumin.

RESULTSThe results showed that curcumin could concentration-dependently inhibit SCC-4 cell proliferation at the concentration range from 20 to 100 micromol x L(-1). Furthermore, Matrigel invasion assay indicated that curcumin can reduce SCC-4 cell invasion under the dosage of 20, 30, 60 micromol x L(-1). Flow cytometry also showed that curcumin can influence the distribution of cell cycle of SCC-4 cell with the dosage of 20, 30, 60 micromol x L(-1). And the dosage of 30 micromol x L(-1) curcumin could lead to the recruitment of alpha-tubulin. cDNA microarray showed that 87 genes were activated and 198 genes were inhibited with the effect of curcumin. These results were validated by the real time quantitative RT-PCR.

CONCLUSIONAccording to the results, it suggests that curcumin has the potential as the leading compound for anti-cancer proliferation and invasion in oral cancer treatment, and cdc27, EGFR substrate 15, PPAR-alpha and H2A histone may play an important role among this multiple anticancer-targeting ability.

Cell Line, Tumor ; Cell Proliferation ; Curcumin ; Humans ; Mouth Neoplasms

OBJECTIVETo observe effectiveness and safety of electroacupuncture at Neimadian for analgesia in the extremities after orthopedic operation.

METHODSTwo hundred cases enrolled were divided into two groups. The test group of 100 cases were treated with electroacupuncture at Neimadian and oral administration of placebo, and the control group of 100 cases with oral administration of tramadoli hydrochloride.

RESULTSThe mean score for pain signs at all the time points before and after analgesic treatment in the test group had more decreases as compared with the control group (P < 0.001); and in the good rate after treatment, the test group was higher than the control group (P < 0.001, P < 0.05), and for safety, the test group was higher than the control group (P < 0.001).

CONCLUSIONThe analgesic effect and safety of electroacupuncture at Neimadian are superior to the routine analgesic after operation of the extremities.

Acupuncture Analgesia ; Analgesics ; Electroacupuncture ; Humans ; Pain Management

BACKGROUNDThere has been an increase in the incidence of breast cancer in China, but no definite risk and protective factors for breast cancer have been identified in Chinese females. This study was designed to identify the risk factors for female breast cancer in North and East China.

METHODSA 1:3 matched, case-control study was conducted. All of the subjects in the case and control groups were selected from a previous epidemiological survey of 122 058 females aged 25 to 70 years. Single and multiple Logistic regression analyses were used to study potential factors in the development of breast cancer.

RESULTSSignificant differences at the level of α=0.20 between case and control groups were observed for the following factors: economic status, social status, family annual income, bean product consumption, body mass index (BMI), family history of breast cancer in the first or second degree, number of miscarriages, menstrual pattern, benign breast disease history, nipple leakage, inverted nipple, history of diabetes mellitus, history of hypertension, history of ovarian cyst, physical exercise, current and global quality of life satisfaction, healthy behavior and prevention, and scores of breast cancer-related knowledge. After Cox-regression model analysis (α=0.10), six factors were found to be significantly related to breast cancer, of which the ORs and 95%CIs were: BMI, 1.696 (1.169-2.460, P=0.005); benign breast disease history, 2.672 (0.848-8.416, P=0.093); family history of breast cancer, 7.080 (1.758-28.551, P=0.006); number of miscarriages, 1.738 (1.014-2.978, P=0.044); global quality of life satisfaction, 3.044 (1.804-5.136, P=0.000); healthy behavior and prevention, 3.294 (1.692-6.412, P=0.000).

CONCLUSIONSA comprehensive range of factors related to breast cancer was identified. Women should be educated about a healthy lifestyle, especially those with a family history of breast cancer or a personal history of benign breast disease.

Adult ; Aged ; Breast Neoplasms ; epidemiology ; Case-Control Studies ; China ; epidemiology ; Female ; Humans ; Middle Aged ; Risk Factors

OBJECTIVETo observe the effectiveness of conscious sedation with midazolam, propofol and sufentanil for patients in plastic surgery.

METHODS81 patients, scheduled for plastic surgery, were randomly selected to receive conscious sedation with midazolam 0.05 mg x kg(-1) and sufentanil 0.1 microg x kg(-1) intravenously, following by a continuous infusion of midazolam-propofol-sufentanil combination (midazolam 5 mg + propofol 200 mg + sufentanil 10 microg, a total of 23 ml). The initial infusion rate was 0.2 ml x kg(-1) x h(-1), and was adjusted (in 20% of initial infusion rate increment) to maintain OAA/S score as 11 during the operation. The patients' vital signs, discomfort and level of sedation were evaluated at 5 to 10 min intervals until the end of the surgery. The complications (i. e. anoxemia, apnea, restlessness, nausea and vomiting), anesthesia duration and drug consumption were recorded. The drug infusion was discontinued at 5 - 10 min before the end of the surgical procedure. On the first postoperative day, patients were asked to rate their satisfaction with the anesthetic management and whether they would choose to receive the same anesthetic technique if necessary in the future.

RESULTSThe OAA/S score decreased from 20.0 +/- 0 to 11.9 +/- 2.6 after midazolam and sufentanil IV (P < 0.05), and was maintained as 10.5-11.1 during the procedure. At the end of the procedure, the OAA/S score returned to 16.0 +/- 2.2, which was also lower significantly compared with baseline value (P < 0.05). The induction of sedation produced a significant decrease in SBP and DBP (P < 0.05) and no significant changes in heart rate (P > 0.05). At the end of the procedure, SBP, DBP and HR returned to the baseline value. The anoxemia happened in 11 cases, apnea in 5 cases and restlessness in 2. No nausea and vomiting occurred. The anesthesia duration and consumption of midazolam, propofol and sufentanil were (101.1 +/- 42.5) min, (8.4 +/- 3.7) mg, (189.1 +/- 88.7) mg and (18.2 +/- 5.6) microg respectively. In an interview on the first postoperative day, 96% (78/ 81) of the patients were satisfied with their anesthesia and were willing to receive the same anesthetic technique if necessary in the future.

CONCLUSIONConscious sedation with midazolam, propofol and sufentanil is an effective anesthetic technique for patients in plastic surgery.

Adolescent ; Adult ; Conscious Sedation ; methods ; Female ; Humans ; Male ; Midazolam ; administration & dosage ; Middle Aged ; Propofol ; administration & dosage ; Sufentanil ; administration & dosage ; Surgery, Plastic ; Young Adult

OBJECTIVETo compare the hemodynamic responses to orotracheal intubation via Upsher-scope (USSP) or Macintosh direct laryngoscope (MDLS) under general anesthesia.

METHODSFifty patients with ASA grade I-II and undergoing the elective plastic surgery and requiring orotracheal intubation were randomly allocated to either the USSP (U group) (n=25) or MDLS (M group) (n=25). After standard intravenous anesthetic induction, orotracheal intubation was performed using a USSP or a MDLS. Noninvasive systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded before and after anesthetic induction, at intubation and every minute thereafter for 5 minutes. The time spent in tracheal intubation was recorded. The mean blood pressure (MBP) and rate-pressure product (RPP) were calculated.

RESULTSThe intubation time was not significantly different between these two groups (P > 0.05). After anesthetic induction, SBP, DBP, MAP, and RPP in these two groups decreased significantly as compared with preinduction values. The orotracheal intubation caused significant increases in SBP, DBP, MAP, and RPP in these two groups in comparision with postinduction values (P < 0.05), but these hemodynamic changes lasted only 1 to 2 minutes and then decreased gradually to the postinduction level. The blood pressure changes caused by orotracheal intubation did not exceed the preinduction values (P > 0.05). As compared to, the maximal HR values in these two groups during observation (from the beginning of intravenous anesthetic induction to 5 min after intubation) were significantly higher than their preinduction values (P < 0.05). The maximal RPP values in M group during observation were significantly higher than their preinduction values (P < 0.05), but no such significant difference was observed in U group (P > 0.05). The hemodynamic data at each time point during the observation had no significant differences between these two groups. (P > 0.05).

CONCLUSIONSOrotracheal intubation using the USSP and MDLS may result in similar hemodynamic responses. The standard general anaesthesia can effectively inhibit the pressor, but not the tachycardiac responses caused by orotracheal intubation via USSP or MDLS. USSP is not superior than MDLS in palliating the adverse cardiovascular stress responses to orotracheal intubation.

Adult ; Anesthesia, General ; Female ; Hemodynamics ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngoscopes ; Male ; Reconstructive Surgical Procedures

OBJECTIVETo observe the safety and feasibility of tracheal intubation by target-controlled infusion of propofol and remifentanil without muscle relaxant in children.

METHODSTotally 100 4-10-year-old pediatric patients (ASA1) who had been scheduled for plastic surgery were equally divided into remifentanil group and control group through computer-generated randomized grouping. In all patients, five minutes after intravenous administration of atropine 0.01 mg/kg and midazolam 0.1 mg/kg, propofol was infused at the targeted effect-site concentration (Ce of 6 μg/ml. When the intended target Ce of propofol was reached, the remifentanil group began to be infused with remifentanil at a Ce of 5 ng/ml, and normal saline (0.1 ml/kg) was injected simultaneously. In the control group remifentanil was replaced by normal saline and rocuronium (0.8 mg/kg) was injected together with the normal saline. After the equilibration of plasma and the Ce of remifentanil were reached, tracheal intubation was attempted. The complications during the induction and tracheal intubation were recorded. The intubating conditions were assessed using a five-point scoring system based on ease of laryngoscopy, vocal cords position, coughing, jaw relaxation and limb movement.

RESULTSThe success rate of tracheal intubation was in 90% in remifentanil group and 98% in the control group (P=0.122).CONCLUSION Target-controlled infusion of propofol and remifentanil at Ce of 6 μg/ml and 5 ng/ml is feasible for the induction and tracheal intubation without muscle relaxant in children.

Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Intubation, Intratracheal ; Male ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

OBJECTIVETo investigate the H(2)S pollution in cabins which caused the fishermen's eye burns.

METHODSFifty-six fishing boats' H(2)S concentration was surveyed and 56 fishermen's eyes were inspected. The air samples were collected from 21 fishing boats' cabins, where the eye burns took place and the monitoring conditions met the inspection requirement, in order to confirm the concentration of H(2)S when eye burns and the systemic poisoning happened. Thirty fishing boats were divided into two groups: one was using air ventilating and spraying, the other was using naturally ventilation to find out the effective method of dispersing H(2)S. Five fishing boats were surveyed in which the fishermen had slight symptom of bulbar conjunctiva hyperemia and cough to find out the minimum concentration of H(2)S which caused the eye burns and respiratory mucosa.

RESULTSAmong 56 fishermen who were surveyed, 46 fishermen's eyes (92 eyes) burnt and they were from 21 vessels, 10 of them (20 eyes) were moderate, 36 of them (72 eyes) were light. The concentration of H(2)S in the 21 fishing boats' cabins which caused eye burns was (99 ± 38) mg/m(3). The first measuring of the concentration of H(2)S in the 30 fishing boats in which fish were not discharged yet was (219 ± 31) mg/m(3). Air ventilating and spraying group's concentration of H(2)S was (213 ± 24) mg/m(3), while that of naturally ventilation group's was (225 ± 36) mg/m(3). Dispersing after 1 hour, the concentration of H(2)S of air ventilating and spraying group was (21 ± 3) mg/m(3), the decreased concentration was (192 ± 21) mg/m(3), fell 90%; the concentration of naturally ventilation group was (184 ± 36) mg/m(3), the decreased concentration was (41 ± 8) mg/m(3), fell 18%. The difference between the two groups' decreased concentration was significant (t = 25.627, P < 0.05). The threshold value of H(2)S concentration that could cause the eye burns was 38 mg/m(3)(exposure time 120 min). In 7 vessels, the concentration of H(2)S in the cabins was (123 ± 9) mg/m(3) where 10 fishermen's moderate eye burns happened. In other 7 vessels, the concentration of H(2)S in the cabins was (54 ± 7) mg/m(3) where 19 fishermen's light eye burns happened. The difference of H(2)S concentration between the two groups was significant (t = 14.236, P < 0.05).

CONCLUSIONHigh H(2)S concentration and long exposure time in cabin can cause serious eye burns. The bilge air ventilation and inner cabin spraying are the effective method to clear the H(2)S in cabin within short time.

Air Pollutants, Occupational ; analysis ; Confined Spaces ; Eye Burns ; epidemiology ; etiology ; Fisheries ; Humans ; Hydrogen Sulfide ; analysis ; Ships

Objective To develop a rapid test for the detection of F1 antigen of Yersinia Pestis based on gold-immunochromatography.Methods F1 antibodies were coupled with colloidal gold to prepare collidal gold reagent,which was used to detect F1 antibodies based on double antigen sandwich.The collidal gold reagent was estimated for its sensitivity specificity and stablity in labs and 1798 samples were detected in 17 surveillance spots.Results The reagent was sensitive to 0.0010 g/L F1 antigens.The reagens kept stable when it had been placed at 4℃ or room-temperature for 12 months and did not react to Yersinia pseudotuberculosis and Yersinia enterolitica.In 17 surveillance labs the reagent was used to test 1798 viscera samples from animal.resulting an accordance rate of 97.11%(1746/1798)to bacterial culture and 96.83%(1741/1798)accordance to reverse indirect hemagglutination assay(RIHA),showing a higher detection rate[9.23%(166/1798)]compared with RIHA[6.79%(122/1798)]and bacterial culture[6.28%(113/1798)].Conclusions The collidal gold reagent,sensitive and specific in diagnosing Yersinia pestis infection of both human and animals,is a rapid method in surveillance spot.

OBJECTIVETo compare the clinical effectiveness of fiberoptic bronchoscope (FOB)-guided intubation through the Cookgas intubating laryngeal airway(CILA)and the Fastrach intubating laryngeal mask airway (FT-LMA) in the management of anticipated difficult airways.

METHODSSixty patients with all three difficult intubation criterion (thyromental distance<60 mm, interincisor distance<35 mm, and Mallampati class 3 or 4) undergoing elective plastic surgery under general anesthesia were randomly allocated into CILA group (n=30) and FT-LMA group (n=30). After anesthesia being induced and CILA or FT-LMA being inserted, the patients were treated with FOB-guided intubation through CILA or FT-LMA. The success of the intubating laryngeal airway(ILA)insertion and FOB-guided intubation, the number of attempts, and the duration of the successful attempt were recorded.

RESULTSThe ILA was inserted successfully in 30 patients from CILA group and 27 patients from FT-LMA group. Three failed cases in FT-LMA group were inserted successfully with CILA. In CILA group, the first FOB-guided intubation attempt succeeded in 26 patients, and 4 cases were intubated at the second attempt. In 27 patients of FT-LMA group, 20 cases were intubated successfully at the first attempt, 4 cases at the second attempt, and 3 cases failed; of these three failed patients, two patients were intubated smoothly with FOB through CILA at the first attempt, one was intubated by FOB via CILA at the second attempt. The duration of FT-LMA insertion [(35.3±12.8)s] was significantly longer when compared with CILA [(23.9±17.5)s] (P<0.05). However, the duration of FOB-guided intubation through CILA and FT-LMA [(48.6±13.5)s vs.(53.2±14.2)s] and the time of ILA removal [(40.4±10.2)s vs. (38.5±11.3)s] were not significantly different between these two groups (P>0.05). The adverse events during and after intubtion were not significantly different between these two groups.

CONCLUSIONSFOB-guided intubation through CILA and FT-LMA is safe and feasible for the management of anticipated difficult airways. However, in patients with severe scar contracture of face and neck and those with huge expander in neck, the CILA insertion and FOB-guided intubation via CILA is superior to FT-LMA.

Adolescent ; Adult ; Airway Management ; methods ; Anesthesia, General ; Bronchoscopy ; Female ; Humans ; Intubation, Intratracheal ; methods ; Laryngeal Masks ; Male ; Middle Aged ; Young Adult