Objective: To summarize our experience on anesthesia management of patients who suffered from cervical spine injury after earthquake. Methods: The anesthesia management data of the 6 patients suffering from cervical spine injury during Wenchuan Earthquake (May 12,2008,China) were retrospectively analyzed. Results: After antishock treatment and stabilization of vital signs, the 6 patients underwo nt surgery under general anesthesia in an open field hospital (intubation was conducted with slow induction) or in our hospital (intubation was conducted with bronchofibroscope). During operation the patients showed smooth respiratory and cardiovascular characteristics, and recovered well after operation. Conclusion: Under the field condition, intubation with slow induction is a good choice for patients with cervical spine injury; while in a hospital, intubation with bronchofibroscope should be chosen because it causes less movement of cervical spine.

Objective: To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF) patients receiving liver transplantation. Methods: The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations (OLT) from January 2006 to January 2007 were retrospectively analyzed, and the anesthetic management experience was summarized. General anesthesia was applied; the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results. Blood samples were obtained before operation, before anheptic, 30 min after anhepatic P base, 5 min before neohepatic phase, and 5 min, 30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function; the drugs were subsequently adjusted according to analysis results. Results: All the 48 patient underwent successful anesthetic management and there was no death during opearation. The average blood loss during operation was (5 219±478) ml. Mild alkalosis, hypokalemia, hyponatrium, and hypocalcemia were present before operations. pH, BE and HCO3-were obviously reduced 30 min after anhepatic phase and increased 60 min after neohepatic phase. Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase. Calium concentration was decreased at the end of preanhepatic phase (P

Objective: To summarize our experience on anesthetic management for liver re-transplantation. Methods: The clinical data of 20 patients who received liver re-transplantation under general anesthesia were retrospectively analyzed. General anesthesia was given to all patients. Ambulatory blood pressure (ABP), electrocardiogram (ECG), central venous pressure (CVP), pulmonary artery pressure (PAP), pulmonary artery wedge pressure continuous cardiac output (CCO), cardiac index (CI), partial pressure of end-tidal carbon dioxide pressure (PetCO2), auditory evoked potentials index (AEPI), body temperature (T), and urine volume were continuously monitored during the operation. Pulse-induced contour cardiac output (PiCCO) technology was used to measure global end-diastolic volume (GEDV), intrathoracic blood volume (ITBV), extravascular lung water (EVLW), systemic vascular resistance (SVR), and stroke volume variation (SVV). The following data of patients, including the periods between the 2 operation, the presence of abdominal infection and multiple organ system failure (MOSF), the mode of re-operation, the operation duration, non-liver time, blood loss, blood transfusion, prothrombin time (PT), international normalized ratio (INR), preoperative creatinine, preoperative bilirubin, and the use of volven, albumin, 5% sodium bicarbonate, fibrinogen and thrombin, were all investigated and compared between the 2 operations. Results: All the 20 patients survived after liver re-transplantation. During the operation the hemodynarnic state, urine volume, electrolytes, and acid-base balance were all stable. The duration of the re-operation was significantly longer compared with that of the first operation (P<0.05), and the blood loss, blood transfusion, and the used of fibrinogen, thrombin and 5% sodium bicarbonate were all significantly more than those of the first operation (P<0.05). Conclusion: Anesthetic management for liver re-transplantation is very complicated; better understanding of patients condition and operation, careful observation during operation, and correct management in time are the keys for successful operation.

Objective: To summarize our experience on the anesthetic management, cardiopulmonary bypass, and protection of major organs total aortic arch replacement in patients with DeBakey type I aortic dissection. Methods: From June 2005 to June 2006, 5 patients with acute DeBakey type I aortic dissection received total aortic arch replacement under general anesthesia and deep low temperature. The 5 patients, including 3 man and 2 women, with an age range of 49-76 years, all received emergent operation. The clinical data were retrospectively analyzed and the experience on anesthesia management was summarized. Results: All the 5 patients had uneventful anesthesia with propofol. The time of cardiopulmonary bypass was 111-148 min, with a mean of (127.2±16.6) min. The priming solution was Ringer acetate solution. The selective cerebral perfusion time was 11-18 min, with a mean of (15.2±2.8) min. The lowest temperature was 19-22°C, with a mean of (20.4±1.5)°C. Modified pH-stat technique was employed for temperature lowing and the rate of rewarming was controlled strictly. The right axillary artery cannulation was routinely performed for cardiopulmonary bypass and selected cerebral perfusion. The blood transfusion was 600-1 400 ml. The auditory evoked potentials index was 0 during lower body arrest. There were no serious cerebral complications after operations. Four patients survived and one died of renal failure 6 days after operation. Conclusion: General anesthesia combined with deep low temperature and selected cerebral perfusion provides a safe condition for ascending arota and total arotic replacement.

Background Laser peripheral iridotomy(LPI) is used as the primary therapy for the eyes at risk of angle closure.But there are still 28% eyes with primary angle closure suspect occur angle closure within 2 years after LPI.It is necessary to explore the associated factors of the efficacy of LPI.Objective The aim of this study was to explore the changes of intraocular pressure(IOP) and anterior chamber angle in the fellow eyes of patients with unilateral acute attack of primary angle closure glaucoma (PACG) and analyze the relevant factors influencing the successful rate of LPI.Methods Eighty-seven fellow eyes received LPI from 87 patients with unilateral acute attack of PACG were included in this study and retrospectively analyzed.The IOP and gonioscopy were performed before and 1 week,3,6,9,12 months after LPI.Successful signs of LPI were defined as an IOP 6-21mmHg without any anti-glaucoma medication,none of glaucomatous neuropathy and the coincident visual field loss,and no need of additional glaucomatous medication or surgery.This study was approved by Ethic Committee of the First Hospital of Xinxiang Medical College,and written informed consent was obtained from each patient.Results Seventy-nine eyes of 79 cases finished the medical visit throughout the follow-up duration with the age 61.4±0.4 years and 33(41.8%) males and 46(58.2%) females.The mean IOP was lowed in various time points after LPI in comparison with before operation with the general difference among different time visiting groups(F=4.056,P＜0.01).Shaffer grade was increased in superior,temporal and nasal quadrants and significant differences were found between 1 week group,3 months group or 6 months group and before operation group (P＜0.05).LPI lessened the range of appositional angle closure (AAC) in postoperative 1 week group and 3 months group compared with pre-operative group (P＜0.05),but no statistically significant reduce was seen in range of AAC from 6 months through 12 months after LPI in comparison with pre-operation (P＞0.05).LPI was determined as successful in 61 cases (77.2%) during one-year fellow-up period.Several variables,such as preoperative IOP,Shaffer grade of each quadrant,mean Shaffer grade and the extent of AAC,were significantly different between LPI success and failure group(P＜0.01).Cox stepwise regression analysis found that the success rate was significantly associated with the extent of AAC (Wald=48.150,RR=1.963,P＜0.01) rather than pre-IOP,Shaffer grade of each quadrant,mean Shaffer grade,age and gender (P＞0.05).Conclusion LPI can widen the anterior chamber angle and low IOP in the fellow eyes of PACG attack eyes.The success rate of LPI is associated with the extent of pre-AAC,suggesting that it is necessary for LPI in consideration of the extent of pre-AAC.

· AIM: To explore the effects of C3F8 tamponade on hypotony on or after primary operation and the prognosis of severe ocular trauma.· METHODS: Twenty-six cases (26 eyes) of severe ocular trauma were treated with pure C3F8 tamponade on or after primary operation. IOP was observed, and the curative effect of C3F8 tamponade was observed on secondary operation with prognosis evaluated.· RESULTS: Hypotony improved in 23 eyes postoperatively,in which 18 eyes with edematous and cloudy cornea, 15 eyes had clear cornea after gas tamponade. Retina was reattached under the gas action in 21 eyes during the secondary operation. Visual acuity improved in 22 eyes, remained unchanged in 3 eyes and decreased in 1 eye during the follow-up of 3-12months.· CONCLUSION: Application of pure C3F8 tamponade on or after primary operation can effectively improve hypotony after severe ocular trauma and benefit a better prognosis.

Objective To investigate the perioperative hemodynamic features of mitral replacement of patients with small left ventricle.Methods Patients with left ventricle end-diastolic dimension (LVEDD) less than 40mm received mitral replacement sur- gery were divided into big size M-2 group and small size M-1 group.The perioperative echo results were analyzed with SPSS software. Results The big size M-2 group has lower trans mitral gradient [ (5.9?1.6) mm Hg vs.(10.7?3.2) mm Hg],larger in vivo va- lular acre[ (2.9?0.2) cm~2 vs.(2.6?0.2) cm~2],and high mitral match index [(1.92?0.23) cm~2/m~2 vs.(1.73?0.18) cm~2/m~2 ].Conclusion With the meticulous perioperative treatment and myocardial protection,the patients with small left ventricle should also receive a mitral replacement as big as possible to achieve the ideal hemodynamics results.

Objective:To summarize our experience in perioperative anesthetic management for fulminant hepatic failure (FHF)patients receiving liver transplantation.Methods:The clinical anesthetic data of 48 FHF patients receiving orthotopic liver transplantations(OLT)from January 2006 to January 2007 were retrospectively analyzed,and the anesthetic management expe- rience was summarized.General anesthesia was applied;the hemodynamics was monitored during the operation and doses of adrenaline and phenylephrine were adjusted according to the monitoring results.Blood samples were obtained before operation, before anheptic,30 min after anhepatic phase,5 min before neohepatic phase,and 5 min,30 min and 60 min after neohepatic phase for blood gas and electrolyte analysis and for determination of coagulation function;the drugs were subsequently adjusted according to analysis results.Results:All the 48 patient underwent successful anesthetic management and there was no death dur- ing opearation.The average blood loss during operation was(5 219?478)ml.Mild alkalosis,hypokalemia,hyponatrium,and hy- pocalcemia were present before operations,pH,BE and HCO_3~- were obviously reduced 30 min after anhepatic phase and in- creased 60 min after neohepatic phase.Kalemia was obviously increased 30 min following anhepatic phase and began to increase 60 min following neohepatic phase.Calium concentration was decreased at the end of preanhepatic phase(P

Complex genetic variation has been known to occur during the transmission of human enterovirus (HEV), and the HEV virulence and pathogenicity enhanced by genetic recombination also pose a serious threat to human health. In recent years, the interest in recombination mechanism of genetic plasticity has been renewed with the emergence of pathogenic recombinant circulating vaccine-derived polioviruses, which were implicated in poliomyelitis outbreaks in several regions of the world with insufficient vaccination coverage. This paper reviews recent research progress in HEV genome, including evolutionary characteristics, recombination types, and in vitro recombinant construction.
Animals ; Biomedical Research ; trends ; Enterovirus ; classification ; genetics ; Enterovirus Infections ; virology ; Humans ; Recombination, Genetic ; Viral Proteins ; genetics

OBJECTIVETo investigate the effects of locking plate fixation through lateral deltoid approach for proximal humeral fracture combined with micro-invasive percutaneous plating (MIPPO) technique.

METHODSFrom April 2009 to March 2012,26 patients with proximal humeral fractures were treated with proximal humeral locking system plate fixation through lateral deltoid approach, including 17 males and 9 females with an average age of 58 years old ranging from 28 to 76 years old. The time from injury to operation was 3 to 10 days (averaged 5.6 days). According to Neer typing for the proximal humeral fractures, 7 cases had 2 parts of fracture,15 had 3 parts of fracture,and 4 had 4 parts of fracture. The Neer score for shoulder function was evaluated.

RESULTSAll patients were followed up,and the duration ranged from 10 to 21 months (averaged 13.6 months). All patients were achieved bony union,the average healing time was 12.5 weeks (ranged from 10 to 21 weeks). No humeral head necrosis and axillary nerve injury occurred. According to Neer scoring system,the total score was 88.36 +/- 7.82, pain 30.82 +/- 3.24, function 23.76 +/- 5.71, activity 17.59 +/- 5.36, anatomical position 7.03 +/- 2.39; the result was excellent in 18 cases, good in 5 cases, fair in 2 cases, poor in 1 case.

CONCLUSIONLateral deltoid approach combined with locking plate fixation for treatment of proximal humeral fracture has advantages of small invasion,less blood lossing, short operative time, stable fixation, high rate of fracture healing, and satisfactory functional recovery.

Adult ; Aged ; Bone Plates ; Female ; Fracture Fixation, Internal ; instrumentation ; methods ; Humans ; Humeral Fractures ; surgery ; Male ; Middle Aged ; Shoulder Fractures ; surgery ; Treatment Outcome