China ; Equipment and Supplies ; Organization and Administration

Objective To explore the feasibility of the ultrasonic atomization surface anesthesia with lido-caine for awake fiberoptic endotracheal intubation in patientsˊautonomous position -display before general anesthesia and to evaluate its advantages.Methods 68 adult patients who needed prone position for elective surgery under general anesthesia were selected and randomly divided into two groups,the control group and the treatment group,each group in 34 cases.In control group patients were received surface anesthesia of cricothyroid membrane puncture.In treatment group,nebulized 2% lidocaine with ultrasonic nebulizer was used for topical anesthesia.Patients lied in the prone position according to their own comfort with the guide of the medical staff in the waking state after an awake fiberoptic endotracheal intubation.The statistics of mean arterial pressure (MAP)and heart rate (HR)were recorded respectively in the basal state(T0),in the time instantly after intubations(T1 ),in the 3 minute after intubations(T2 ) and in the time instantly after the body turning(T3 ).Choking cough response were recorded during endotracheal intubation.Patients were asked the efficacy of surface anesthesia and the tolerance for awake intubation after operation.Results Patients in both two groups completed the whole process smoothly.MAP and HR had no signifi-cant differences between the two groups in the same time point (all P >0.05).There were no statistical significance between the two groups in choking cough response,the time of surface anesthesia and intubation,neither (all P >0.05).Conclusion The surface anesthesia with lidocaine by continuous ultrasonic atomizing inhalation is a good and simple method deserving generalization with plenty merits and is practicable for patients to display position autonomously. This method have the advantages of small operation,it will and can replace cricothyroid membrane puncture.

Objective To amplify natural killer (NK) cells in vitro and explore its killing effect on ovarian cancer cells.Methods (1) The separation of NK cells and identification.A total of 20 ml peripheral blood of one healthy volunteer was collected in Nov.2015,Peking University People's Hospital.The peripheral blood mononuclear cells of normal volunteers were isolated,cultured in vitro and amplificated cultivation for 14 days with K562 cells transfected and expressing interleukin 21 (IL-21-K562) as nourish cells.The number and dynamic state of the growth cells were monitored during the cultured process.Cells were harvested and counted after 14 days cultured.The NK cells phenotypes were detected by flow cytometry.(2) The killing effect of NK cells on ovarian cancer cells:the ratio of effector cells (NK cells) and target cells (ovarian cancer cells and its control) was 50∶ 1,20∶ 1,10∶ 1,5∶1 or 1 ∶ 1,NK cells killing effect on ovarian cancer cells was detected by the lactate dehydrogenase (LDH) release experiments.Results (1) The results of NK cells establishment and phenotypic characterization:the cells were induced in vitro for 14 days by amplification culture.With the extension of incubation time,the number of NK cells increased constantly,from 2.0× 107 on day 0 to 5.1 × 109 on day 14.Obvious amplification of the total number of cells were detected for 255 times.Living cells unstained by trypan blue eventually reached 95％ above.Before and after the induction and amplification in vitro,the percentage of NK cells (CD3-CD56+cells) in CD3-cells were 2.33％ and 85.32％,respectively (P＜0.01),which covered the whole lymphocytes 1.06％ and 69.42％,respectively (P＜0.01),which showed that NK was the main cell type in the amplificated lymphocytes.(2) The killing rate of NK cells on ovarian cancer cells in vitro:the results detected by LDH release experiments showed that NK cells could performed strong nonspecific killing effect on ovarian cancer cell lines SKOV3,HOC1A,3AO and CAOV3,as well the normal ovarian cell line T29 and NK sensitive cell line K562,and the killing effect increased significantly along with the increase of effector cells and target cells ratio (P＜0.01).When the ratio was 1 ∶ 1,the killing rate was 37％ for K562,while the rate of killing of other cells was around 10％ (P＜0.05).When the effect-target ratio was 20∶1 and 50∶ 1,in addition to CAOV3 cells (more than 70％),NK cells had a kill rate of more than 80％ for other ovarian cancer cells lines and their control cell K562 and T29 cells (P＞0.05).Conclusion NK cells could be established in vitro and have a good non-specific killing effect on ovarian cancer cells.

ObjectiveTo evaluate the neuroprotective effect and possible mechanisms of edaravone (3-methyl-1-phenyl-2-pyrazolin-5-one) in neonatal Harlequin (Hq) mutant mice brain after hypoxia-ischemia brain injury(HIBD) insult.MethodsThe nine-day-old male Hq mutant mouse pups were assigned randomly either edaravone (n=16) and vehicle (n=17) treatment group. The Hq mice were subjected to left common carotid artery occlusion combined with inhalation 100 mL/L oxygen for 45 minutes. The mice were injected intraperitoneally either with edaravone (10 mg/kg) or equivalent volume of saline immediately after artery occlusion and after hypoxia. Nitrotyrosine and lipid peroxidation formation were evaluated at 3 h and 24 h after hypoxia-ischemia(HI) by using immunohistochemistry staining. Nitrotyrosine formation and caspases activation were evaluated either by immunoblotting or fluorogenic activity measurement at 24 h after HI. Brain injury was evaluated at 72 h by neuropathological score and calculating the infarct volume.ResultsBrain injury encompassed cortex, hippocampus, striatum and thalamus. Edaravone treatment reduced brain injury significantly in all the brain regions. The total infarct volume was reduced 52.8% in edaravone treatment group compared with vehicle group (P<0.001). The edaravone treatment reduced nitrotyrosine formation as well as lipid peroxidation formation significantly, but without obviously effect on caspases activation.ConclusionEdaravone affords neuroprotection after neonatal HI insult, which correlated with the reduction of free radical formation.

OBJECTIVE To investigate the positive rate of ?-lactamase,oprD2,aminoglycosides modifying enzyme and qacE△1 gene among clinical isolated strains of multi-resistant Pseudomonas aeruginosa in our hospital.METHODS P.aeruginosa was determined by VITEK,and MIC was determined by agar dilution method.TEM,IMP,VIM,oprD2,aac(3)-Ⅱ,aac(6′)-Ⅰ,aac(6″)-Ⅱ,ant(3″)-Ⅰ,ant(2″)Ⅰ and qacE△1 in strains were detected by polymerase chain reaction(PCR).RESULTS The positive rate of TEM,aac(3)Ⅱ,aac(6′)-Ⅱ,ant(3″)-Ⅰ and ant(2″)-Ⅰ in multi-resistant P.aeruginosa were 51.4%,48.6%,40.0%,54.3%,45.7% and 60.0%,respectively.No IMP and VIM genes were detected.CONCLUSIONS Positive rate of ?-lactamase, aminoglycosides modifying enzyme is high in 35 tested strains,and that should be paid more attention.

Objective To observe the 12-lead ECG ( electrocardiogram ) characteristics of Japanese rabbits , and provide basic ECG data for cardiovascular disease research .Methods The 12-lead ECG and X-rays of 55 male Japanese rabbits were recorded in supine position after intraperitoneal injection of 20% urethane.Results ECG:① The 12-lead ECG characteristics of male Japanese rabbits were similar to humans .The rabbit heart rate was 265.5 ±36.8 beats/min, faster than that of humans .No arrhythmia was found in all the 55 rabbits.② The supine position average ECG axis was between 19 °to 250 °, varying a lot .③P wave:The shape of P wave was blunt round or a little bit sharp .P waves were all in accordance with the sinus P wave rules , which were more obvious in lead II , aVF and all chest leads .④ The PR interval was 0.063 ±0.007 s.⑤The QRS duration was 0.040 ±0.005 s.The main waves were mostly upward in leadsⅡ,Ⅲ, and aVF .The same as humans , the R/S ratios were increased by degrees in chest leads .⑥The ST segment was short, and was located in the equipotential line .⑦ The shapes of T wave were mostly round , partly had twin peaks .T waves were more obvious in leads Ⅱ,Ⅲ, aVR, and AVF and chest leads .⑧The QT interval was 0.142 ±0.015 s, and QTc was 0.306 ±0.034 s.In the X-rays, most heart shadows were in the center and right chest .Conclusions The normal values of 12-lead ECG characteristics of Japanese rabbits are obtained in this study , which are of certain application value in experimental studies of cardiovascular diseases .

Objective To observe the expression changes of CD34 and M30 in skin homogenate from a mouse model of scleroderma after irradiation with different doses of UVA1, and to investigate the effect of UVA1 phototherapy on vascular endothelial cell function in scleroderma. Methods The experimental mouse models of scleroderma were established by the injection with bleomycin and randomly divided into model control group (n = 10), UVA1 irradiation group (n = 30) and unirradiated group (n = 10). The UVA1 irradiation group was further equally divided into 3 groups, HD-UVA1 group irradiated with UVA1 at 100 J/cm2, MD-UVA1group with UVA1 at 60 J/cm2, and LD-UVA1 group with UVA1 at 20 J/cm2; phototherapy was performed thrice weekly for 10 weeks followed by the sacrifice of mice. The mice in model control group were killed immediately after the establishment of models, and the mice in unirradiated group received no irradiation after the establishment of models and were maintained till the killing of mice in UVA1 irradiation groups. Skin specimens were obtained from the bleomycin-induced scleroderma lesions of mice and separated into two parts, one was subjected to histopathological examination, and the other one was used to prepare skin homogenate for the detection of CD34 and M30 content with ELISA assay. Results After 30 sessions of treatment with UVA1,the softening and thinning of sclerotic skin were seen by the naked eye, with the most obvious changes in HDUVA1 group; pathological examination revealed a reduction in dermal thickness and the presence of hair follicular structures in subcutaneous fat tissue with no obvious proliferation of collagen in these mice. Compared with the mice in model control group and unirradiated group, there was an increase in CD34 and decrease in M30 content in skin homogenate from UVA 1-irradiated mice, with the most marked changes in mice irradiated with UVA1 at 100 J/cm2. The concentration of CD34 and M30 in skin homogenate from unirradiated group and model control group was significantly different from that in HD-UVA1 group (22.25 ± 8.91 μg/L and 31.97 ±17.97 μg/L vs. 72.39 ± 13.04 μg/L, 162.41 ± 58.00 U/L and 195.71 ± 71.09 U/L vs. 38.06 ± 19.89 U/L, all P ＜ 0.01 ). Additionally, significant differences were observed between the three UVA1 groups in the concentration of CD34 and M30 (F = 21.23, 15.32, respectively, both P ＜ 0.01 ). Conclusions UVA1 phototherapy could up-regulate the expression of CD34 but down-regulate that of M30 in skin homogenate from the mouse model of scleroderma, and the effect is correlated with the intensity and cumulative dose of irradiation.

Objective To study the precipitating factors, clinical features, histopathological changes and treatment in patients with localized and generalized granuloma annulare (GA). Methods Clinical data of 24 cases of localized GA and 19 cases of generalized GA were analyzed retrospectively. Results Some cases of GA were found to be related to the exposure of sunlight, especially in the generilized patients. In the patients with localized GA, lesions usually distributed on the dorsal surface of the hands, nape of the neck, dorsum of feet. Annular lesions with 1-2 centimeters in diameter were formed by small papules. The largest lesion was 7 centimeter in diameter. Generalized GA presented as a diffuse papular eruption, 0.5 ~ 1 cm in diameter, and the lesions favoured the trunk and four limbs. The histopathological study showed that palisading granuloma pattern accounted for 61.9% in all patients, and scattered histiocytic infiltration accounted for 38.1%. Ultraviolet light avoidance, topical steroids, cryotherapy, surgical excision, systemic vitamin E or nicotinamide were effective for localized lesions. Systemic administration of chloroquine in low dosage was an alternative way for the stubborn localized GA. Systemic chloroquine, dapsone, corticosteroids, isotretinoin were effective in most generalized GA cases, but some cases relapsed when treatment was stopped. Conclusions Ultraviolet may be associated with the development of generalized GA. The histopathological changes were variable, the palisading granuloma pattern is the most common pattern. Topical therapy is effective in localized GA, and systemic therapy is mainly used for generalized GA.

Objective To study the role of photoallergens and contact allergens in the pathogenesis of chronic actinic dermatitis (CAD).Methods Ba sed on the standard procedures of photopatch test recommended by the British Pho todermatology Group (BPG) and the routine procedures of patch test,photopatch a nd patch tests were performed on 56 patients with CAD,42 patients with polymorp hous light eruption (PLE) and 25 patients with chronic eczema on scalp and face by standard photopatch test series recommended by the International Contact Derm atitis Research Group (ICDRG) and home-made standard series of contact allerge ns.A set of ten Philips TL20W/09N tubes was used as the source of irradiation.Results In the 56 CAD patients,the positive rates were 46.43 %,57.14 % and 32.14% for photopatch test,patch test and both tests,respectively,which appea red to be significantly higher than those in the patients with PLE.Positive pa tch reactions were found in 65% of the patients with chronic eczema,which was s imilar to that of CAD.And the frequency of the positive allergens in chronic ec zema was the same as that in CAD,in which fragrance mixture (FM) ranked the fir st,followed by balsam of Peru (BOP),cobalt chloride,nickel sulphate.In CAD,FM and BOP were the most common allergens and photoallergens,which accounted fo r 44% and 32% of the positive reactions in patch tests,15.38% and 17.95% in pho topatch tests,respectively.Conclusions Both photoallergens and contact aller gens may play important roles in the pathogenesis of CAD.Allergens positive in patch tests and photopatch tests and related compounds which can cause cross-r eactivity with the above allergens should be avoided by the patients with CAD.

Objective To study the relationship of sunlight exposure and photoprotection with clinical activity in systemic lupus erythematosus. Methods A structured questionaire was administered to 107 SLE patients, to assess their attitudes and behavior regarding sunlight exposure and photoprotection. The clinical manifestations, laboratory findings and treatment were evaluated. Results All patients were classified into two groups based on the duration of exposure to sunlight per day. Fourty-eight (44.86%) patients were exposed to direct sunlight for an average of less than one hour per day in one group and 59 (55.14%) for one hour or more in the other group. Twenty-four (22.43%) patients reported use of photoprotective measures in spring and summer. The patients in the former group had significantly lower incidences of photosensitivity, arthritis, alopecia, exacerbations, presence of anti-dsDNA antibody, decrease of complement C3, C4 and CH50 than those in the latter group(P