Objective To compare medical students' learning curve between Macintosh laryngoscope and optical laryngoscope in endotracheal intubation and to decide which one is more suitable for novice personnel.Methods Totally 26 interns after being trained by experienced anesthesiologists were enrolled in this study.They performed intubation on 6 patients by using both Macintosh laryngoscope and optical laryngoscope ( each laryngoscope for 3 patients) under the supervision of experienced anesthesiologists.The sequence of laryngoscope was determined by computer-generated random number list.Results Totally 149 patients who were ready to receive surgery under general anesthesia were enrolled in this randomized crossover controlled study.Duration of intubation was significantly shorter in Airtraq group (78 -± 33 ) s than in Macintosh group (114 ± 32) s,P ＜ 0.001.Intubation success rate was significantly higher in Airtraq group than in Macintosh group ( 87.8％ vs.66.7％,P ＜ 0.05 ).Conclusions With the advantages of rapid learning curve,higher intubation success rate and shorter intubation duration,Airtraq laryngoscope is easier to master for novice personnel.

Objective To understand the dietary intake of pregnant women, and try to give a reasonable sug-gestion to promote fetal development. Methods 400 pregnant women in Fushan city were enrolled in this study and their dietary intake were investigated, then the software of Analysis of pregnancy nutrition guidance system was used to make nutrition analysis. Results The ratio of the energy in each pregnancy provided by dietary protein, carbohy-drate and fat were relatively appropriate. But the intake of dietary calcium, ferrum, zinc, vitamin B1 and vitamin B2 in early pregnancy were very low, the intake were respectively 764.51 mg, 26.94 mg, 15.71 mg, 1.12 g, 1.13 g. Each pregnancy the ratio of high-quallty protein in total protein intake were more than 50%, an average protein RNI% was 48.50%. Conclusion The dietary style of pregnant women is relatively reasonable. But they should strengthened nutritional guide to intake more calciuro,ferrum, zinc,vitamin B1 and vitamin B2.

Objective: To discuss the relationship between vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and the biological behaviors of gastric cancer and, the relationship between the serum levels of VEGF, bFGF and the chemotherapeutic efficacy in patients with recurrent and metastatic gastric cancer. Methods: The serum levels of VEGF and bFGF were detected by ABC-ELISA method. Results: (1) The serum levels of VEGF and bFGF were significantly higher in preoperative stomach cancer patients than those in the healthy controls (P < 0.05) and postoperative stomach cancer patients (P < 0.05). (2) The serum levels of VEGF and bFGF significantly correlated with the depth of invasion, TNM staging, lymph node metastasis, and distant metastasis of primary cancer. (3) The serum level of VEGF had positive correlation with the serum level of bFGF in gastric cancer patients before radiochemotherapy (r =0.439, P <0.01). (4) The levels of VEGF and bFGF are significantly higher in preoperative patients with recurrent and metastatic gastric cancer than that in healthy controls and disease-free survival subjects (P < 0.05). After chemotherapy the serum levels of VEGF and bFGF in patients with no change (NC) or in progressive disease (PD) were a little higher than that before chemotherapy but the difference was not significant (P >0.05). (5) The serum levels of VEGF and bFGF were significantly lower in patients with complete response (CR) + partial response (PR) than that with NC + PD group after recurrent and metastatic patients received chemotherapy (P < 0.05). Conclusion: The serum levels of VEGF and bFGF were related with biological behaviors and chemotherapeutic efficacy of gastric cancer. The serum levels of VEGF and bFGF may provide new markers for preoperative diagnosis, postoperative follow-up, monitoring of the metastasis or recurrence of gastric cancer.

Objective To evaluate the effect of intrathecal administration of ?-conopeptide SO3 on inducible nitric oxide synthase(iNOS)expression of spinal cord and the ligated sciatic nerve in a rat model with chronic constriction injury(CCI).Methods 40 male SD rats were randomly divided into 4 groups of 10 animals each.Rats in the N group served as controls;in group C 4 loose ligatures were placed around the right sciatic nerve for 14 days;in group CN,normal saline 1?l/h was injected intrathecally slowly for 7 days seven days after the ligation;in group CS,?-conopeptide SO3 30ng/h was administered intrathecally slowly for 7 days seven days after the ligature.Local expression of iNOS was assayed in samples taken from injured nerves(between and distal to the CCI site)and the spinal cord using Western blotting analysis,with GAPDH as an internal reference.Results A 130 kDa band,corresponding to iNOS protein was detected in the middle and distal sections of the injured nerves and the spinal cord.The iNOS immunoreactivity was inhibited by continuous intrathecal injection of ?-conopeptide SO3.There was no difference in the expression of iNOS between group CN and group C.Conclusion The expression of iNOS in the spinal cord and injured nerves of CCI rats was enhanced.Intrathecal injection of ?-conopeptide SO3 can inhibit the expression of iNOS.The data suggested that N-type calcium channel blocker took part in the expression of iNOS.

Extracorporeal membrane oxygenation(ECMO) is a kind of extra life support technique that can support cardiac and pulmonary function in a relatively long time.With the application of nitric oxide,pulmonary surfactant and high frequency ventilation,the use of ECMO in neonatal respiratory failure decreased.Although received these treatment,there are some newborn with respiratory failure still required ECMO at last.On this paper,the application of ECMO in neonatal respiratory failure from foreign medical institute was introduced,and compared with the domestic situation,in order to improve the application of ECMO in neonatal respiratory failure.

BACKGROUND:Tranexamic acid administered either in intra-articular route or in intravenous route can significantly reduce blood loss during total knee arthroplasty. Recent studies are stil controversial in application mode of tranexamic acid in the clinic.
OBJECTIVE:To compare the clinical outcomes of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty.
METHODS:PubMed, OVID, Web of Science, and EMBASE were searched to identify randomized control ed trials concerning the comparison of tranexamic acid in intra-articular route and intravenous route during total knee arthroplasty published before 1 May 2015. Transfusion rate, hemoglobin decline, drainage volume and thromboembolic complication rate were considered as indexes to evaluate the clinical effect, for meta-analysis.
RESULTS AND CONCLUSION:Six randomized control ed trials involving 847 patients were included. Meta-analysis results showed no significant difference between intra-articular and intravenous administration of tranexamic acid in terms of transfusion rate, hemoglobin decline, drainage volume, total blood loss, and thromboembolic complication rate. Subgroup analysis for dose regimen showed that when occlusion time of drainage tube was<2 hours. Intra-articular route of tranexamic acid showed high drainage volume and hemoglobin decline compared with the intravenous route of tranexamic acid (P<0.01). Results confirmed that during total knee arthroplasty, clinical effects of intra-articular and intravenous routes of tranexamic acid are similar during total knee arthroplasty. Moreover, it is recommended that occlusion of drainage tube can be conducted for 2 hours in intra-articular route of tranexamic acid.

Objective To establish a multi-drug resistant model of temporal lobe epilepsy,and to observe the changes of γ-aminobutyric acid (GABA) receptor expression in the hippocampal tissues so as to explore its effects in pharmacoresistant epileptogenesis.Methods One hundred rats were selected to prepare the amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.After the kindled model of epilepsy was prepared successfully(n =52),pharmacoresistant epileptic rats were selected according to their response to the phenobabital and phenytoin.The selected pharmacoresistant epileptic rats (n =8)were sacrificed and the hippocampus was removed to determine the GABA receptor expression,and the same number of pharmacosensitive epileptic rats was used as control.Results The pharmacoresistant epileptic rats displayed degenerative and necrotic hippocampal neurons.The arrangement of hippocampal neurons was disordered,and the structural characteristics of the arrangement of the hippocampal neurons disappeared.The gray values of GABAA-positive neurons in the hippocampal tissues (141.15 ± 14.72) increased significantly compared with the pharmacosensitive epileptic rats (92.56 ± 5.17; t =3.380,P =0.006).Western blot method demonstrated that the band of GABAA became narrowed and thin.The relative quantity of GABAA in the hippocampal tissues (0.38 ± 0.08) decreased significantly as compared with the pharmacosensitive epileptic rats (0.88 ± 0.18).A significant difference was observed (t =5.420,P =0.002).Conclusions GABA receptor expression might be decreased in the hippocampal tissues of pharmacoresistant epileptic rats.It might play a certain role in the formation of pharnmacoresistant epilepsy.

10.3969/j.issn.1000-3606.2013.06.015

Objective To establish a multi-drug resistant model of temporal lobe epilepsy,and then the sodium current of pyramidal neurons in CA1 areas of the hippocampus was used as as index to observe the effect of hippocampal stimulation on pharmacoresistant epileptic rats.Methods Eighty Wistar rats were selected to prepare an amygdaloid kindled model of epilepsy by chronic stimulation of amygaloid basal lateral nucleus.When the kindled model of epilepsy was prepared successfully,the pharmacoresistant epileptic rats were selected according their response to phenobabital and phenytoin.The selected pharmacoresistant epileptic rats were divided into a hippocampal stimulation group (HS group) and a pharmacoresistant control group (PR group).A low-frequency hippocampal stimulation was performed in the HS group,while the PR group received sham stimulation.The whole-cell recording technique by patch-clamp was used to observe the changes of sodium current of hippocampal pyramidal neurons after the hippocampal stimulation.Results Compared with the PR group,the pharmacoresistant epileptic rats in HS group underwent low-frequency stimulation for 2 weeks showed that the amygdale stimulus-induced seizures were decreased (2.32 ± 0.38 in HS group and 4.45 ± 0.42 in PR group,t =84.600,P =0.000) and the parameters of the after-discharges were improved significantly.In HS group,the peak current shifted towards depolarization,the sodium channels were difficult to activate,and were more susceptible to inactivation.Moreover,the recovery time after the sodium channel inactivation was slower in HS group ((17.9 ±0.6) s) than in PR group((16.3 +0.3) s,t =-25.420,P =0.000).Conclusions Hippocampal stimulation may inhibit the sodium channel current of pyramidal neurons in CA1 areas of hippocampus.The mechanism of hippocampal stimulation in the treatment of pharmacoresistant epilepsy might be achieved partly by inhibiting the sodium channel current so as to decrease the excitability of hippocampal neurons.

ObjectiveTo investigate the effects of platelet derived growth factor (PDGF) on brain cell apoptosis rate and serum neuron-specific enolase (NSE) concentration after hypoxic-ischemic brain damage (HIBD) in neonatal rats. MethodsForty-eight HIBD models of 7-day old neonatal Wistar rats were established and then divided into two groups randomly:PDGF group and normal saline control group (n =24 in each).Another 24 neonatal Wistar rats were taken into the sham operation group.The treatment group received intraperitoneal injection of PDGF-BB (50 ng/kg) once,while the other two groups received normal saline at the same time.In each group,rats were randomly sacrificed immediately at 12,24 and 72 hours after injection (n=8).The serum of rats were reserved for NSE concentration determination by enzyme linked immunosorbent assay,and the right brains of the sacrificed rats were used to prepare brain cell suspension for neurocyte apoptosis rate examination by flow cytometry.Mono-variate analysis and q-test were performed for statistical analysis. Results(1) The brain cell apoptotic rates of treatment group [ (6.09 ± 0.70)％,(9.67 ± 1.52) ％ and (14.15±1.52)％] and control group [(8.00± 1.10)％,(11.45±2.42)％ and (22.90±2.03) ％] were significantly increased compared to that of sham group [(2.11 ± 0.54)％,(2.34 ±0.46)％ and (2.21±0.49)％] at all time points (all P＜0.01 or ＜0.05),the apoptotic rate of treatment group was lower than that of control group (P＜0.01 or ＜0.05).Statistical differences were found among the three groups at 12,24 and 72 hours (F =39.01,66.60 and 194.20respectively; P＜0.01).(2) Serum NSE concentration was significantly increased in the treatment group [(8.43 ± 0.17) μg/L,(6.73 ± 0.16) μg/L and (6.12 ± 0.13) μg/L] and control group [(10.04±0.19) μg/L,(9.330.15) μg/L and (8.36 ± 0.16) μg/L] than in the sham group [(4.22±0.53) μg/L,(3.96±0.60) μg/L and (3.59±0.55) μg/L] at all time points,and it was significantly lower in treatment group than in control group (P＜ 0.01).Statistical difference was found among three groups at 12,24 and 72 hours (F=371.25,245.61 and 236.22 respectively,P＜0.01). ConclusionsPDGF might have neuroprotective effect,which could inhibit apoptosis of neural cells and decrease the serum NSE concentration.