Objective To compare the efficacy of laryngeal mask of Supreme and i-gel for the airway management in patients undergoing elective lumbar vertebral surgery in prone position. Methods A total of 264 patients,ASA physical status Ⅰ or Ⅱ,scheduled for elective lumbar verte-bral surgery in prone position under general anesthesia were divided into two groups (n =132)using a random number table:laryngeal mask of Supreme group (group S)and laryngeal mask of i-gel group (group I).The laryngeal mask of Supreme or i-gel were respectively placed in group S and group I im-mediately after anesthesia induction according to manufacturers’specification.Volume-controlled ven-tilation was used to observe the ventilation quality.The number of laryngeal mask insertion,laryngeal mask insertion time and the ventilation quality in supine and prone position were recorded,as well as the airway seal pressure.The position of laryngeal mask was evaluated by fibero ptic examination in both supine and prone positions.The blood on the laryngeal mask was noted.Finally,the occurrence of laryngeal mask related complications was observed.Results One patient in group I was excluded due to the failure of laryngeal mask insertion after three attempts.No significant difference in type of laryngeal mask,insertion time,adjusted cases,peak airway pressure,and fiber optic examination in both supine and prone positions between two groups.Compared with group S,group I required signif-icantly more attempts of insertion (P < 0.01 ).Nevertherless,ventilation quality in prone position was improved and airway seal pressure in supine and prone position increased (P <0.01 or P <0.05) in group I.No significant difference was found in the occurrence of laryngeal mask related complica-tions.Conclusion In the airway management of patient undergoing elective lumbar vertebral surgery in prone position,laryngeal mask of i-gel is more difficult to be inserted but can maintain higher air-way seal pressure compared with laryngeal mask of Supreme.

Objective To study curative effect of core decompression and autologous bone marrow stem cell transplantation combined with traditional Chinese medicine in the treatment of early femoral head necrosis (ANFH).Methods 30 patients with femoral head necrosis treated by different methods were divided into 3 groups: core decompression A group) 10 cases(12 hips) ;core decompression pus stem cells transplantation(B group) 10 cases(13 hips) ;core decompression pus stem cells transplantation combined with traditional Chinese medicine(C group) 10 ca-ses( 10 hips) ;The X-ray 、CT MRI、Harris score( HHS) .curative effect were observed.Results The phase of Ⅰ,Ⅱ,Ⅲ,in 3 groups didn't appear deformation and collapse at 3,6,12 months;The score of Harris after 12 months 93 points were higher than that preoperatively 57.5 points(χ 2= 5.81 ,P<0.05) ;The signal ratio of femoral head volume in MRI was 42% before treatment,disappearance of femoral head necrosis after treatment;Total curative effect of B,C group,werehighter than that Agroup(χ2 =3.81,χ2 =3.98,P<0.05).Conclusion The operative treatment of ANFH with core decompression and stem cells transplantation combined with traditional Chinese medicine had the advantage of minimal damage,simplicity,accuracy,and effectiveness.

The three‐dimensional digital substraction angiography (3D‐DSA) significantly elevated detection rate of intracranial small vessel aneurysms in recent years .It has become the novel gold standard diagnosing antracranial small vessel aneurysms .The present article made a review on 3D‐DSA value for diagnosis ,treatment and prognostic assessment of intracranial small vessel aneurysms .

Han Jiangbo. Department of Theoretical Mechanics, Luoyang Industry College. Luoyang Since January 1982 we have relocated the insertion of a part of pectoralis major or deltoid muscle in the treatment of 5 cases of habitual dislocation of shoulder. After over a year of follow-up no recurrence of dislocation has been found in all the cases. The shoulder joint seemed to be stable, the range of movements increased, and disturbance in supination was corrected. The operative procedure was studied in fresh cadavers and human skeleton. Studies on mechanical model of shoulder joint, with theoretical calculation of changes in pronation after muscle displacement, showed that movements of pronation were remarkably increased after displacement of partial pectoralis major and deltoideus. It could also compensate the weatened subscapularis.

As a new technique ,CT spectral imaging can obtain two images of different energy level at same phase simultaneously ,then immediately rebuild high definition monoenergetic images ranging from 40 kV to 140 kV .It provides reliable data and information for early qualitative and quantitative diagnosis of diseases ,which possess huge potential in clinical and science research ;and more extensive developing space for developing of scientific research and clinical application .

Objective To study the characteristics and therapeutic effect of femoral neck fractures in young adults by many treatment methods. Methods 32 cases with femoral neck fractures in young adults 21-50 years. Using of tube decompression of the femoral head involvement, fracture of drug injection, intravenous drip and so many ways of delivery, to regular observe their fracture healing and clinical efficacy. Results All 32 cases with femoral neck fracture postoperative follow-up 5-9 months to obtain bone healing;Follow-up to 1 year of hip joint function was basically normal,non-femoral head necrosis. Follow-up to 3 years,32 cases in 26 cases of excellent,good in 5 and poor in example 1. Example 1 due to poor weight -bearing walking premature and older (50 years) appear avascular necrosis of femoral head,the total hip arthroplasty. Conclusion The joint methods have an exact effect in patirnts with femoral neck fracture.The advantages were easy to operate,less trauma and fewer complications,fast recovery ,easy to promote.

Objective:To investigate therapeutic effect of cisplatin sequential recombinant human vascular endostatin thoracic perfusion in treatment of malignant pleural effusion.Methods:A total of 80 patients with malignant pleural effusion in Maoming People's Hospital from January 2018 to February 2021 were enrolled, and all patients were divided into 2 groups according to the random number table methods, each group with 40 cases. The control group was treated with small-bore catheter minimally invasive drainage combined with cisplatin thoracic perfusion, and the study group was treated with small-bore catheter minimally invasive drainage combined with cisplatin sequential recombinant human vascular endostatin thoracic perfusion. And then the clinical efficacy, expressions of vascular endothelial growth factor (VEGF) expression, pain degree and adverse reactions were compared of both groups.Results:The treatment efficacy rate of the study group was higher than that of the control group [90% (36/40) vs. 75% (30/40)], and the difference was statistically significant ( χ2 = 5.04, P < 0.05). After treatment, the level of VEGF in pleural fluid and serum of the study group was lower than that of the control group [(304±106) pg/ml vs. (598±159) pg/ml,(103±43) pg/ml vs. (189±49) pg/ml], and the difference was statistically significant ( t = 6.62, P < 0.001; t = 6.23, P < 0.001). After treatment, the visual analogue scale (VAS) score of the study group was lower than that of the control group [(3.7±0.3) scores vs. (4.4±0.7) scores], and the difference was statistically significant ( t = 2.10, P < 0.05). The incidence of adverse reactions including stethalgia, fever, nausea and vomiting in both groups had no statistically significant differences (all P > 0.05). Conclusions:Cisplatin sequential recombinant human vascular endostatin thoracic perfusion combined with small-bore catheter minimally invasive drainage can effectively ameliorate clinical symptoms, inhibit the expression of VEGF, and alleviate pain degree with no serious adverse reactions in patients with malignant pleural effusion.

OBJECTIVETo test validity and reliability of Personality Diagnostic Questionnaire-fourth vision (PDQ-4) and a self-report DSM-IV axis-II personality disorder (PD) assessing instrument as well as to study the prevalence of personality dysfunction among students of first grade senior high schools in Beijing.

METHODSAmong 100 PD patients, 91 non-PD patients with mental disorder, and 100 normal people, sensitivity, specificity and consistency were tested by ICD-10 criteria. By means of stratified cluster sampling, 10 039 students from 25 senior high schools in urban and rural in Beijing were studied using PDQ-4.

RESULTSPDQ-4 had high sensitivity and moderate specificity for most axis II disorders when compared with ICD-10. Among different samples, PDQ-4 yielded various levels of sensitivity and specificity. Meanwhile, the test-retest consistency was 92.2%. Among 130 adults, the total PDQ-4 score was 18.9 +/- 9.8. The score in males was 20.6 +/- 10.1, versus 17.1 +/- 9.2 in females with significant difference (t = 2.09, P < 0.05). Scores in different age groups were 21.5 +/- 10.5 in age 16 - 25, 16.9 +/- 11.3 in age 26 - 35, 16.4 +/- 9.7 in age 36 - 45, 16.2 +/- 7.9 in age 46 - 55, and 20.0 +/- 7.8 in age 56 and over respectively. No statistical significant difference of scores at age groups was found (F = 2.07, P > 0.05). Among 9 547 students, the total PDQ-4 score was 25.4 +/- 9.6, being significantly higher than that of adult sample. The prevalence of personality dysfunction was 5.6%. Regarding the distribution of personality dysfunction in gender, residential area, and type of school, data showed that the prevalence rates were higher in males, rural area and lower-ranking schools.

CONCLUSIONPDQ-4 can be used as a PD screen tool in psychiatric institutions and community settings. The distributions of personality dysfunction in Beijing were significantly different on gender, residential area and type of schools. Attention should be paid to personality dysfunction during adolescence.

Adolescent ; Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Middle Aged ; Personality Disorders ; diagnosis ; epidemiology ; Sex Factors

There have been different views over the resection extent of hilar cholangiocarcinoma worldwide.In this review,we will describe expert-views on the resection extent of hepatic tissue,as well as the hilar vascular resection and reconstruction.We hope this article will be helpful to the optimal operation of hilar cholangiocarcinoma.

Objective To compare the effects of different anesthetics on the recovery of neurologi-cal function after intracranial aneurysm embolization. Methods One hundred patients of both sexes with aneurysmal subarachnoid hemorrhage, aged more than 18 yr, with body mass index of 18. 5-24. 0 kg∕m2 , of American Society of Anesthesiologists physical status Ⅱ or Ⅲ and WFNS grade Ⅰ-Ⅳ, with the thick-ness of subarachnoid hemorrhage more than 4 cm, were divided into 2 groups (n= 50 each) using a random number table: propofol group (group P) and sevoflurane group (group S). After anesthesia induction, group P received intravenous infusion of propofol 100-300 μg·kg-1 ·min-1 , while the end-tidal sevoflu-rane concentration was maintained at 1. 4％-3. 5％ in group S. Immediately before induction (T0 ), imme-diately after the end of induction (T1 ), immediately after successful embolization of aneurysm (T2 ) and at 1, 2, 3 and 5 days after surgery (T3-6 ), central venous blood samples were collected for determination of plasma neuron-specific enolase and S100β protein concentrations by enzyme-linked immunosorbent assay. The development of postoperative cerebral vasospasm and delayed ischemic neurological deficit was recorded. The patients were followed up, and the Glasgow outcome score and occurrence of newly developed cerebral infarction were recorded within 6 months after surgery. Results There was no significant difference in the concentrations of plasma neuron-specific enolase and S100β protein at each time point, incidence of postop-erative cerebral vasospasm and delayed ischemic neurological deficit, or Glasgow outcome score and inci-dence of newly developed cerebral infarction within 6 months after surgery between two groups (P>0. 05). Conclusion Propofol and sevoflurane exert no effect on the recovery of neurological function after intracra-nial aneurysm embolization.