Objective To use evidence-based nursing on patients with artificial airway to the practice of stomach tube, and to evaluate the self made guidance for difficult gastric tube placement in patients with artificial airway.Methods Forty patients with artificial airway and were difficult to put the tube, and admitted to Department of Critical Care Medicine of Harrison International Peace Hospital Affiliated to Hebei Medical University from April to December in 2016 were enrolled as observation group. Through the evidence-based nursing strategy, the related literatures at home and abroad were collected to search clinical evidence and formulate and implement the nursing program, the gastric tube was inserted into the stomach tube under the direct vision of the laryngoscope. Thirty-six patients of difficult gastric tube placement with artificial airway straightly under the direct vision of the laryngoscope from August 2015 to March 2016 were retrospectively analyzed as the control group. The success rate of first catheterization, indwelling time, throat edema and bleeding of pharyngeal mucosa were compared between the two groups.Results All patients were enrolled in the final analysis. In the control group, 28 patients were successfully placed once, while 8 failed. Only 1 patient in observation group failed to catheterize, and successful placed after symptomatic treatment, the one-time success rate of catheter was significantly higher than that of control group (97.5% vs. 77.8%), and catheter time was significantly shortened (minutes: 4.8±1.2 vs. 5.1±1.0), the difference was statistically significant (bothP < 0.05). There were 2 patients with laryngeal edema in the control group and 4 patients of pharyngeal mucosal hemorrhage. In the observation group, there was no laryngealedema and laryngeal edema occurred in the patients with laryngoscopy, and only 1 patient had a hemorrhage of pharyngeal mucosa.Conclusion Using self made guiding device can effectively insert the difficult gastric tube in patients with artificial airway, and increase the one-time success rate of intubation, shorten the catheter time, and have a trend in reduce complication as compared with traditional gastric tube placement.

Two hundred and sixty-one subjects were recruited from in-patients and subjects for phaysical Check-up,and were divided into normal control group (NC),nonalcoholic fatty liver disease group (NAFLD),type 2 diabetes mellitus group (T2DM),and T2DM accompanied by NAFLD group (DMN).According to the result of ultrasonic examination,the patients with T2DM were further divided into non-NAFLD group,light fatty liver group (NAFLD-L group),moderate fatty liver group(NAFLD-M group),and severe fatty liver(NAFLD-S group).Fasting plasma glucose,blood lipid,liver function,kidney function,and serum retinol-binding protein 4 (RBP4) levels were determined.The risk of various indicators for NAFLD was determined by correlation analysis and logistic regression analysis.The results showed that fasting glucose levels in diabetics with or without NAFLD were significantly higher than those in NC and NAFLD groups(P＜0.01).Triglyceride (TG) level in DMN group was significantly higher than those in other three groups(all P＜0.01),while high density lipoprotein-cholesterol level was lower than those in other three groups(all P＜0.01).Systolic blood pressure and diastolic blood pressure in DMN group were higher than those in NC and T2DM groups (P＜0.05 or P＜0.01).Serum RBP4 level in patients with NAFLD was significantly higher compared with the subjects without NAFLD [45.00 (38.75,51.00) mg/L vs 51.00 (43.00,62.00) mg/L,P ＜0.01],and was rising with the progress of NAFLD [NAFLD-L group 44.00 (37.00,51.00) mg/L,NAFLD-M group 52.00(46.00,63.00) mg/L,and NAFLD-S group 78.5 (72.75,83.00) mg/L,all P＜0.01].Logistic regression analysis showed that the RBP4 level was an independent factor associated with NAFLD (P =0.029).In addition,serum RBP4 level was correlated with body mass index,waist-to-hip ratio,serum gamma-glutamyl transpeptidase,total cholesterol,TG,aspartate aminotransferase,alanine aminotransferase,prealbumin,creatinine,blood urea nitrogen,and uric acid.These resuhs suggest that serum RBP4 is an independent risk factor of NAFLD.

BACKGROUND: Ephedra, a Chinese medicine, is often used to treat obesity with relatively satisfying results recently. However, the effects of Ephedra on the perimenopausal and postmenopausal obese women remain unclear.OBJECTIVE: To observe the effects of oral Ephedra decoction on body mass and the levels of blood lipids, blood glucose and hormone in ovarietomized obese rats.DESIGN: A completely randomized and controlled experiment.SETTING: Institute of Physiology and Psychology, School of Basic Medical Sciences, Lanzhou University.MATERIALS: The experiment was performed in the Key Laboratory of Pre-clinical Study for New Drugs of Gansu Province and the Laboratory of Institute of Physiology and Psychology, School of Basic Medical Sciences,Lanzhou University from February 2006 to June 2006. Forty-four healthy female SD rats were randomly divided into four groups with 11 rats in each group, namely sham-operated group, ovariectomized group, estrogen replacement therapy group and Ephedra group.METHODS: ① After having been narcotized by cloraminone (110 mg/kg),rats were underwent a bilateral ovariectomy except those in the sham-operated group, which were also operated, but their ovaries were not cut off. ②Rats in the sham-operated group and ovariectomized group were subcutaneously injected with sesame oil (0.2 mL/each rat) every day postoperatively till the end of the experiment. ③ The rats in the estrogen replacement therapy group were given estradiol (1 mg/kg) by subcutaneous injection every day postoperatively till the end of the experiment. ④ The rats in the Ephedra group freely drank 1% water extracts from Ephedra postoperatively, later the concentration of Ephedra gradually increased to 8% on the sixth day, which lasted until the end of the experiment. ⑤ The food intake was monitored daily, and body mass was measured every ten days. ⑥ At the end of the experiment, all the rats were fasted for 12 hours and collected blood samples for the measurement of serum indexes. The body mass and body length were measured to calculate the Lee's index [(g)×103/body length (cm)] at the same time.MAIN OUTCOME MEASURES: ① Body mass and Lee's index at different time points in each group. ② Food intake at different time points in each group. ③ Levels of blood lipids and blood glucose in each group. ④Levels of estrogen, progesterone and insulin in each group.RESULTS: Forty-four rats all entered the analysis of results. ① Result of body mass and Lee's index at different time points: The body masses on the 20th, 30th, 40th and 50th days in the ovariectomized group were (256.4±14.3),(271.3±16.1), (276.4±12.7), (285.7±24.2) g, which were significantly higher than those in the sham-operated group [(226.5±11.5), (241.8±12.6),(243.1±13.5), (251.1±22.4) g, P ＜ 0.05-0.01], and the Lee's index in the ovariectomized group was greater than that in the sham-operated group(317.2±13.5, 280.4±11.2, P ＜ 0.01). The body masses on the 40th and 50th days in the estrogen replacement therapy group were (243.7±14.8) and(246.2±11.9) g, which were significantly lower than those in the ovariectomized group (P ＜ 0.05-0.01), and the Lee's index (289.9±13.5) was lower than that in the ovariectomized group (P ＜ 0.01). The body masses on the 40th and 50th days in the Ephedra group were (245.4 ±14.1) and(252.4±14.9) g, and the Lee's index was 294.4±11.0, which were all lower than those in the ovariectomized group (P ＜ 0.05). ② Result of Food in take at different time points: The food intakes on the 30th, 40th and 50th days in the Ephedra group were (17.8±2.4), (22.3±3.9), (26.1±3.5) g per day,which were decreased as compared with those in the ovariectomized group[(25.9±4.7), (28.5±5.3), (32.8±5.5) g per day, P ＜ 0.05]. ③ Levels of blood lipids and blood glucose: The levels of triglyceride, cholesterol and low density lipoprotein cholesterol (LDL-C) in the ovariectomized group were (1.73±0.32), (1.45±0.50), (0.78±0.19) mmol/L, which were higher than those in the sham-operated group [(0.94±0.29), (1.05±0.30), (0.08±0.11) mmol/L, P ＜ 0.01]. After the estrogen replacement therapy, the levels of triglyceride, cholesterol, LDL-C and blood glucose were (1.10±0.34),(1.14±0.30), (0.17±0.05), (5.88±1.21) mmol/L, which were lower than those in the ovariectomized group (P ＜ 0.05-0.01), but the level of high density lipoprotein cholesterol (HDL-C) was higher than that in the ovariectomized group [(1.11±0.31), (0.88±0.21) mmol/L, P ＜ 0.05]. The levels of triglyceride, cholesterol, LDL-C and HDL-C in the Ephedra group were (0.97±0.16), (1.11±0.20), (0.59±0.07) and (0.45±0.061) mmol/L, which were lower than those in the ovariectomized group (P ＜ 0.05-0.01). ④ The serum levels of estrogen, progesterone and insulin in each group: The serum levels of estrogen and progesterone in the ovariectomized group were lower than those in the sham-operated group [(17.09±9.00), (28.51 ±7.99) μg/L;(58.69±12.11), (62.73±10.93) μg/L, P ＜ 0.01], the serum level of insulin was higher than that in the sham-operated group [(31.74±6.69),(23.75±6.66) mU/L, P ＜ 0.01]. The serum levels of estrogen in the estro gen replacement therapy and Ephedra group were (36.03±8.83) and (30.18±8.61) ng/L, which were higher than those in the ovariectomized group(P ＜ 0.05-0.01), the level of insulin were (21.34±4.57), (24.86±6.20) mU/L,which were lower than those in the ovariectomized group (P ＜ 0.05-0.01).The serum level of progesterone in the Ephedra group [(17.68±6.19) μg/L]was lower than that in the ovariectomized group (P ＜ 0.01).CONCLUSION: Ephedra can promote loss of body mass, reduce levels of the blood lipids and insulin, and increase the serum levels of hormones in ovariectomized obese rats.

Objective To investigate the effect of early coronary artery bypass grafting (CABG)to the left ventricular wall motion state and the significance of CABG to awake hibernating myocardial in dogs with acute myocardial infarction.Methods The anterior descending coronary of all thirty dogs were ligated into MI model.According to the operation date,the experimental groups included the 1 st week (n =6),the 2nd week (n =4),the 4th week (n =6) and the 6th week (n =6) CABG,and established control group (n =2) for every experimental group.Operators marked hibernate myocardial and determined the room wall motion score by means of dobutamine ultrasound load test (DSE) combining with tissue doppler imaging (DTI)technology before CABG and after eight weeks CABG through thoracotomy surgery for the experimental group and the control group.Every dog was executed and detected the area of MI.Results Four dogs of experimental group and all dogs of control group survived to the end of the study.The change of ventricular room wall motion score in the 1st and the 2nd week CABG was smaller than that in the 4th and the 6th week CABG and MI group(0.03 ±0.06,0.05 ±0.09,0.23 ±0.08,0.27 ±40.06,0.32 ±0.05,P ＜0.05).The change of room wall motion score in all CABG groups was smaller than that in MI group(1.195 ±0.09,1.25 ±0.18,1.30 ±0.18,1.36 ±0.11,1.65 ±0.17,P＜0.05).The hibernate myocardial were more awaken in all CABG groups than that in MI group (0.27 ± 0.12,0.22 ± 0.04,0.31 ± 0.09,0.23 ± 0.03,0.03 ± 0.04,P ＜ 0.05).The area of MI became smaller in 1 and 2 weeks CABG than that in 4 and 6 weeks CABG and MI group(20.75 ± 2.63,21.25 ± 2.5,27.25 ± 1.71,27.75 ± 2.22,P ＜ 0.05).Conclusions Early CABG surgery for dogs acute MI could improve the ventricular room wall motion obviously and wake up more hibernate myocardial.Especially,CABG surgery among two weeks could lessen the effect of MI to the ventricular room wall motion and reduce the scope of myocardial infarction maximatily.

Objective To investigate whether rat grimace scale (RGS)could be used to assess pain in chronic pancreatitis,so as to provide evidence for pain research and clinical assessment of rat pain.Methods Twenty-eight adult male wister rats were evenly randomized into two groups (n =14):an experimental group and a control group.The experimental group was intravenously given 8 mg/kg body weight dibutyltin dichloride (DBTC)to induce chronic pancreatitis,and the control group was injected with ethanol and glycerin solution.Abdominal hypersensitivity,RGS scores and weight at different time points was detected.HE staining was used to detect the histological changes of pancre-atic tissue.Results Compared with the control group,the rats in the experimental group showed chro-nic inflammation in pancreatic tissue in two weeks.There was a significant increase in the number of abdominal withdrawals (P < 0.001 )and RGS in the experimental group.Conclusion Rat grimace scale might lead to a successful transition of basic science findings into clinical application.

OBJECTIVE: To explore the treatment effect of selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate in the treatment of perennial allergic rhinitis (PAR). METHOD: Seventy cases of perennial allergic rhinitis were selected and subjected to selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate,and the treatment effect was observed by analysis of the the symptoms and signs score of all cases preoperatively and postoperatively. RESULT: The total effective rate were 90.0% at 1 year follow-up. CONCLUSION Selective neurotomy of anterior ethmoid nerve and squeezing operation of inferior turbinate were effective for the patients with PAR. It is worthy to be popularized for its convent and rare complications.
Adolescent ; Adult ; Denervation ; methods ; Ethmoid Bone ; innervation ; Female ; Humans ; Male ; Middle Aged ; Rhinitis, Allergic, Perennial ; surgery ; Turbinates ; surgery ; Young Adult

Objective:Based on single-center clinical results of endovascular recanalization for symptomatic non-acute internal carotid artery occlusion (ICAO), a new patient classification method is proposed to distinguish the most suitable ICAO patient subgroups for endovascular recanalization.Methods:A total of 140 patients with symptomatic non-acute ICAO accepted endovascular recanalization in Department of Cerebrovascular Intervention, He'nan Provincial People's Hospital from January 2019 to December 2021 were selected. These patients were divided into low risk group ( n=57), medium risk group ( n=54) and high risk group ( n=29) according to the occlusion segments, occlusion times, plaque features, calcification at the occlusion site and occlusion segment angulation. The immediate postoperative recanalization rate, perioperative complications, perioperative death, and prognoses 90 d after endovascular recanalization (modified Rankin scale scores of 0-2 as good prognosis) were evaluated in the 3 groups. Results:The immediate postoperative recanalization rate was 82.9% (114/140), perioperative complication rate was 11.4% (16/140), and perioperative mortality was 0.7% (1/140). The success recanalization rate decreased gradually from the low risk group to the high risk group (100%, 85.2%, and 37.9%), while the perioperative complication rate was the opposite (0%, 11.1%, and 34.5%), with significant differences ( P<0.05). Ninety d after endovascular recanalization, 109 patients had good prognosis and 27 had poor prognosis; the good prognosis rate in low risk group, medium risk group and high risk group was 98.2%, 79.6% and 34.5%, respectively, with significant differences ( P<0.05). The vascular restenosis rate in low risk group, medium risk group and high risk group was 0%, 8.7% and 18.2%, and re-occlusion rate was 0%, 6.5% and 27.2%, respectively, 90 d after endovascular recanalization, with significant differences ( P<0.05). Conclusion:Endovascular recanalization is technically feasible for patients with symptomatic non-acute ICAO, especially those met the criterions of low and medium risk groups in our study.