Objective To design a new type of nasopharyngeal airway tube,which can resolve the upper respiratory tract obstruction due to general anesthesia.Methods All types of used flex endotracheal tube were collected.Take off the cuff outside of the tube wall and cut them into different lengths.Then,the connectors were reinstalled to the prepared tubes.Results With the designed nsopharyngeal airway tubes inserted,50 patients having complicated glossocoma in general anesthesia no longer snored and they could breathe freely.Conclusion The new type of nsopharyngeal airway tube is easy to produce and adapts well to clinical work.

ObjectiveTo assess the reliability and validity of Chinese version of tools in measuring yangsheng.MethodsChinese version of tools in measuring yangsheng was administered to 706 elderly citizens and evaluated for the reliability and validity.ResultsThe fittingness of the both exiting model were unidentified.A model of six factors and twenty-six items was determined using exploratory factor analysis.The fitness of such model was perfect ( RMSEA =0.050,AGFI =0.871,GFI =0.902,NFI =0.903,CFI =0.953 ) and all the construct reliability were more than 0.6 while the average variance extracted were higher than 0.5 except the diet yangsheng factor.The Cronbach's α of Chinese version of tools in measuring yangsheng was 0.918 and Cronbach's α of factors were all above 0.7.ConclusionThe Chinese version of tools in measuring yangsheng appears to have good validity and reliability to estimate the Yangsheng of elderly citizens in China.

Objective To investigate the effects of caffeine citrate and aminophylline in treatment of primary apnea of premature infants and its related complications. Methods A total of 152 preterm infants who were diagnosed primary apnea within 10 days after birth were randomly divided into caffeine citrate group(n=77) and aminophylline group(n =75). The changes in the time of the apnea disappeared after treating,needing oxygen,non-invasive and invasive mechanical ventilation,and the incidence of bronchopul-monary dysplasia ( BPD ) , necrotizing enterocolitis, retinopathy of prematurity, patent ductus arteriosus (PDA),intercranial hemorrhage(ICH)were compared between the two groups. Results The time of the apnea disappeared after treating[(47. 4 ± 5. 3) h],needing oxygen[(20. 5 ± 7. 6) d],non-invasive mechani-cal ventilation[(8. 7 ± 4. 2) d] and invasive mechanical ventilation[(1. 0 ± 1. 3) d] in the caffeine citrate group were significantly lower than those in the aminophylline group [ ( 54. 8 ± 6. 2 ) h, ( 24. 4 ± 8. 5 ) d, (10.4±5.3)d,(10.4±5.3)d,respectively](P<0.05).TheincidenceofBPD[16.9%(13/77)],PDA [13. 0%(10/77)] and ICH[16. 9%(13/77)] in the caffeine citrate group were significantly lower than those in the aminophylline group[33.3%(25/75),26.7%(20/75),22.7%(17/75),respectively](P <0. 05),but there were no differences between the two group about the incidence of necrotizing enterocolitis [caffeine group 7. 8%(6/77),aminophylline group 9. 3%(7/75)] and retinopathy of prematurity[caffeine group 6. 5%(5/77),aminophylline group 9. 3%(7/75)](P>0. 05). Conclusion The caffeine citrate has a better efficacy in the treating primary apnea of preterm infants than aminophylline. It can also decrease the incidence of BPD,PDA and ICH in premature infants.

Objective To investigate the anti-apoptosis effects of heme oxygenase-1 (HO-1) in a mouse model of liver ischemia-reperfusion ( IR ) injury and to analyze the possible mechanisms . Methods A cell model of hypoxia/reoxygenation injury was established after transfecting mouse liver AML12 cells with HO-1 small interfering RNA ( siRNA) . Real-time PCR and Western blot assay were performed to detect the changes of HO-1, B-cell lymphoma 2 (Bcl2) and caspase-3 at the cellular level. The mouse models of liver ischemia-reperfusion injury were established with/without pretreatments with cobalt proporphyrin (CoPP), CoPP+znic proporphyrin ( ZnPP) and/or ZnPP. The levels of aspartate transaminase ( AST) and alanine transaminase ( ALT) in serum samples were measured. Immunohistochemistry was used to analyze the chan-ges of caspase-3. Western blot assay was used to detect the expression of HO-1 and Bcl2 at protein level. The pathological changes of liver tissues were observed under light microscope. The apoptosis of hepatocytes was observed by using Tunel assay. Results Decreased expression of HO-1 and Bcl2 and increased expres-sion of caspase-3 were observed in the model of hypoxia/reoxygenation injury by pre-transfecting the AML12 cells with HO-1 siRNA. Compared with the IR injury group, the CoPP pretreatment group showed lower lev-els of AST and ALT (P<0. 05) and alleviated pathological damages in liver tissues. Moreover, the expres-sion of caspase-3 was inhibited, but the expression of HO-1 and Bcl2 were enhanced. Less apoptotic cells was detected by the Tunel assay (P<0. 05). However, these protective effects could be suppressed by adding ZnPP. Conclusion HO-1 has anti-apoptotic effects in the in vitro model of hypoxia/reoxygenation. CoPP can upregulate the expression of HO-1 and play the role of anti-apoptosis in a mouse model of liver is-chemia-reperfusion injury.

Objective To make a comparison between noninvasive blood pressure (NIBP) and invasive blood pressure (IBP). Method Totally 450 patients undergoing selective surgery received radial artery or dorsalispedis artery puncture and catheter under local anesthesia to figure out the difference between NIBP and IBP. Results The systolic blood pressure difference of IBP from different positions and NIBP were as follows:left radial artery group (18.20 ± 0.67, 15.27 ± 0.62) mmHg, right radial artery group (18.54 ± 0.79, 14.68 ± 0.77) mmHg, left foot dorsal artery group (41.98 ± 2.26, 40.54 ± 1.77) mmHg and right foot dorsal artery group (37.57 ± 0.01, 37.93 ± 2.90) mmHg. The noninvasive systolic blood pressure difference between left and right arms was (2.84 ± 0.45) mmHg, the noninvasive diastolic blood pressure difference (3.19 ± 0.34) mmHg, and the noninvasive mean blood pressure difference (2.85 ± 0.35) mmHg. The NIBP of right arm was higher than that of left arm. Conclusions IBP is higher than NIBP, and the invasive artery systolic blood pressure is about 20mmHg higher than noninvasive systolic blood pressure. Meanwhile we confirm that systolic blood pressure gradually rises over 30 years old, and diastolic blood pressure increases while gradually declines after 50.

ObjectiveTo observe the effect of adipose-derived stem cells (ADSCs) compound injective thermo-sensitive chitosan scaffold transplantation on content of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) in early degenerate lumbar intervertebral disc of rabbits. Methods24 white New Zealand rabbits (no limit of male or female) were randomly and equally divided into 4 groups: A. Degeneration model group: nucleus aspiration. B. ADSCs compound chitosan transplantation group. C. Cell-free chitosan transplantation group. D. Blank control group: only explore the target intervertebral disc. When aspirate pulposus with 21G needle, inject ADSCs-scaffold complex and chitosan scaffold respectively. The samples of L2-3, L3-4, L4-5, L5-6 intervertebral disc were obtained from 2 rabit in each group 2, 4, 8 weeks after operation. The contents of TNF-α, IL-1β were measured with ELISA. ResultsAll animals survived after the operation. Compare with the blank control group, the contents of TNF-α, IL-1β in degeneration model group increased significantly (P＜0.05). It decreased significantly (P＜0.05) in ADSCs compound chitosan transplantation group and cell-free chitosan transplantation group compared to model group. IL-1β decreased significantly (P＜0.05) 8 week after operation in ADSCs compound chitosan transplantation group compared to cell-free chitosan transplantation group. ConclusionADSCs compound injective thermo-sensitive chitosan scaffold transplantation in early degenerate lumbar intervertebral disc could decrease the content of TNF-α, IL-1β, and may regulate the inflammatory response.

Objective To investigate the effect of neurally adjusted ventilator assist(NAVA) and synchronized intermittent mandatory ventilation(SIMV) on respiratory function in premature infants with respiratory distress syndrome.Methods A total of 54 preterm infants who were diagnosed neonatal respira-tory distress syndrome after birth and needed invasion mechanical ventilation in our hospital from Oct.2014 to Dec.2016 were given SIMV for 4 hours and NAVA mode ventilation for 4 hours,with a total of 4 cycles.The peak inspiratory pressure(PIP),tidal volume(TV),Compliance,respiratory rate(RR),Edi peak,Edi min, FiO2and mean airway pressure(MAP) were monitored every 30 minutes, and pressure of carbon dioxide (PaCO2)were monitored every 2 hours in different modes.Results The mean values of PIP[(19.5 ± 3.1) cmH2O,1 cmH2O=0.098 kPa],RR[(51.4 ± 7.9)breaths/min],Edi peak[(5.1 ± 3.2)μV],FiO2[(38.2 ± 12.9)%],MAP[(12.0 ± 0.8)cmH2O],PaCO2[(41.2 ± 9.3)mmHg,1 mmHg=0.133 kPa] and Edi min[(1.2 ± 1.4)μV] in NAVA mode were significantly lower than those in SIMV mode[(22.9 ± 3.4) cmH2O,(56.9 ± 8.3)breaths/min,(7.9 ± 4.9)μV,(39.9 ± 14.1)%,(13.2 ± 0.7)cmH2O,(47.1 ± 10.4)mmHg,(2.0 ± 1.7)μV,respectively](P<0.05).But the mean values of TV,Compliance in SIMV mode[(6.2 ± 1.0)ml/kg,(0.25 ± 0.33)ml/cmH2O,respectively] were significantly lower than those in the NAVA mode[(7.2 ± 0.9)ml/kg,(0.37 ± 0.21)ml/cmH2O,respectively](P<0.05).The downward trend of PIP,RR,Edi peak,FiO2,Edi min,MAP and upward trend of TV,Compliance were found during the first circle from NAVA mode to SIMV mode.The decrease and increase of above ventilator parameters were more obvious in NAVA mode compared with SIMV mode.Conclusion The respiratory muscle load is reduced, TV increases,and pulmonary compliance improves during NAVA ventilation.NAVA is better than SIMV in improving respiratory function of premature infants with respiratory distress syndrome. NAVA has lung protective effect.

Objective To analyze and evaluate the efficacy of living donor liver transplantation (LDLT) and deceased
donor liver transplantation (DDLT). Methods The clinical data of prognosis and influencing factors of 320 children with liver transplantation were analyzed retrospectively. The 320 children were divided into LDLT group (n=252) and DDLT group (n=68) based on their operation styles. In LDLT group, all donors to recipients were immediate relatives within three generation. In DDLT group, all livers were obtained from cardiac death or brain death donors. The survival and incidence of complications were observed between two groups. Results The 1-year, 2-year and 3-year cumulative survival rates for recipients were 95.1%, 93.5% and 93.5% in LDLT group, and 92.3%, 92.3% and 82.4% in LDLT group. There was no significant difference between the two groups (Log-rank χ2=0.69,P=0.41). During the follow-up period,14 cases died (5.56%) in LDLT group, in which 8 deaths due to respiratory complication, 3 deaths due to multiple organ failure, and 3 deaths due to graft failure. In DDLT donor group, 5 cases died (7.35%), in which 1 death due to respiratory complication, 2 deaths due to multiple organ failure, 1 death due to intra-abdominal hemorrhage, and 1 case of unknown cause of death. There were no significant differences in portal vein thrombosis (PVT), outflow tract obstruction, biliary tract complications and pulmonary infection between the two groups (P>0.05). The ratio of hepatic artery thrombosis (HAT) was lower in LDLT group than that of DDLT group (1.98%vs. 10.29%,χ2=10.245,P<0.01). Conclusion Living donor liver transplantation is an effective method to treat end-stage liver disease.

Objective To investigate the effect of nucleotide-binding oligomerization domaincontaining protein 1 (NOD1) on pyroptosis in hepatic ischemia-reperfusion injury.Methods An animal model of ischemia-reperfusion injury was established.Thirty healthy,male,and clean C57 BL mice were randomly divided into sham operation group (sham group) and ischemia-reperfusion group (IR,including 2 h,6 h,12 h,24 h subgroups),6 per group.Serum ALT and AST levels in each group were measured by blood biochemistry.HE staining and TUNEL were used to observe the pathological changes of liver and hepatocyte apoptosis.Immunohistochemistry was used to detect the expression and distribution of NOD1 in each group.Western blotting was used to detect NOD1,MM2,pro-Caspase-1 and active-Caspase-1 expression.NOD1 siRNA and empty control siRNA were transfected into AML12 cells,then the hypoxia/reoxygenation model was established and cells were collected to detect the expression of NOD1,AIM2 and active-Caspase-1.Results The ALT and AST levels in IR group were significantly higher than those in sham group,and peaked at IR 12-h subgroup (P＜0.05).HE staining showed that hepatic injury was the most severe at 12 h after reperfusion.TUNEL results showed that the number of apoptotic cells was the greated at 12 h after reperfusion.Western blotting showed that NOD1 protein expression was highest at 12 h after reperfusion.With the prolongation of reperfusion time,the expression of AIM2 and active-Caspase-1 gradually increased,and that of pro-Caspase-1 gradually decreased.The expression of NOD1,AIM2 and activeCaspase-1 decreased after transfection of NOD1 siRNA into AML12 cells.Conclusions NOD1 promotes liver ischemia-reperfusion injury,which may be related to NOD1 promoting liver injury by activating pyroptosis.

Objective:To analyze the complications and outcomes during the hospitalization of extremely premature infants (EPI) and extremely low birth weight infants (ELBWI).Methods:Clinical data of 168 cases of EPI and ELBWI admitted to 4 hospitals of grade three in Shaanxi Province between January 1, 2015 and December 31, 2017 were retrospectively analyzed.The information of general data, prenatal care, complications and outcomes were summarized.Outcomes of different groups were compared according to birth weight and gestational age.Results:A total of 168 cases of EPI and ELBWI were collected.The rate of delivery in tertiary hospitals was 86.9% (146/165 cases), 86 patients (57.7%) received prenatal Dexamethasone.The mean gestational age was (27.9±1.7) weeks, and the mean birth weight was (951.6±148.9) g. The highest rates of pregnancy complications included gestational hypertension (44/149 cases, 29.5%), premature rupture of membranes (43/149 cases, 28.9%) and gestational diabetes (16/149 cases, 10.7%). The first three neonatal complications were neonatal respiratory distress syndrome (16/168 cases, 95.2%), bronchopulmonary dysplasia (73/110 cases, 66.4%) and retinopathy of prematurity (65/110 cases, 59.1%). The survival rate of EP and ELBWI in 168 cases was 61.9% (104/168 cases), the abandonment rate was 27.4% (46/168 cases), and the mortality in hospital was 10.7% (18/168 cases). According to birth weight and gestational age, there were no statistically significant differences in survival, abandonment and hospital mortality among different birth weight groups( χ2=4.361, 5.104, 1.630, all P>0.05), while there were statistically significant differences in survival, abandonment and hospital mortality among different gestational age groups( χ2=21.650, 8.164, 13.490, all P<0.05). Conclusions:There are many complications of EPI and ELBWI and the outcomes are closely related to the gestational age of birth.Improving the perinatal management level and the professional diagnosis and treatment level of neonatology are helpful to improve the survival rate and prognosis.