Objective To compare the effects of electroacupuncture at points Shangjuxu(ST37), Zusanli(ST36), Xiajuxu(ST39) and Yanglingquan(GB34) on colonic expressions of interleukin-1b (IL-1b) and nicotinic acetylcholine receptor a7 mRNA (nAchRa7mRNA) in ulcerative colitis rats and investigate if large intestine lower He-Sea point Shangjuxu has relative specificity to fu organ diseases. Method Seventy healthy SD rats were randomized into blank, model, Shangjuxu, Zusanli, Xiajuxu, Yanglingquan and Chengjin groups, 10 rats, half male and half female, each. A rat model of ulcerative colitis was made by induction of 2-4-6 three nitrobenzene sulfonic acid/ethanol solution enema in every group except the blank group. After successful model making and ten days of treatment, rat colonic mucosal ulcers and inflammation were observed macroscopically, colonic IL-1bcontent was measured by ELISA and the expression of nAchRa7mRNA was determined by RT-PCR. Result Compared with the model group, colonic lesions were reduced in varying degrees, colonic IL-1b content was significantly lower and the expression of nAchRa7mRNA was higher in every acupoint group (P<0.05, P<0.01);the colonic ulcer score was lower in the Shangjuxu and Zusanli groups (P<0.05, P<0.01). Compared with the Shangjuxu group, colonic expression of nAchRa7mRNA was lower in the other four acupoint groups (P<0.01); colonic mucosal ulcers and inflammatory lesions were more severe and the colonic ulcer score and the IL-1bcontent were higher in the Xiajuxu, Yanglingquan and Chengjin groups (P<0.05, P<0.01). Conclusion The mechanism of electroacupuncture treatment for ulcerative colitis may be that it regulates abnormal immunologic function by modulating IL-1b and nAchRa7mRNA and reduces mucosal lesions. The overall therapeutic effect of Shangjuxu is better than those of Zusanli, Xiajuxu, Yanglingquan and Chengjin, indicating that Shangjuxu has relative specificity to fu organ large intestine.

OBJECTIVETo evaluate the safety and efficacy of oral endotracheal intubation in the patients with difficult laryngoscopy undergoing general anesthesia.

METHODSA total of 1 683 patients with difficult laryngoscopy, aged 1.5-67 yr, and scheduled for the elective plastic surgery were observed in this study from 1989-1997. All these patients were at American Society of Anesthesiologist physical status I. According to the preoperative predictive results for difficult laryngoscopy, we classified these patients into two groups: Group I included 1 375 patients, whose epiglottis could be viewed (laryngoscopic view grades II and III); and Group II, included 308 patients, whose epiglottis could not be viewed (laryngoscopic view grade IV). For group I, anesthesia was induced with thiopentone 4-5 mg/kg and succinylcholine 1 mg/kg; Laryngoscopy was carried out using modified Macintosh method. For Group II, anesthesia was induced with a total intravenous anesthesia or inhaled anesthesia; anesthetic depth was required to effectively inhibit laryngeal reflexes with reservation of spontaneous breathing. Tracheal intubation was performed by fiberoptic stylet laryngoscope (FOSL). During anesthesia induction and tracheal intubation procedures, electrocardiogram, arterial pressure, heart rate and pulse oxygen saturation (SpO2) were continuously monitored. Complications of intubation (arrhythmia, and so on) were observed and recorded. Immediately after laryngoscopy and successful intubation, patients were examined for any traumatic injuries at teeth, lips, tongue, and oropharyngeal tissues.

RESULTSIn group I, tracheal intubation was accomplished by the first attempt in 1 279 cases (93.0%) and the intubation time was less than 3 min in 1 304 cases (94.8%). In group II, tracheal intubation was accomplished by the first attempt in 114 patients (37.0%), and 123 patients (39.9%) had the intubation time of less than 3 min. Tracheal intubation was successful by the second or third attempt in 96 patients of group I and 156 patients of group II, respectively. Thirty-eight patients required four or more attempts, which only occurred in group II. Of all the complications of tracheal intubation, the traumatic complications were most common. The incidences of traumatic complications in the patients with laryngoscopic view grade II, III (group I ) and IV (group II) were 0.7%, 3.9% and 14.3%, respectively. Other complications such as respiratory depression were only seen in group II. A pooled incidence of the intubation complications was 6.7% (113/1 683).

CONCLUSIONAn anesthesiologist who is skillful in difficult airway management may safely manage the airway in the patients with difficult laryngoscopy under general anesthesia.

Adolescent ; Adult ; Aged ; Anesthesia, General ; Child ; Child, Preschool ; Dyspnea ; etiology ; Female ; Humans ; Infant ; Intubation, Intratracheal ; adverse effects ; methods ; Laryngoscopy ; Lip ; injuries ; Male ; Middle Aged ; Mouth Mucosa ; injuries

Host genetic factors, such as human leukocyte antigen (HLA) alleles, are important in Human immunod-eficiency virus (HIV) infection and its progression to AIDS. HLA class I genes, especially highly polymorphicHLA-B genes, are involved in the activation of HLA-restricted cytotoxic T lymphocytes (CTLs) against HIV, andthus control susceptibility to or protect against this virus. The present study was aimed to determine the distributionof HLA-B alleles in the Chinese Uygur ethnic group and its association with HIV infection. One hundred ten healthycontrol (HIV negative) and 128 HIV positive Chinese Xinjiang Uygur ethnic individuals were used in this study.HLA typing for B allele was performed by polymerase chain reaction (PCR) with sequence-specific primers (SSP).Hardy-Weinberg equilibrium was calculated using POPGENE software for the healthy control group. The HLA-Bfrequency of each allele was compared between the patients and the controls using the chi-square test. In HIV-1-pos-itive group, gene frequency of allele B * 4901 was significantly higher compared to the healthy control subjects (P=0.02, OR=3.06, 95%CI=1.16～8.10 forB*4901). In contrast, the gene frequency of B * 40 in healthy controlswas significantly higher than in the HIV-positive patients (P=0.02, OR=0.39, 95%CI=0.07～0. 92 for B* 40).In this study, HLA allele B * 4901 may be associated with increased susceptibility to HIV-1 infection, whereas the B* 40 allele may be associated with resistance to H HIV-1 infection.

Objective To explore the molecular mechanism of Gasdermin B(GSDMB)regulating the fate of intestinal epithelial cells.Methods The human GSDMB plasmid was overexpressed into two human intestinal epithelial cell lines(NCM460 and HT-29 cells)and human colon-derived organoids.Western blotting was used to confirm the efficiency of electroporation.Cell counting kit(CCK8),cell apoptosis,and cell cycle by flow cytometry were performed to analyze the effect of GSDMB overexpression on cell function.Transcriptome sequencing was used to analyze the downstream effector molecules of GSDMB.T test was used to compare the data between the two groups.Results The overexpression of GSDMB protein in the two intestinal epithelial cell lines was successfully reconstructed.The absorbance value(A)of human intestinal epithelial cells overexpressing GSDMB protein[NCM460 cells:(1.17±0.01),HT-29 cells:(0.96±0.06)]was significantly lower than that of blank control cells[NCM460 cells:(1.67±0.12),HT-29 cells:(1.24±0.07)](t=7.24 and 5.46,P＜0.05).The number of apoptotic cells in the GSDMB overexpression group[NCM460 cells:(12.03±1.55),HT-29 cells:(29.30±4.48)]was significantly higher than that in the blank group[NCM460 cells:(4.96±1.74),HT-29 cells:(6.95±3.42)](t=5.26 and 6.97,P＜0.05).Cell cycle analysis showed that the ratio of cells at G0/G1 phase in the GSDMB overexpression group[NCM460 cells:(47.98±5.28)％,HT-29 cells:(38.04±3.45)％]was significantly lower than that in the control group[NCM460 cells:(59.54±3.90)％,HT-29 cells:(63.81±1.76)％](t=3.05 and 11.53,P＜0.05).Transcriptome sequencing results showed that the dual specificity phosphatase 4 and 6(DUSP4 and DUSP6)genes were significantly upregulated after GSDMB protein expression.Fluorescence quantitative PCR results confirmed that the relative expression levels of DUSP4(2.45±0.15)and DUSP6(4.34±0.22)in intestinal epithelial cells transfected with GSDMB were significantly higher than those in the control group(1.06±0.05 and 1.01±0.02)(t=15.08 and 26.52,P＜0.05).After GSDMB-expressing NCM460 cells were treated with the DUSP inhibitor BCI,the BCI treatment group had a significantly increased expression level of p-ERK compared to the control group[(1.14±0.17)vs.(0.58±0.12)](t=5.42,P=0.002);the A value(1.84±0.07)and G0/G1 phase ratio(59.83±2.17)％in the BCI treatment group were significantly higher than those in the non-treatment group[(1.52±0.10)and(52.10±2.23)％],and the number of apoptosis in the BCI treated group(7.60±0.56)was significantly lower than that in the untreated group(12.57±1.00)(t=4.71,4.31,7.52,P＜0.05).TUNEL staining in human colon organoids showed a significant increase in apoptotic cells,and the relative expression level of DUSP6 protein(0.85±0.09)was significantly higher than that of the control group(0.21±0.04),accompanied by a decrease in p-ERK levels[(0.83±0.18)vs.(0.19±0.06)],with statistical significance(t=11.95,P＜0.001;t=6.56,P＜0.001).Conclusion GSDMB may inhibit cell proliferation,induce cell cycle arrest,and promote apoptosis by upregulating dual specificity phosphatase DUSP6-mediated ERK phosphorylation,thus affecting the fate of intestinal epithelial cells.

OBJECTIVETo evaluate the feasibility of the fibreoptic intubating laryngeal mask airway (LMA) CTrach (CTrach) in anticipated difficult airway caused by face and neck scar contracture.

METHODSTotally 33 patients undergoing selective face and neck scar plastic surgery and requiring general anesthesia were enrolled in our study. After anesthesia induction, the CTrach was inserted and the viewer was attached, which allowed fibreoptic visualization of the larynx before and during passage of the tracheal tube through the vocal cords. The duration and the success rates of CTrach insertion, tracheal intubation, and CTrach removal were recorded. The view of glottis on viewer and the adjusting maneuvers for improving the laryngeal view were recorded. Noninvasive blood pressures and heart rates were recorded before and after anesthesia induction and at CTrach insertion, tracheal intubation, and CTrach removal.

RESULTSThe CTrach was successfully inserted in all patients, among whom 4 patients succeeded at the second attempt. The full view of glottis were shown in 10 patients, while partial view and no view of glottis were shown in 8 and 15 patients, respectively. The good view of glottis was achieved by adjusting manoeuvres. Tracheal intubation via the CTrach was successful in 27 patients at the first attempt and in 6 patients at the second attempt. Hemodynamic changes during the performance with the CTrach were minimal.

CONCLUSIONSThe CTrach can be easily inserted, with clear view and high success rate of tracheal intubation. Therefore, it is an effective way to resolve difficulty intubation caused by face and neck scar contracture.

Adolescent ; Adult ; Cicatrix ; complications ; surgery ; Contracture ; etiology ; surgery ; Face ; Female ; Fiber Optic Technology ; methods ; Humans ; Intubation, Intratracheal ; instrumentation ; methods ; Laryngeal Masks ; Male ; Middle Aged ; Neck ; Young Adult

OBJECTIVETo observe the clinical effectiveness of inductions and tracheal intubating conditions with 3% sevoflurane and different doses of remifentanil without muscle relaxant in children.

METHODSTotally 120 peadiatric patients (aged 4-10 years, American Society of Anesthesiologists grade I for inhalational induction) were randomly allocated into group I (remifentanil 1 microg/kg), group II (remifentanil 2 microg/kg), group III (remifentanil 3 microg/kg), and control group (vecuronium bromide 0.1 mg/kg). After inhalational induction with 3% sevoflurane and 60% nitrous oxide in 40% oxygen for 2 minutes, remifentanil 1 microg/kg, 2 microg/ kg, and 3 microg/kg were intravenously injected over 1 minute into patients in group I , group II, and group III, respectively. After remifentanil administration and manual ventilation for 1 minute, the trachea was intubated. In the control group, 2 minutes after intravenous administration of vecuronium bromide 0.1 mg/kg, tracheal intubation was attempted. Agitation, intubating satisfactoriness, and the circulation changes after tracheal intubation and anesthesia induction were observed.

RESULTSIn these four groups, agitation occurred in 37.5% of patients during sevoflurane induction. Satisfactory intubation rate was 70.0% in group I, 86.7% in group II, 90.0% in group III, and 93.3% in the control group. Compared with the control group, the impact of tracheal intubation on the circulatory system was smaller in group I , II , and III.

CONCLUSIONSInduction with 3% sevoflurane combined with remifentanil can be smoothly performed, followed by the successful tracheal intubation. The intubating conditions are more satisfactory with 3% sevoflurane combined with remifentanil 2 microg/kg or 3 microg/kg.

Anesthesia, Inhalation ; Anesthetics, Inhalation ; administration & dosage ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Humans ; Intubation, Intratracheal ; adverse effects ; Male ; Methyl Ethers ; administration & dosage ; Piperidines ; administration & dosage

OBJECTIVETo investigate the clinical effects of manipulative reduction and percutaneous locking compression plate internal fixation for the treatment of mid-distal tibiofibula shaft fractures.

METHODSFrom January 2006 to October 2009,46 patients suffering from mid-distal tibiofibula shaft fractures were treated with closed manipulative reduction and LCP, involved 27 males and 19 females with an average age of 39 years old ranging from 17 to 56 years. According to AO classification, there were 12 cases of type A, 24 of type B, 10 of type C. The duration of visiting hospital were from 2 hours to 3 days after being injured for these patients. The injured limbs of the patients were swollen and painful,even with bony crepitus. The wound, function of the injured limb and union of fractures were observed after operation.

RESULTSAll the patients were followed up from 12 to 18 months (averaged 15 months). It was found that the wound of all patients had primary healing without any infection. The fracture healing time was 12 to 18 weeks (means 14 weeks). The results were excellent in 40 cases,good in 4 and fair in 2.

CONCLUSIONLess invasive, more stable fixation, shorter healing time and better functional rehabilitation are observed in the treatment of mid-distal tibiofibula shaft fractures after manipulative reduction and percutaneous locking compression plate internal fixation.

Adolescent ; Adult ; Aged ; Bone Plates ; Female ; Fibula ; diagnostic imaging ; injuries ; surgery ; Fracture Fixation, Internal ; instrumentation ; Fractures, Bone ; diagnostic imaging ; surgery ; therapy ; Humans ; Male ; Middle Aged ; Musculoskeletal Manipulations ; methods ; Tibia ; diagnostic imaging ; injuries ; surgery ; Tomography, X-Ray Computed ; Young Adult

OBJECTIVETo observe the safety and feasibility of tracheal intubation by target-controlled infusion of propofol and remifentanil without muscle relaxant in children.

METHODSTotally 100 4-10-year-old pediatric patients (ASA1) who had been scheduled for plastic surgery were equally divided into remifentanil group and control group through computer-generated randomized grouping. In all patients, five minutes after intravenous administration of atropine 0.01 mg/kg and midazolam 0.1 mg/kg, propofol was infused at the targeted effect-site concentration (Ce of 6 μg/ml. When the intended target Ce of propofol was reached, the remifentanil group began to be infused with remifentanil at a Ce of 5 ng/ml, and normal saline (0.1 ml/kg) was injected simultaneously. In the control group remifentanil was replaced by normal saline and rocuronium (0.8 mg/kg) was injected together with the normal saline. After the equilibration of plasma and the Ce of remifentanil were reached, tracheal intubation was attempted. The complications during the induction and tracheal intubation were recorded. The intubating conditions were assessed using a five-point scoring system based on ease of laryngoscopy, vocal cords position, coughing, jaw relaxation and limb movement.

RESULTSThe success rate of tracheal intubation was in 90% in remifentanil group and 98% in the control group (P=0.122).CONCLUSION Target-controlled infusion of propofol and remifentanil at Ce of 6 μg/ml and 5 ng/ml is feasible for the induction and tracheal intubation without muscle relaxant in children.

Child ; Child, Preschool ; Female ; Humans ; Infusions, Intravenous ; Intubation, Intratracheal ; Male ; Piperidines ; administration & dosage ; Propofol ; administration & dosage

Objective To evaluate the clinical value of neonatal peripheral blood smear spherical erythrocyte count in the diagnosis of ABO-HDN.Methods 165 cases clinically diagnosed with ABO-HDN in Zhongshan Boai Hospital from 2009 to 2015 were listed as the experimental group by retrospective analysis,68 cases of non-ABO-HDN were listed as control group.Besides,relevant clinical data and experimental examination were investigated,and the results of their hemolysis test were analysed.Results Peripheral blood smear spherical erythrocyte count were positive in 110 cases of 165 patients with ABO-HDN,the positive rate of spherical erythrocytes was 66.7 ％ (x2 =58.069,P＜ 0.05).The spherical erythrocyte positive rates were 68.8 ％,60.5 ％ and 66.7 ％ in patients aged ≤2d,3 ～4d,≥5d respectively.The diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7 ％,the specificity was 88.2 ％,the positive predictive value was 93.2 ％,and negative predictive value was 52.2 ％.When spherical erythrocyte count positive point was set as ≥5 ％ spherical erythrocytes,the diagnostic sensitivity of spherical erythrocytes to ABO-HDN was 66.7％ and the specificity was 88.2％.If the positive point was set as ≥10％ spherical erythrocytes,the sensitivity of ABO-HDN decreases to 9.3％,and the specificity reaches 98.5 ％.In ABO-HDN group,the levels of nucleated red blood cell,RDW and Ret were higher,along with the lower level of hemoglobin compared with non-ABO-HDN group (all P＜0.05).Conclusion The peripheral blood smear spherical erythrocyte count had a high sensitivity and specificity for the diagnosis of ABOHDN.Combined with jaundice,anemia and RDW,peripheral blood smear spherical erythrocyte count can provide guidance for the early diagnosis,prevention and treatment of ABO-HDN.

Objective To investigate the expression of long-chain non-coding RNA gastric cancer high expression transcription factor 1 (GHET1) in hepatocellular carcinoma (HCC) and the correlation with prognosis,cell proliferation,migration and invasion.Methods 20 HCC patients who underwent surgery from Fuzhou General Hospital of Chinese People's Liberation Army from March to May 2016 were included.The HCC tissue and adjacent normal tissue of 182 patients from June 2012 to December 2013 were retrospectively collected.According to the median value of GHET1 expression,it was divided into GHET1 high expression group and low expression group,91 cases each.Huh7 and HepG2 cells were divided into:blank control group (Con) with serum-free medium,siRNA-GHET1 group transfected with siRNA-GHET1,and negative control group (siRNA-NC) transfected with negative control sequence.The expression of GHET1 was detected by real-time fluorescence quantitative polymerase chain reaction,and the effect of GHET1 on HCC cells was analyzed by CCK-8,Transwell assay and Western blot.Results Compared with adjacent normal tissue,the relative expression of GHET1 mRNA in HCC tissues was significantly increased.Compared with LO2 cells,the mRNA expression of GHET1 in Huh7 and HepG2 cells was higher (P＜0.05).The GHET1 high expression group had tumor＞5 cm,vascular invasion,AFP＞400 μg/L,Edmonson grade Ⅰ,and the tumor-free ratio was lower in the expression group (P＜0.05).Survival analysis showed that HCC patients with high GHET1 expression had a poorer prognosis than patients with low expression.Multivariate Cox regression analysis showed that high expressed GHET1,vascular invasion (HR=2.067,95％ CI:1.350 to 3.162),and without tumor capsule are independent predictors of recurrence in HCC patients.After transfection with Huh7 and HepG2 cells,the proliferation of siRNA-GHET1 group was significantly decreased comparing with Con and siRNA-NC groups.Compared with siRNA-NC group,the migration and invasion ability of siRNA-GHET1 group decreased,and E-cadherin expression increased.The expression of fibronectin and vimentin decreased,and the difference was statistically significant (P＜0.05).Conclusions The expression of GHET1 in HCC tissue is higher comparing with normal tissue,which increases the proliferation,migration and invasion of hepatoma cells.It is an independent predictor of prognosis in HCC patients and a potential target for clinical treatment.