Objective To observe clinical application of the apparent Shikani laryngoscope in difficult airway, so as to provide reference for basic-level hospitals to deal with difficult airway. Methods 50 patients with difficult airway were randomly divided into 2 groups:Shikani laryngoscope group (S) that direct laryngoscope group (M) . After conventional induction, patients in two groups were given endotracheal intubation with different intubation tools by the same anesthesiologist, then the intubation time and the one-time success rate of intubation were compared between two groups. The hemodynamics of patients, were observed in two groups,the HR,SBP,DBP and SPO2 at before (T0),during (T1),2 min after (T2) and 5 min after intubation (T3) were recorded. The complications including gingival and oral mucosa bleeding, sore throat, hoarseness were also recorded in two groups.Results During the process of intubation, the hemodynamic changes of patients had statistically significant difference between T0 and T1, T2,T3 subgroups ( <0.05),T2 and T3 subgroups ( <0.05) . The intubation had less influence on hemodynamics of patients in group S than M group,but the SPO2 and T0 had no significant difference between two groups ( >0.05) .Comared with M group,the one-time success rate of intubation was higher,and the intubation time was shorter in S group and there were significant differences ( <0.05) . There was no significant difference in the intubation complications between the two groups ( > 0.05), and this may be associated with small sample cases. Conclusion Compared with ordinary laryngoscope, Shikani laryngoscope has incomparable advantages in handling difficult airway and is convenient to apply,so it is worth popularizing in basic-level hospitals.

Objective To evaluate the reliability of PainVision method for assessment of postoperative pain in patients undergoing gynaecological laparoscopy.Methods Twenty ASA physical status Ⅰ-Ⅱ patients,aged 30-45 yr,undergoing gynaecological laparoscopy under fentanyl-propofol-cisatracurium anesthesia,were studied.Pain intensity was simultaneously assessed using PainVision method and visual analog scale (VAS) at 12,24 and 48 h after surgery.PainVision was a new method for quantitative measurement of pain intensity using a painless electrical stimulation (PainVision PS-2100 device).Pain degree was calculated from two parameters,current perception threshold and pain compatible electrical current by using PainVision.The former parameter was defined by the lowest electrical current detected ; the latter parameter defined by the electrical current judged as being compatible with the intensity of ongoing pain.Results There was a significant positive correlation between pain degree calculated by PainVision method and VAS scores,and the correlation coefficient was 0.902 (P ＜ 0.01).Conclusion PainVision method can be applied for assessment of postoperative pain in patients undergoing gynaecological laparoscopy.

Adult ; Case-Control Studies ; Comet Assay ; DNA Mutational Analysis ; Female ; Humans ; Male ; Micronucleus Tests ; Middle Aged ; Occupational Exposure ; Vincristine

Objective:To summarize the clinical features, genetic testing and treatment efficacy of 6 children with Dent disease.Methods:Six children diagnosed with Dent disease in Guangzhou Women and Children′s Medical Center from January 2014 to March 2019 were enrolled.Their medical history, clinical manifestations, laboratory results, genetic test results, and proteinuria level, calciuria level and renal function after medication were measured.Results:All patients were male, with the onset age ranged from 1 to 9 years old.They were followed up for 6 months to 4 years.All the children had low molecular weight proteinuria.Urine protein electrophoresis showed that the ratio of low molecular weight proteinuria in only 2 cases was more than 50%.Renal biopsy suggested that all cases were combined with glomerular lesions.Five cases had hypercalciuria.Under the microscope, there were 5 cases of hematuria.Two case had rickets, and there was no renal calcium deposition and hypophosphatemia.Five cases were detected with CLCN5 mutations, of which p. C160Yfs*49 and p. G523D were first reported.One case had an OCRL1 mutation.Patients were treated with Hydrochlorothiazide and angiotensin converting enzyme inhibitor (ACEI). The 24 h urinary calcium level after treatment was lower than that before treatment [0.40 (0.24, 0.43) mmol/kg vs.0.12 (0.11, 0.14) mmol/kg, U=2.00, P<0.01]. However, there was no significant decrease in the 24 h-urinary protein level before and after treatment [77.09 (62.41, 88.01) mg/kg vs.80.33 (66.03, 92.52) mg/kg, U=12.00, P>0.05]. Conclusions:Dent disease is mainly characterized by low molecular weight proteinuria, and some patients may not be associated with hypercalciuria.Gene tests help to identify the disease type.ACEI and Hydrochlorothiazide can reduce the urinary calcium level, but cannot improve the level of urinary protein.

Objective To investigate the clinical,endoscopic and pathologic features in the differential diagnosis between Crohn' s disease (CD) and intestinal tuberculosis (ITB).Methods The complete clinical data of 107 patients with CD and 69 patients with ITB in our hospital from January 2011 to January 2012 were retrospectively analyzed.The diagnostic value of the clinical and endoscopic scoring system was evaluated.Results CD occurred mainly in male.The salient features of CD included long duration of disease high incidence of colectomy.Comparing with patients with ITB,patients with CD have more cases of diarrhea,hematochezia,abdominal mass,intestinal obstruction,intestinal hemorrhage,perianal lesions,and extraintestinal manifestations (all P ＜ 0.05).It's more frequent to have positive results of anti-Saccharomyces cerevisiae antibody (ASCA),perinuclear antineutrophil cytoplasmic antibody (pANCA) and fecal occult blood in CD patients,as well as low albumin,high C-reactive protein (CRP),elevated platelet count and hematocrit (P ＜ 0.05 or P ＜ 0.01).The salient features of ITB included low fever,night sweats,active parenteral tuberculosis,increased erythrocyte sedimentation rate (ESR),chest X-ray abnormalities,the positive PPD (purified protein derivatives tuberculin) and T-SPOT (P ＜ 0.05 or P ＜0.01).Based on the imaging,CD often involved the small intestine,such as the intestinal stricture and abdominal abscess (P ＜ 0.05),while mesenteric lymphadenopathy was more common in ITB (P ＜ 0.05).The endoscopic examination showed that some patterns of disease involvement such as fissure-shape ulcer [41.12％ (44/107) vs 5.80％ (4/69)],cobblestone sign [15.89％ (17/107) vs 4.35％ (3/69)],lesions over four segment [24.30％ (26/107) vs 7.25％ (5/69)],rectum involvement [17.76％ (19/107) vs 5.80％ (4/69)],ileocecal valve stenosis [21.50％ (23/107) vs 8.70％ (6/69)] and mucosal bridge [5.61％ (6/107) vs 0(0/69)] were more frequent in CD patients than those in ITB patients(P ＜ 0.01 or P ＜0.05).However circular ulcers[37.68％ (26/69) vs 9.35％ (10/107)],rat-bite-like ulcers[24.64％ (17/69) vs 12.15％ (13/107)],persistent open ileocecal valves [39.13％ (27/69) vs 19.63％ (21/107)],tuberous and polypoid lesions [36.23％ (25/69) vs 20.56％ (22/107),37.68％ (26/69) vs 22.43％ (24/107)] were more common in ITB (P ＜ 0.01 or P ＜ 0.05).In terms of pathological findings,certain characteristic features such as transmural inflammation [5.61％ (6/107) vs 0 (0/69)],fissure-liked ulcers [14.02％ (15/107) vs 4.35％ (3/69)],non-caseous granulomas [5.61％ (6/107) vs 0(0/69)],lymphoid hyperplasia [16.82％ (18/107) vs 5.80％ (4/69)] and crypt abscess [9.35％ (10/107) vs 1.45％ (1/69)] were more common in CD than those in ITB(P ＜ 0.05).According to the clinical and endoscopic scoring system,the positive diagnostic rate of CD was 50.47 ％ (54/107)and of ITB was 66.67 ％ (46/69) (P ＜ 0.05).Conclusions The differential diagnosis between CD and ITB should be considered carefully based on clinical,endoscopic,pathological characteristics.The clinical and endoscopic scoring system may contribute to distinguish CD and ITB.

OBJECTIVETo study the effect of phenformin hydrochloride that may be illegally added in traditional Chinese medicine preparations on the pharmacokinetics of puerarin in rats.

METHODRats were randomly divided into the single pueraria group and the phenformin hydrochloride combined with pueraria group. After oral administration in the two groups, their bloods were sampled at different time points to determine the drug concentration of puerarin in rat blood and calculate pharmacokinetic parameters.

RESULTAfter oral administration with pueraria extracts and phenformin hydrochloride combined with pueraria extracts, the two groups showed main pharmacokinetic parameters as follows: Cmax were (2.39 +/- 1.01), (1.03 +/- 0.35) mg x L(-1), respectively; Tmax were (0.50 +/- 0.09), (1.5 +/- 0.5) h, respectively; Ke were (0.153 +/- 0.028), (0.172 +/- 0.042) h(-1), respectively; t(1/2) were (4.65 +/- 0.86), (4.20 +/- 0.81) h, respectively; AUC(0-t), were (5.73 +/- 2.60), (5.45 +/- 1.81) mg x h x L(-1), respectively; AUC(0-infinity) were (6.72 +/- 2.89), (6.26 +/- 1.88) mg x h x L(-1), respectively. Compared with the single puerarin group, the Cmax was significantly decreased (P < 0.05) and the Tmax was markedly longer (P < 0.01) than the hydrochloride combined with pueraria group.

CONCLUSIONPhenformin hydrochloride can slow down the absorption process of puerarin and change the pharmacokinetic process of puerarin to some extent.

Administration, Oral ; Animals ; Drug Interactions ; Hypoglycemic Agents ; administration & dosage ; pharmacology ; Isoflavones ; administration & dosage ; pharmacokinetics ; Male ; Phenformin ; administration & dosage ; pharmacology ; Rats ; Rats, Wistar ; Vasodilator Agents ; administration & dosage ; pharmacokinetics

OBJECTIVETo study the changes of the amplitude-integrated electroencephalography (aEEG) tracings within 6 hours after birth in term infants with hypoxic-ischemic encephalopathy (HIE) and explore the value of aEEG in early diagnosis and prediction of neurological outcome in term infants.

METHODSFrom May 2003 to February 2005, 33 term infants with HIE at the Division of Neonatology, Pediatric Hospital of Fudan University were studied by aEEG within 6 hours after birth. The results of aEEG were categorized into three groups (normal, mildly abnormal and severely abnormal aEEG), while HIE was clinically classified into three grades (mild, moderate and severe) and the neurological outcomes at 18 months were assessed (normal, disabled and dead). The correlation between the results of aEEG, severity of HIE and neurological outcome at 18 months were analyzed, respectively. The values of aEEG on early diagnosis and neurological outcome prediction of HIE were analyzed.

RESULTSAmong the 33 term infants with HIE, 20 infants had normal aEEG (normal amplitude aEEG), 5 had mildly abnormal aEEG (4 with mildly abnormal amplitude aEEG, 1 with normal amplitude and seizure) and 8 had severely abnormal aEEG (2 with mildly abnormal aEEG and seizures, 4 with severely abnormal amplitude and 2 with severely abnormal amplitude and seizures), respectively. Seventeen infants (51.5%) had mild HIE, 19 moderate (27.3%) and 7 (21.2%) severe HIE, respectively. Twenty-five cases were followed up, which showed that 19 had normal neurological outcome, 1 had disability and 5 died. By CMH square analysis and Spearman rank correlation analysis, the results of aEEG classification were correlated with the severity of HIE and the neurological outcome of term infants. Abnormal aEEG could predict the severity of HIE in term infants with a sensitivity of 100%, specificity of 81.3%, positive predictive value of 85.0% and negative predictive value of 100%, respectively. Abnormal aEEG could predict the neurological outcome of term infants with HIE, which showed a sensitivity of 100%, specificity of 90.9%, positive predictive value of 93.3% and negative predictive value of 100%, respectively. Severely abnormal aEEG could predict the severe HIE in term infants with sensitivity of 96.2%, specificity of 100%, positive predictive value of 100% and negative predictive value of 87.5%, respectively. Severely abnormal aEEG could predict the neurological outcome of term infants with HIE, which showed sensitivity of 94.7%, specificity of 100%, positive predictive value of 100% and negative predictive value of 85.7%, respectively.

CONCLUSIONSMonitoring with aEEG in term infants with HIE within 6 hours after birth could predict the severity of HIE and its neurological outcome at 18 months.

Early Diagnosis ; Electroencephalography ; methods ; Female ; Follow-Up Studies ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; Infant ; Infant, Newborn ; Male ; Predictive Value of Tests ; Prognosis ; Sensitivity and Specificity ; Severity of Illness Index ; Term Birth

AIM: To investigate the expression of extracellular matrix metalloproteinase inducer(EMMPRIN) and endothelin converting enzymes(ECE) in non-small-cell lung carcinoma(NSCLC),and their relationship with lymphoid metastasis and prognosis.METHODS: Expression of EMMPRIN and ECE in 77 cases of patients with NSCLC was detected immunohistochemically.The relationship of the expression of EMMPRIN and ECE with tumor size,histological type,differentiation,lymphoid metastasis,clinical stage,and prognosis were analyzed.RESULTS: The expressive rate of EMMPRIN and ECE was 66% and 45%, respectively.The expression of EMMPRIN and ECE was associated positively with lymphoid metastasis(both P0.05).The expression of EMMPRIN was associated with the expression of HGF in NSCLC(P

Objective: To explore the effect of persistent atrial ifbrillation (AF) on circadian rhythm of blood pressure (BP) in patients with essential hypertension (EH).
Methods: A total of 173 EH patients treated in Gansu Provincial Hospital from 2013-02 to 2014-01were studied. The patients were divided into 2 groups: EH group,n=88 and Persistent AF combining EH group,n=85. The baseline information was studied and the risk factors of persistent AF combining EH were investigated by multivariate logistic regression analysis.
Results: Compared with EH group, the Persistent AF combining EH group showed decreased average daytime DBP, minimum daytime SBP, minimum daytime DBP and the average 24-hour DBP, while increased maximum nighttime SBP and the percentage of reverse dipper in DBP, allP<0.05. There were no significant differences for the average of daytime SBP, maximum daytime SBP, maximum daytime DBP, the average 24-hour SBP, average nighttime SBP, average nighttime DBP, maximum nighttime DBP, minimum nighttime SBP, minimum nighttime DBP and the percentage of reverse dipper in SBP between 2 groups, allP>0.05. Multivariate logistic regression analysis indicated that the maximum nighttime SBP was obviously related to persistent AF combining EH (OR=1.038, 95 CI 1.014-1.062,P=0.001).
Conclusion: Persistent AF may incur daytime BP dropping, such change was not obviously observed for nighttime BP in EH patients.

Objective There have been a few reports on chronically recurrent and generalized superficial mycosis caused by trichophyton rubrum.This article was to investigate the cause, diagnosis and therapy of the mycosis. Methods 5 patients with chron-ically recurrent and generalized superficial mycosis caused by trichophyton rubrum were collected from June 2012 to June 2014 in our hospital.Bacterioscopic examination and cultivation were made on skin lesions of the patients.A typical patient who had 7-year course of desease with toenails seriously infected and widespread skin eruption was selected for histopathology examination on skin lesions, mi-crobiology and molecular biology study on 4 bacterial strains isolated from skin lesions in different parts, and in vitro chemosensitivity assay for drug selection.PCR (rDNA ITS sequence analysis) was performed for diagnosis and early treatment. Results Microscopic examintion on skin lesions demonstrated numerous septate, branched hyphae.Cultivation and molecular biology study identified tricho-phyton rubrum.The strain was identified as trichophyton rubrum by ITS sequence analysis and the isolated strains from different lesions were the same fungal species.Histopathology examination revealed slight hyperplasia of squamous epithelium , epidermal hyperkeratini-zation and the upper dermis presented a sparse perivascular lymphocytic infiltrate.The PAS-stain confirmed the presence of few hyphae in the horny layer.The pathogen of this case was trichophyton rubrum. A combination therapy with systemic itraconazole and topically applied terbinafine hydrochloride cream was successful.A follow-up examina-tion one year later showed no recurrence of symptoms. Conclusion The isolation and identification of pathogen is the key to the diagnosis of chronically recurrent and generalized superficial mycosis, with ad-ditional attention to all or none toenail infection.The therapy should not focus simply on the tinea corporis, while comprehensive treatment combined with chemosensitivity assay is preferred.