Objective The existing laryngoscope can not be used to observe the ultrastructure of cells.As a result,doctors always have to conduct biopsies on some patients who can not be diagnosed.The timeconsuming procedure of biopsy may be detrimental to the timely diagnosis and treatment.To solve this problem,we aimed to design the integrative confocal-microscopic hard laryngoscope system (ICMHL).Methods ICMHL system integrated the technique of existing laryngoscope and confocal microscopy,which allows doctors to observe the macrostructure and microstructure of lesions at the same time. Results With the effect of fluorescein sodium,ICMHL system could record the dynamic changes of cells at a rate of 30 fps,and the confocal-microscopic host machine could photograph images at a rate of 230 fps and diagnose invisible minute lesions.Conclusion ICMHL system provides a new,real-time approach for clinic biopsy.

Objective To compare the influences of combined spinal-epidural anesthesia(CSEA)and general anesthesia(GA)on patients who underwent laparoscopic gynecological operation.Methods A total of 60 patients of ASA Ⅰ～Ⅱ,were divided into two groups:the CSEA group and the general anesthesia group.Each group consisted of 30 patients.Glucose and cortisol levels were determined before anesthesia,10 minutes after anesthesia,10 minutes after pneumoperironeum and 10 minutes after abdominal deflation.Results No significant differences existed between the two groups on age,weight,operation time,pneumoperitoneum time,time to regain consciousness after operation,HR,SpO2,ECG and MABP(P＞0.05)No significant difference was found in cortisol level between two groups at various time points(P＞0.05).In the general anesthesia group,glucose level at 10 minutes after pneumoperitoneum was significantly lower than that before anesthesia(P＜0.05),but no significant difference was found in glucose level between the two groups at other time points(P＞0 05).At the same time,significant difference was found in postoperative complication rate between two groups(P＜0.01).Conclusion Both CSEA and general anesthesia can effectively inhibit the patients'stress response in laparoscopic gynecological operation.

Objective Through analyzing nursing course-teaching plans of 10 representative higher vocational colleges,to realize advantages of the curriculum implementation and contents to be improved from the practical teaching perspective,to review the application of China's educational objectives as well as to provide the reasonable choice and practical support for deepened teaching reforms.Methods Statistical models were employed in analyzing 10 colleges' class hours and course composition.The results were compared with relative guidance documents in national scope.Results All 10 colleges' practical teaching relevant indicators exceeded the national criteria in running higher vocational colleges,but deviations were appeared in response of the national guidance of the nursing education,especially in clinical clerkship.Conclusions The quality guarantee of nursing course-teaching should be improved.A national policy should be implemented to combine the professional education accreditation with the nursing practitioner admittance,apply the minimum professional education standards to achieve the educational quality guarantee and guidance in each level.

Objective:To observe the changes of salivary Lysozyme (LZM),immunoglobulin A (IgA),lactate dehydrogenase (LDH),mean grey values (MGVs)of hard tissue of teeth and caries index(CSI)in patients after oral administration of glucocorticoid (GC).Methods:30 patients with oral administration of GC were included.The mixed saliva samples before and after 6 and 12 months of GC treatment were collected.LZMand IgA and LDH were examined.Surface layer panaorama films were taken and MGVs of hard tissue of teeth were measured.The decayed,missing and filled tooth(DMFT),decayed,missing and filled surface (DMFS), CSI were recorded.The same indexes were obtained from 30 age and gender matched healthy subjects as the control data.All statisti-cal analyses were performed using SPSS 17.0 software package.Results:After taking GC orally,the concentration of LZM,IgA and MGVs of hard tissue of teeth in the patients were lower than those in the controls(P <0.05),the LDH concentration,DMFT,DMFS and CSI in the patients were increased(P <0.05).In the patients the MGVs of hard tissue of teeth was negatively correlated with DM-FT,DMFS and CSI(P <0.01),LDH concentration was positively correlated with CSI(P <0.01),the concentration of LZMand IgA were negatively correlated with CSI(P <0.05).No change of the indexes was found in the controls.Conclusion:Oral administration of GC may increase DMFT,DMFS and CSI,decrease MGVs of hard tissue of teeth significantly reduce,the patients may be under higher risk of caries.

Objective To evaluate the effect of electroacupuncture on postoperative cognitive func?tion in elderly patients undergoing carotid endarterectomy. Methods Fifty patients of both sexes, aged≥65 yr, of American Society of Anesthesiologists physical status Ⅱ orⅢ, with the educational level≥ the level of primary school, scheduled for elective unilateral carotid endarterectomy, were divided into 2 groups ( n=25 each) using a random number table: control group ( group C) and electroacupuncture group ( group EA). In group EA, electroacupuncture (frequency 2∕100 Hz, intensity 5-12 mA) of Baihui (GV20), Neiguan (PC6) and Zusanli (ST36) was performed throughout surgery starting from 30 min before opera?tion, and then general anesthesia was performed. General anesthesia was performed directly in group C. Before operation ( T0 ) , at the end of operation ( T1 ) and at 24 h after operation ( T2 ) , blood samples were collected from the internal jugular vein for determination of plasma S?100βprotein, tumor necrosis factor?αand brain?derived neurotrophic factor ( BDNF) concentrations by enzyme?linked immunosorbent assay. The cognitive function was assessed using Montreal Cognitive Assessment at T0,2 and at 3 and 7 days after opera?tion ( T3,4 ) . Results Compared with group C, the Montreal Cognitive Assessment scores were significantly increased at T2?4 , the plasma S?100β protein and tumor necrosis factor?α concentrations were significantly decreased at T1,2 , and the plasma BDNF concentrations were significantly increased at T2 in group EA ( P<0?05) . Conclusion Electroacupuncture can improve postoperative cognitive function in the elderly pa?tients undergoing carotid endarterectomy, which may be related to inhibition of inflammatory responses,
promotion of BDNF production and reduction of brain injury.

Objective To understand the cleaning status of hospital environment,and evaluate the effect of fluo-rescence labeling method plus feedback and training on hospital environmental cleaning effectiveness.Methods A total of 27 departments in a hospital were investigated,1 cleaning staff and 2 inpatients were selected from each de-partment,cleaning staff’s knowledge about cleaning and disinfection of environmental object surfaces,as well as cleaning status of inpatients’wards were surveyed,cleaning efficacy of hospital environmental object surfaces were detected with fluorescence labeling method,the surveyed results were performed timely feedback to clinical depart-ments,training on cleaning and disinfection knowledge was conducted,the effective cleaning rate of environmental object surface before and after the training was compared.Results A total of 27 cleaning staff were surveyed,the correct response rate for cleaning frequency was 96.30% ,awareness rate for section concept was 96.30% ,accuracy rate of cleaning order was 92.59% ,accuracy rate of post-cleaning immersion time of sanitary wares in disinfectant was 85.19% ,accuracy rates of replacing,drying,and repeated immersing wiping cloths were 81.48% ,48.15% ,and 25.93% respectively,rates of correct disinfectant formulating method and mop drying time were both 0. Among 54 investigated patients,bed units and ground of wards of 28 patients were cleaned both 1-2 times/day;bed units of 8 patients had never been wiped,18 patients in 9 departments cannot be conducted statistics due to completely in-consistent responses with the other patients of the same departments. The effective cleaning rates of environmental object surfaces before and after the training were 34.62% and 64.96% respectively,difference was significant(χ2=21.81,P<0.01).Conclusion Fluorescence labeling method plus feedback and training can improve cleaning efficacy of hospital environmental object surfaces.

Objective To study the protective effect of δ-opioid receptor agonist DADLE Oil hypoxia-in-duced injury of rat cortical neuronfl.Method Cortical neuron,q cultured for 8,lays were assessed by MAP2 im-munofluorescenee and randonly divided into hypoxia group(n=6),and DADLE preconditioning plus hypoxia group(n=6),normoxia group(n=6),and DADLE preconditioning plus normoxia group(n=6).The cells in hyoo O'oup Were cultured in a hyooxic incubator containing I%02,5%c02,and 94%N2 at 37℃.The cens in DADLE preconditioning groups Wel'preconditioned with 10 ttmol/L DADLE before culture.The cells in normoxia group were cultured in an incubator COntaining95%air and 5%c02 at 37℃.The survival rate ofneu.rOllS cultured for 72 hours was analyzed with hochest-33258 staining,and lactate dehydrogenase(LDH)release Wills detected.Glucose in the culture medium was detected to assess glucose/energy metabolism.The data of LDH re.1ease and ducose level were analyzed by A.NOVA.and cell survival rates wG:qanalyzed by Chi-square Tests.Re.vtats When cortical neurons were cultured for 8 davs,95%the cells were cortical neurous as assayed by MAP2 immunofluorescence·Cell survival rate was significantly higher in DADLE preconditioning Cus hypoxia group than in hypoxia group[(71.88±1.77)%vs.(43.58±3.07)%(P<0.05)].LDH release was significantly lower in DADLE preconditioning plus hypoxh group than in hypoxgroup[(3824.27±294.86)vs.(4516.59±605.02),P<0.05].Glucose level in the culture medium was significantly higher in DADLE preconditioning plus hypoxia group than in hypoxia group[(11.92-4-2.05)mmol/L vs.(9.88±0.71)mmol/L,P<0.051.Conclusions 6-opioid receptor agonist DADLE Can protect rat cortical neurons from hypoxia injury, which might be the mechanism of reducing glucose/energy metabolism in cortical neurons during the period of hypoxia.

Objective To investigate the effect of heart preservation solution containing pinacidil on mitochondrial function in isolated rat hearts. Methods One hundred and twenty pathogen-free SD rats of both sexes weighing 250-350 g were used in this study. The animals were anesthetized with intraperitoneal pentobarbital 65 mg/kg. Their hearts were immediately removed and perfused in a Langendorff apparatus. Left ventricular enddiastolic pressure was measured from a fluid-filled latex balloon inserted in the left ventricle. The isolated hearts were randomized into 5 groups (n = 24 each):group Ⅰ was perfused with cardioplegic solution HTK; group Ⅱ with HTK containing pinacidil (a non-specific sarcKATP and mitoKATP channel opener) 0.5 mmol/L; group Ⅲ with HTK containing pinacidil 0.5 mmol/L + 5-HD (a selective mitoKATP channel blocker) 100 μmol/L; group Ⅳ with HTK containing pinacidil 0.5 mmol/L + HMR-1098 100 μmol/L (a selective sarcKATP channel blocker) and group Ⅴ with HTK containing pinacidil 0.5 mmol/L + 5-HD 100 μmol/L + HMR-1098 100μmol/L. The isolated hearts were perfused with simple HTK or HTK containing pinacidil or pinacidil + 5-HD and/or HMR 20 ml/kg at 10 ml/min and then removed from Langendorff apparatus and dipped into the same HTK solution for 8 h at 4 ℃followed by 60 min reperfusion. The respiratory function of mitochondria (respiratory control rate (RCR), the rate of oxygen consumption in state 3/state 4 and P/O) was measured at the end of equilibration (T1) after 8 hpreservation (T2) and at the end of 60 min reperfusion (T3). The CK-MB and LDH activities and cTnI expression in myocardium was detected at T1 and T3. The ultrastructure of myocardium was examined at T3. Results Perfusion suspension-reperfusion (PS/R) significantly decreased mitochondrial respiratory function (RCR, P/O and rate of O2 consumption in state 3) and increased myocardial cTnI concentration and CK-MB and LDH activities at T3 compared with baseline at T1 in group Ⅰ. Pinacidil significantly increased mitochondrial respiratory function (RCR, P/O and rate of O2 consumption in state 3) and decreased myocardial cTnI concentration and CK-MB and LDH activities in group Ⅱ as compared with group Ⅰ-indicative of protective effect of pinacidil on mitochondria against PS/R injury. The protective effect of pinacidil against PS/R injury was attenuated by 5-HD and/or HMR1098. The myocardial damage was slightest in group Ⅱ . Conclusion Both sarcolemmal and mitochondrial KATPchannel are involved in the protective effect of pinacidil against PS/R-induced myocardial damage during heart preservation.

Objective To explore the effect of erythropoietin (EPO) on cognition and neuron apoptosis in CA1 region of hippocampus in vascular dementia (VaD) rats.Methods 54 Wistar rats were randomly divided into three groups:sham control group,VaD group,VaD+ EPO group (n=18,each).The bilateral common carotid arteries of Wistar rats were permanently ligated to establish VaD models.Spatial study and memory were observed by Y maze test at 4,8 and 12 weeks after operation.Neuron apoptosis in CA1 area of hippocampus was measured by terminal deoxynucleotidyl-transferase (TdT) mediated dUTP-biotin nick end labeling (TUNEL) method.The protein and mRNA expressions of Bcl 2 and Bax in CA1 region of hippocampus were detected by immunohistochemistry and RT-PCR at 4,8,12 weeks after operation.Results Compared with VaD group,the VaD+ EPO group had better performances including less error reaction times and shorter total reaction time in Y-maze (both P＜0.05) at 4,8,12 weeks after operation.The apoptotic neuronal cells in CA1 region of hippocampus was decreased in VaD+ EPO group than in VaD group at 4,8,12 weeks after operation [(10.50±±2.43) vs.(20.50±± 3.29),(23.92±±3.18) vs.(33.58±3.48) and (36.92±4.10) vs.(54.17±4.26),t=4.23,3.54,5.05,P=0.013,0.024,0.007,respectively].The Bcl-2-positive cells and Bcl-2 mRNA expression were increased,and the Baxpositive cells and Bax mRNA expression were decreased in VaD+ EPO group than in VaD group (all P ＜0.05).Conclusions Erythropoietin can improve cognitive function by inhibiting neuron apoptosis through regulation of Bcl-2 and Bax expression in CA1 region of hippocampus.

Objective To investigate the diagnostic value and the efficacy of magnetic resonance tomographic angiography(MRTA) in identifying the relationship between nerves and blood vessels of the patients with idiopathic trigeminal neuralgia.Methods Clinical and MR data of 280 ITN patients were analyzed retrospectively,and then were compared with operation results by using blind con-trol trials.Results Of the 280 ITN patients,there were a total of 267 patients with neurovascular contact,dubious contact or com-pression in affected sides (positive rate:95.3%),and 66 patients in normal sides (false positive rate:23.6%).And of 120 surgical patients,1 18 were found to have neurovascular contact or compression during the operation.There was significant statistical differ-ence between the neurovascular contact or compression in affected sides and that in normal sides (P <0.05).Using operation results as the gold standard,the specificity,sensitivity and the diagnostic accordance rate of MRTA in diagnosing neurovascular contact or compression were 100%,96.6% and 96.7% respectively.Conclusion MRTA can reliably display the relationship between nerves and blood vessels with higher diagnostic sensitivity and accuracy,thus providing the objective basis for the etiological diagnosis of and surgical treatment for ITN.