Objective To evaluate the value of ultrasound-guided nasotracheal intubation in the patients undergoing oral maxillofacial surgery by comparing with blind intubation.Methods Forty ASA physical status Ⅰ or Ⅱ patients of both sexes,aged 18-75 yr,weighing 45-90 kg,scheduled for elective oral maxillofacial surgery,were randomly divided into blind intubation group (group B,n =20) and ultrasound group (group U,n =20) according to a random number table.Nasotracheal intubation was performed after routine topical analgesia and conscious sedation.The front end of catheter was adjusted to the aditus glottidis according to the sound of respiratory air,and tracheal intubation was placed when the strongest inspiratory phase appeared in group B.A linear array probe (frequency 7-15 MHz) was used,and the images of glottis expansion and wired catheter insertion were visualized in the thyroid cartilage window in U group.Before intubation and at 0,1,3 and 5 min after successful intubation,mean arterial pressure (MAP),HR and SpO2 were recorded.The development of responses to intubation was recorded during intubation.The successful intubation at first attempt,the number of intubation,intubation time,and postoperative complications such as sore throat or hoarseness were recorded.Results Compared with group B,the number of intubation was significantly reduced,intubation time was shortened,the rate of successful intubation at first attempt was increased,the failure rate of intubation and incidence of sore throat and hoarseness were decreased,and no significant changes were found in the parameters of hemodynamics and incidence of responses to intubation in group U.No intraoperative awareness of intubation occurred in patients.Conclusion Compared with blind intubation,ultrasound-guided nasotracheal intubation can raise the probability of successful intubation at first attempt,reduce the number of intubation,and shorten intubation time,and it is safe and convenient and provides significant value clinically for the patients undergoing oral maxillofacial surgery.

lusions Cardiac MSCT can accurately assess the RV size and function in comparison to MRI. Patients with severe COPD have RV dysfunction.

Objective To prospectively assess right ventricular dysfunction and the metergasis before and after therapy of thrombolysis with ECG gated multi-detector spiral computed tomography (MSCT)in patients with acute pulmonary embolism. Methods Triple rule-out ECG gated MSCT examination was performed in 96 consecutive patients suspected of PE. 25 patients with central PE were confirmed. 25 agematched subjects without cardiac and pulmonary disease were recruited as control group. Triple rule-out ECG gated MSCT were performed again to assess cardiac function after therapy of thrombolysis. Dimension ratios for the right ventricle (RV) and left ventricle ( LV), main pulmonary artery and aorta were measured.Furthermore, the RV and LV end-diastolic volumes (EDV), end-systolic volume (ESV) and ejection fraction (EF) were also measured. The mean values were compared with analysis of variance (ANOVA) and Newman-Keuls test before and after thrombolysis. Results The mean values of RVEDV, RVESV, RVEF,RV/LV ESV volume ratio, RV/LV dimension ratio and main pulmonary artery/aorta dimension ratio in control group were (150.5±24.1) ml,(71.5 ±18.5) ml, (53.5 ±4.2)%, 1.08 ±0.04, 1.01 ±0.04 and 0. 99 ±0. 02, respectively. While those in PE group were ( 190. 3 ± 16. 2) ml, ( 128. 1 ± 13.2) ml,(32.7 ± 3.6 ) %, 2.00 ± 0.26, 1.30 ± 0. 09 and 1.34 ± 0. 11, respectively. Those after therapy of thrombolysis were ( 159. 2 ± 21.5 ) ml, ( 80. 7 ± 9.4) ml, (49. 2 ± 5.9) %, 1.22 ± 0.25, 1.02 ± 0.02 and 1.02±0.11,respectively. ESV and EDV of RV were larger (q= 6.28, P<0.01; q=7.59, P<0.01),EF value was lower (q = 4. 82, P < 0.01 ) in PE group than those in control group. RV/LV ESV volume ratio, the RV/LV dimension ratio and main pulmonary artery/aorta dimension ratio were larger ( q = 6. 04,P <0. 01; q =4. 43, P <0. 01; q =4. 36, P <0. 01 ) and EDV of LV was lower in PE group than those in control group. However, ESV and EDV of RV and RV/LV ESV volume ratio were lower (q = 5.03, P <0.01;q=6. 11,P<0.01;q=4.74,P<0.01), EF value was larger (q=6.29, P<0.01) and EDV of LV was larger(q =4.01 ,P <0.01 ) after therapy of thrombolysis than before. Conclusion Retrospective triple rule-out ECG-gated MSCT can show pulmonary embolism, measure the function of RV and LV and evaluate curative effect of thrombolysis.

Objective To develop a method for dynamically observing the biological efficacy of botulinum toxin A (BTX-A) and to investigate the dose-effect relationship between BTX-A dosage and muscle strength.MethodsFifty-four male Sprague Dawley rats were randomly divided into 9 groups.Groups 1-7 were injected intramuscularly with 0.1 ml BTX-A (0.01 U to 4.0 U) into the gastrocnemius on the right side.Rats in group 8 were injected intramuscularly with an equal volume of saline solution as the control group,and group 9 was used to determine the location of injection.Gastrocnemius muscle strength was evaluated using a self-made evaluation system before and after the toxin injection and on the 3rd,7th,14th,21st,30th,45th,60th and 75th day following.ResultsMuscle strength reached its lowest level on days 3 to 7,with a significant difference in the decline of muscle strength between the test groups and the control group up to day 60.With the lower BTX-A doses (0.01 U,0.1 U,0.5 U,1.0 U),muscle strength had decreased significantly on the 21st day,but recovered to its initial levels in all groups at the same time.There was no significant difference among the 1.0 U,1.5 U,2.0 U and 4.0 U groups.ConclusionsStandardized gastrocnemius injection combined with neuromuscular functional evaluation can establish a model of BTX-A dosage and muscle paralysis which can be used to assess the evolution of the biological efficacy of BTX-A.

The levels of low-density lipoprotein(LDL)glycation from control group,diabetic HbA1C < 7.0%,and HbA1C>7.0% groups were(17.7±2.31),(34.29±5.73),and(48.79±7.82)Glycogroups/LDL by fluorimetry.The LDL binding to its receptor in three groups were(37.65±5.20),(27.36±4.34),and(15.07± 2.23)ng/mg cell protein measured by enzyme-linked immunoreceptor assay.The glycated levels in two diabetic groups were higher than that in control group,and higher in HbA1C>7.0% group than in HbA1C<7.0% group(all P< 0.01).The results of LDL binding capacity to its receptor were just the opposite.

Objective To evaluate the role of mitochondrial permeability transition pore (mPTP) in attenuation of myocardial ischemia-reperfusion (I/R) injury by sufentanil postconditioning in rats.Methods Sixty male Sprague-Dawley rats,aged 14-15 weeks,weighing 350-420 g,were randomly divided into 4 groups (n =15 each):sham operation group (group S),group I/R,cyclosporin A group (group CP) and sufentanil postconditioning group (group SP).Myocardial I/R was produced by occlusion of left anterior descending branch of coronary artcry for 30 min followed by reperfusion.In groups CP and SP,cyclosporin A 5 mg/kg and sufentanil 1 μg/kg were injected via the jugular vein at 5 min before reperfusion respectively,while the equal volume of normal saline was injected in group I/R.At 10 min of reperfusion,hearts were excised,the myocardial mitochondria were immediately isolated and the activity of mPTP was measured by spectrophotometry.MAP and HR were recorded at 30 min of equilibration,at 30 min of ischemia and at 120 min of reperfusion and rate-pressure product (RPP) was calculated.Arterial blood samples were obtained at 120 min of reperfusion for determination of the plasma cardiac troponin Ⅰ (cTnⅠ) concentration.The animals were then sacrificed for determination of infarct size (IS) and area at risk (AAR),and IS/AAR was calculated.The mitochondrial ultra-structure was examined with electron microscope.Results Compared with group S,the mPTP activity and plasma cTnI concentration were significantly increased,and MAP and RPP were significantly decreased in the other three groups (P ＜ 0.05).Compared with group I/R,the mPTP activity,plasma cTnI concentration and IS/ARR were significantly decreased in groups CP and SP,and MAP was significantly increased in group CP (P ＜ 0.05).Compared with group CP,MAP was significantly decreased (P ＜ 0.05),while no significant change was found in the other indexes in group SP (P ＞0.05).Significant mitochondrial swelling,and disruption and disappearance of cristae were showed in I/R group.The mitochondrial structure was more complete in CP and SP groups than that in group I/R,and the disrupted cristae were found in a small number of mitochondria in CP and SP groups.Conclusion The mechanism by which sufentanil postconditioning reduces myocardial I/R injury is related to inhibition of mPTP opening in rats.

Objective To investigate the effect of type 2 diabetes mellitus (DM) on the attenuation of myocardial ischemia-reperfusion (I/R) injury by sufentanil postconditioning in rats.Methods Male pathogen-free Sprague-Dawley rats,weighing 160-180 g,were used in the study.A model for type 2 DM was established by the feeding of high-fat diet-induced insulin resistance and intraperitoneal streptozocin 35 mg/kg.DM was confirmed by blood glucose level ≥ 16.7 mmol/L one week after injection.Eighteen type 2 diabetic rats were randomly divided into 3 groups (n =6 each):DM sham operation group (DM-S group) ; DM-I/R group; DM sufentanil postconditioning group (DM-SP group).Another 18 healthy nondiabetic rats were chosen and randomly divided into 3 groups (n =6 each):nondiabetes mellitus sham operation group (NDM-S group) ; nondiabetes mellitus I/R group (NDM-I/R group) ; nondiabetes mellitus sufentanil postconditioning group (NDM-SP group).Myocardial I/R was induced by 30 min occlusion of the left anterior descending branch of coronary artery (after 30 min of equilibration) followed by 120 min of reperfusion.Sufentanil 1.0 μg/kg was injected via the right jugular vein 5 min before reperfusion in NDM-SP and DM-SP groups.MAP,SP and HR were recorded immediately before ischemia,at 30 min of ischemia and at 120 min of reperfusion and rate-pressure product (RPP) was calculated.Arterial blood samples were collected at 120 min of reperfusion for measurement of plasma cardiac troponin Ⅰ (cTnⅠ) concentration.The rats were then sacrificed for determination of the myocardial infract size.Results MAP and RPP were decreased,while the plasma cTnl concentration was increased during reperfusion in diabetic and nondiabetic rats.Sufentanil postconditioning decreased the myocardial infract size and plasma concentrations of cTnⅠ,and increased MAP and RPP during reperfusion in nondiabetic rats,but had no effect on the parameters in diabetic rats.Conclusion Type 2 DM interferes with sufentanil postconditioning-induced myocardial protection in rats.

OBJECTIVE To control the spread of multi-drug resistant(MDR) bacteria in hospital and to ensure patients′ medical safety.METHODS We had established a network monitoring system,improved MDR monitoring,enhanced management of antibiotics rational use and cut off the transmission of MDR bacteria.RESULTS After taken these measures,the standard preventing of medical workers,handwashing compliance and specimen censorship rate had been greatly improved.Antimicrobial drug use was more standardized.In the last two years,we hadn′t found any epidemic outbreak due to MDR bacteria event.CONCLUSIONS Taking comprehensive prevention and control measures can prevent and control the development and proliferation of MDR bacteria and ensure patients′ medical safety.

OBJECTIVE To investigate the incidence of hospital infection in patients with indwelling catheter and its risk factors, the inpatients were monitored and the measures were taken to prevent the patients from infection. METHODS Monitoring 617 patients with indwelling catheter, retrospective survey and analysis study were available , including a plan to detect microbe, to study the medical history and to examine the patients. RESULTS Eighty nine patients with 106 cases-times of urinary tract infection happened, and its incidence rate was 14.42 percent with the highest rate in all the hospital infection cases. The main risk factors of urinary tract infection included inserting catheter, unclean operation, delayed removing of catheter and unreasonable application of antibiotic . CONCLUSIONS Controlling the indication, shortening the time of indwelling catheter, keeping urinary aseptic manipulation and rational application of antibiotic are effective measurement for the patients with indwelling catheter.

Objective To investigate the present situation of institutes of rehabilitation medicine in Guangxi. Methods From March to July, 2015, all 287 hospitals in Guangxi were investigated with the Human Resource Statistics of Guangxi Rehabilitation Medicine Depart-ment and the Specialist Questionnaire of Guangxi Rehabilitation Medicine Department by E-mail through the local Health and Family Plan-ning Commissions. Results There were 125 rehabilitation medicine departments with 2146 personnels in Guangxi, 0.2 therapists per bed in average. The proportion was 1∶0.725 for rehabilitative physicians to therapists;1∶1.92∶3.14 for senior, intermediate and primary title for physicians;1∶8∶63 for therapists and 1∶5.6∶18.9 for nurses. About 91.3%of the department of rehabilitation medicine was in the tertia-ry hospitals and was able to provide the services of physical therapy, occupational therapy, speech therapy, swallowing rehabilitation, cogni-tive rehabilitation, psychological therapy and rehabilitation engineering, and so on. Conclusion Rehabilitation has made a big progress com-pared with that in 2009 in Guangxi, in term of institutes, human resources and the service ability. However, the distribution of institutions and human resources remains unbalanced.