Objective:To access the feasibility and safety of application of flexible laryngeal mask air-way ( FLMA) in oral&maxillofacial day surgery. Methods:Retrospective study was conducted of 40 oral& maxillofacial day surgery patients (3 to 61 years of age) using FLMA under general anaesthesia in De-partment of Oral & Maxillofacial Surgery, Peking University School and Hospital of Stomatology. All the patients were with American Society of Anesthesiologists ( ASA ) physical status Ⅰ -Ⅱ, including 19 males and 21 females. The patients' vital signs were recorded at five different time points:baseline before anesthesia ( T0 ) , time right after the FLMA insertion ( T1 ) , time at incision ( T2 ) , 15 min after incision ( T3 ) and time at the end of the operation ( T4 ) . The first attempted FLMA insertion successful rate and the number of timed of changing to endotracheal intubation were recorded. During operation, frequencies of movement, hypoxia and obstruction of airway were noted and the operation time, anesthesia time, time from the end of the operation to extubation, movement and coughing following extubation and sore throat within 24 h were taken down. Operation-related complications of bleeding, hematoma and injury of local nerves were recorded within 24 h as well. Results:The operations of all the 40 patients were successfully done under general anaesthesia. The 36 ( 90%, 36/40 ) patients using FLMA successfully were under steady process, including 16 males and 20 females. The first attempted successful rate of FLMA insertion was 80% (32/40), and the second 50% (4/8). Three out of the 4 failed FLMA patients were changed to endotracheal intubation after the second attempt failed. The other patient was changed to endotracheal intubation before operation because of leak. The average operation time was (46. 58 ± 22. 57) min, the anesthesia time was ( 77 . 97 ± 26 . 82 ) min and the time from the end of operation to extubation was (8. 31 ± 3. 33) min. All the patients were recorded without obvious body movement during the operation procedure. There were 4 patients (11. 11%, 4/36) with slight body movement during extubation. The incidence of sore throat was 13. 89% (5/36) within 24 h postoperatively. There were no complications of bleeding, hematoma and injury of local nerves. The vital signs of baseline T0 were significantly different from those at other time points T1, T2, T3, and T4 (P<0. 01). As to the hearts rate after anesthesia, the values at T1, T2, T3 and T4 for two-two comparison, there was no statistical difference (P>0. 05). As to the values of systolic blood pressure and diastolic blood pressure after anesthesia at T1 and T4 , T2 and T3, for two-two comparison, there was no statistical difference (P>0. 05). As to the respiratory rate from the start of the surgery, the values at T2, T3 and T4 showed no statistical difference (P>0. 05). Conclusion:Flexible laryngeal mask airway is a supraglottic airway management method. It is suitable and safe for securing the airway in oral & maxillofacial day surgery. The advantages of fewer haemody-namic changes and postoperative complications are confirmed.

ObjectiveTo evaluate the safety and efficacy of a modified hand-assited laparoscopic splenectomy (HALS) plus pericardial devascularization for the treatment of cirrhotic portal hypertension.MethodsFrom March 2009 to Dec 2011,modified hand-assited laparoscopic splenectomy plus pericardial devascularization was performed on 47 patients with portal hypertension and liver cirrhosis.We performed HALS first, thenconvertedtototallylarparocopicpericardialdevascularizationduring operation.ResultsAll patients received modified HALS plus pericardial devascularization without convertion to open surgery,the mean operative time was ( 154 ± 32) min,the mean intraoperative blood loss was ( 115 ±73) ml,and the mean postoperative hospitalization was (9.2 ± 1.6) days.The perioperative complications included plural effusion in 3 cases,ascites in 4 cases,pancreatic leakage in 1 case and wound dehiscence in 1case. Therewasnoperioperativemortality.ConclusionsModifiedHALSpluspericardial devascularization is a relatively safe and effective procedure in the treatment of portal hypertension due to liver cirrhosis,it has the advantage of hand-assisted and totally laparoscopic procedures.

Objective:To compare the quantitative measurements of the retinal capillary nonperfusion areas in a cohort of proliferative diabetic retinopathy (PDR) patients with fluorescein fundus angiography (FFA) and swept source optical coherence tomography angiography (SS-OCTA), and to determine the intrapersonal variability between examiners.Methods:A cross-sectional study. Eighteen eyes of eleven PDR patients diagnosed in Department of ophthalmology of Henan Provincial People's Hospital from September 2019 to January 2020 were included in this study. FFA was performed using Spectralis HRA+OCT (Germany Heidelberg Company) from and SS-OCTA was performed using VG200D (China Vision Micro Image Corporation). SS-OCTA was used to collect images of retinal layer, superficial capillary plexus (SCP) and deep capillary plexus (DCP). The same observation area was 80°×60° for SS-OCTA and 55° for FFA with both setting centered on the fovea. The forty-nine retinal capillary nonperfusion areas were observed. The area measurement was completed independently by three examiners. Paired sample t test or paired sample Wilcoxon test were used to compare the measured values of retinal capillary nonperfusion areas between the two examination methods and among the three examiners. Results:There was no significant difference in the retinal layer, SCP and DCP nonperfusion area measured by FFA and SS-OCTA among the three examiners ( P>0.05), and the consistency is good (consistency correlation coefficient> 0.9, P<0.05). The nonperfusion area measured by FFA was 0.786 mm 2. The median nonperfusion area of retinal layer and SCP measured by SS-OCTA were 0.787 mm 2 and 0.791 mm 2, respectively, and the average nonperfusion area of DCP was 0.878±0.366 mm 2. The nonperfusion area of retinal layer and SCP measured by FFA and SS-OCTA showed no statistically significant difference ( P=0.054, 0.198). The nonperfusion area of DCP measured by SS-OCTA was significantly larger than that of FFA, and the difference was statistically significant ( P<0.001). The results of repeatability analysis showed that 93.88% (46/49) of the DCP nonperfusion area data measured by SS-OCTA were greater than those measured by FFA. Conclusion:The retinal nonperfusion area of DCP in PDR patients measured by SS-OCTA is larger than that of FFA.

The fruit of Pandanus tectorius (PTF) has a long history of use as a folk medicine to treat hyperlipidemia in Hainan province, South China. Our previous studies have shown that the n-butanol extract of PTF is rich in caffeoylquinic acids and has an adequate therapeutic effect on dyslipidemic animals induced by high-fat diet. In this work, seven caffeoylquinic acids isolated from PTF were screened for the lipid-lowering activity in HepG2 hepatoma cells. Oil-Red O staining, microscopy and intracellular triglyceride (TG) and total cholesterol (TC) quantification showed that 3-O-caffeoylquinic acid (3-CQA), 3, 5-di-O-caffeoylquinic acid (3,5-CQA), and 3,4,5-tri-O-caffeoylquinic acid (3,4,5-CQA) significantly inhibited lipid accumulation induced by oleic acid and decreased intracellular levels of TC and TG in a dose-dependent manner. These three caffeoylquinic acids showed no significant cytotoxicity at concentrations of 1 -50 μmol x L(-1) as determined by MTT assay. Realtime quantitative PCR revealed that 3-CQA and 3, 5-CQA significantly increased the expression of lipid oxidation-related genes PPARα, CPT-1 and ACOX1 while 3-CQA, 3, 5-CQA and 3,4,5-CQA decreased the expression of lipogenic genes SREBP-1c, SREBP-2, HMGR, ACC, FAS. Overall, 3-CQA, 3, 5-CQA and 3, 4, 5-CQA may be the principal hypolipidemic components in PTF which can decrease intracellular lipid accumulation through up-regulating the expression of lipid oxidative genes and down-regulating the expression of lipogenic genes.
Carcinoma, Hepatocellular ; metabolism ; China ; Cholesterol ; metabolism ; Gene Expression Regulation ; Hep G2 Cells ; Humans ; Lipid Metabolism ; Liver Neoplasms ; metabolism ; Oleic Acid ; Pandanaceae ; chemistry ; Quinic Acid ; analogs & derivatives ; chemistry ; Sterol Regulatory Element Binding Protein 1 ; Triglycerides ; metabolism

Objective To compare clinical outcomes of modified hand-assisted versus total laparoscopic splenectomy and esophagogastric devacularization for treatment of portal hypertension due to cirrhosis.Methods From Jan 2007 to Dec 2011,modified hand-assisted laparoscopic splenectomy plus esophagogastric devascularization (MHLSED) and total laparoscopic splenectomy and esophagogastric devascularization (LSED) were performed on 47 and 38 patients with portal hypertension due to cirrhosis,respectively.For the MHLESD group,we performed hand-assisted laparoscopic splenectomy first,then converted during operation to totally laparoscopic esophagogastric devascularization.The operating time,intra-operative blood loss,postoperative complications and postoperative hospitalization time were analyzed.Results MHLSED were performed on 47 patients successfully without any need to convert to open surgery,and LSED were performed on 36 patients with 2 patients having to convert to open surgery.The mean operative time [(154 ±32)min] and mean intra-operative blood loss [(115± 73)ml] in the HLSED group were significantly lower than the LSED group [(212±45)min and (172±57)ml,respectively].There was no mortality.There were no significant differences in the time period for gastrointestinal function to recover,postoperative hospital stay and overall complication rate between the two groups.Conclusions MHALSD is a relatively safe and efficacious treatment for portal hypertension due to cirrhosis.It combines the advantages of hand-assisted and totally laparoscopic operations.

To make sure the role of flagellin as mucosal adjuvants and the protective effect of streptococcus pneumonia infection when combined with DnaJ protein.Methods:Recombinant plasmid pET-28 ( a)/flagella was transferred to E.coli BL21(DE3).Over-expression of flagella was induced by IPTG and purification for animal study.All the C57BL/6 mice were randomly divided into three groups ,then respectively intranasally given the mixture of flagellin and DnaJ protein ( experimental group ) , DnaJ protein( control group 1 ) and the mixture of GST and DnaJ protein ( control group 2 ).The serum IgG and its subtype , cytokines secreted by mice spleen cells were detected by ELISA.At last all the C57BL/6 mice were intranasally immunized with Streptococcus pneumoniaD39.The protective effect by survival times were evaluated.Results: The mice of experimental group could secrete high level of serum IgG and cytokines IFN-γ,IL-4 and IL-17A.What more,the survival rate of mice in experimental group was 60%,a significant statistical difference with the control group.Conclusion:The flagellin as an adjuvant can reinforce the immune response of DnaJ protein and have better protection of resistance D 39 infection.We suggest that flagellin can be used as protein vaccine adjuvants.

Objective To evaluate laparoscopic radical resection of metachronous colorectal carcinoma.Methods A total of 13 patients with metachronous colorectal carcinoma undergoing laparoscopic resection in Department of Gastrointestinal Surgery,Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January 2013 to December 2015 were analyzed retrospectively.Results The mean time of surgery was (156 ± 9) min.Tumors were located in the right hemicolon in 3 cases,in the transverse colon in one,in the left hemicolon in 2,in the sigmoid colon in four and in the rectum in 4.The mean blood loss was (66 ± 21) ml.There was no conversion to open surgery.Two patients were done with protective ileostomy.Postoperative gastrointestinal function recovery time was (2.5 ± 0.7) days.One postoperative intra-abdominal bleeding was successfully controlled laparoscopically.Posteperative length of hospital stay was (26.2 ± 2.9) days.The median follow-up was 12 months (5-30 months) with no cancer recurrence.Conclusions Laparoscopic radical resection of metachronous colorectal carcinoma has good curative effect,and high success rate in spite of previous history of laparotomy.

Object: To study the proliferation of hCTGF on cells and its biological function on bone injury healing.Methods: The fibroblast with potential differentiation was transfected by eukaryotic gene delivery system and then transferred into the experimental animal model with bone fracture.The data were collected by molecular biological and clinical orthopedic technique detection analysis.Results: The results demonstrated an obvious proliferation of hCTGF on cells,suggesting that hCTGF have the biological activity of repairing bone injury via gene therapy.The results provide a new activity factor and treatment approach for bone injury in clinics.

Objective To observe the effect of Yang-warming and Qi-tonifying Recipe (YQP)on aquaporin 3(AQP3) and AQP8 in rats with slow transit constipation,and to explore its therapeutic mechanism. Methods Forty rats were randomly divided into modeling group(N=30)and normal control group(N = 10). After successful modeling by gastric gavage of loperamide,the modeled rats were randomly divided into model group,YQP group and Mosapride group,10 rats in each group,and were separately treated with corresponding medicine for 2 weeks. After treatment, the colonic transit function was measured by carbon propelling test. The protein levels of AQP3 and AQP8 were detected by immunohistochemistry and their mRNA expression levels were detected with real-time fluorescence polymerase chain reaction (qPCR). Results Compared with the normal control group,the propelling rate of carbon particle in the model group was decreased,and the protein and mRNA expression levels of AQP3 and AQP8 were significantly increased(P<0.05 or P<0.01). Compared with the model group,the propelling rate of carbon particle of YQP group and mosapride group was significantly increased, and the protein and mRNA expression levels of AQP3 and AQP8 were significantly decreased (P<0.05),but there was no significant difference between YQP group and mosapride group (P >0.05). Conclusion YQP had therapeutic effects on loperamide-induced constipation through decreasing the expression of AQP3 and AQP8 in the intestine,reducing the reabsorption of intestinal fluid, and increasing the fecal water content.

OBJECTIVETo understand the overall HIV sero-conversion rate and its trend and risk factors of uninfected partners in sero-discordant couples.

METHODSA total of 3088 uninfected partners, whose HIV positive partners infected via former plasma donation or blood transfusion from July, 2006 to December 2010, were chosen as a fix cohort. They were tested for HIV antibodies twice a year using ELISA by local CDC from July, 2006 to December, 2010. Data regarding demographic, sexual behavior information of uninfected partners and infection, serologic characteristics of positive partners were retrospectively surveyed and collected to analyze possible risky factors.

RESULTSA total of 132 in 3088 uninfected partners were sero-converted, with a sero-conversion rate of 1.17/100 person years (95%CI: 0.99/100 person years -1.39/100 person years). Sero-conversion rate reached the peak (0.82%) in the following interval of January and June in 2008 and have a bottom conversion rate (0.13%) in the same month interval in 2010. Conversion rate outcome showed a downward trend in following(χ(2)trend = 8.907, P < 0.05). In the survey, 56.6% (1513/2673) uninfected partners were males, 56.2% (1501/2673) were with lower education level. Among uninfected partners, as reported by themselves, having sex in recently 6 months accounted for a proportion of 81.4% (2176/2673), sex frequency of less than 4 times per month accounted for 45.7% (1169/2558) and consistent using of condom accounted for 94.5% (2418/2558). The proportion of the index partners' most recently CD4 cell count less than 200 cells per µl was 17.4% (437/2505). Results from multivariate of Cox regression showed that male negative partners (RR = 1.58, 95%CI: 1.02 - 2.43), negative partners with lower education level(RR = 2.77, 95%CI: 1.68 - 4.57), having sexual activity in latest one year(RR = 4.39, 95%CI: 1.53 - 12.56) and CD4 count less than 200 cells per µl (RR = 2.36, 95%CI: 1.42 - 3.93) were associated with increased risk of HIV sero-conversion, while intercourse frequency less than 4 times per month(RR = 0.18, 95%CI: 0.10 - 0.32), consistent using of condom(RR = 0.07, 95%CI: 0.05 - 0.12) decreased the risk of conversion.

CONCLUSIONIn this city, the conversion rate of negative partners whose positive partner infected via former plasma donation or blood transfusion is relatively low and behave a downward trend. Serologic surveillance, education and intervention based on couple are needed to be enhanced.

Adult ; China ; epidemiology ; Cohort Studies ; Family Characteristics ; Female ; HIV Antibodies ; blood ; HIV Infections ; epidemiology ; HIV Seropositivity ; epidemiology ; Humans ; Male ; Middle Aged ; Risk Factors