Objective To explore the effect of ProSeal laryngeal mask airway and endotracheal tube on analepsia stage of general anesthesia in geriatric patients undergoing radical mastectomy.Methods Thirty geriatric females with breast cancer of American Standards Association (ASA)Ⅰ-Ⅱscheduled for selective radical mastectomy under general anesthesia were randomly allocated to two groups: ProSeal laryngeal mask airway group(PLMA group, n=15) and endotracheal tube group (ET group, n=15). The patients were put on PLMA or were intubated with ET under general anesthesia in the two groups, respectively. The heart rate (HR), systolic blood pressure(SBP)and diastolic blood pressure (DBP) were recorded at the time points of 5 min after entering operation room (T0), end of surgery (T1), opening eyes (T2), after extubation (PLMA) immediately (T3) and 3 min after extubation (PLMA) (T4). The numbers of patients who were given antihypertensive agent,showed bucking, agitation or sore throat, nausea and vomiting after extubation were recorded during the analepsia stage of general anesthesia. Results The blood pressure (BP) and HR were mildly.increased in PLMA group at T2, and there was no significant difference compared with T0(P＞0.05). But the BP and HR were significantly higher at T3 than at T0 (P＜0.05). In ET group, the BP and HR were both significantly elevated at T2 and T3 than at T0 (P＜0.05), and reached the peak at T3. The increased levels of BP and HR were significantly lower in PLMA group than in ET group at T2 and T3 (P＜0.05). The quantities of patients who were given antihypertensive agent, showed bucking and sore throat were less in PLMA group than in ET group(P＜0.05). No differences in incidence rate of agitation, nausea and vomiting after extubation between the two groups were observed(P＞0.05). Conclusions PLMA can obviously reduce the occurrence of complications in analepsia stage of general anesthesia in geriatric patients scheduled for selective radical mastectomy,and is beneficial to provide much safer anesthesia.

Objective To study clinical evaluation of xinqin granule combined with loratadine in treatment of allergic rhinitis and its effects on serum eosinophil(EOS),colony stimulating factor(CSF)and tumor necrosis factor(TNF)-α.Methods 90 patients of allergic rhinitis who received therapy from January 2014 to November 2016 in our hospital were selected.According to random number table,those patients were divided into the observation group(n=45)and the control group(n=45).The control group was treated with loratadine,while the observation group was combined with xinqin granule.Then the serum EOS,CSF and TNF-α,symptom score,clinical efficacy and adverse reactions were compared.Results After treatment,the serum levels of EOS,CSF and TNF-αin the observation group were significantly lower than that of the control group(P<0.05); the symptom score in the observation group was significantly lower than that of the control group(P<0.05); the total effective rate in the observation group was significantly higher than that of the control group[93.33％(42/45)vs.73.33％(33/45)](P<0.05); there was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Xinqin granule combined with loratadine is well for allergic rhinitis,which can effectively reduce serum levels of EOS,CSF,TNF-α,relieve clinical symptoms,it's worthy of application and promotion.

Objective To summarize and analyze the clinical experiences of treatment of complicated geriatric odontoptosis for the purpose of establishing a better technique to cope with such situation.Method The data of 542 outpatients with geriatric odontoptosis,from 1998 till the present treated in the Department of Outpatient,General Hospital of PLA,were summarized and analyzed according to the type and location of odontoptosis,with complications such as severe attrition,periodontitis,food impaction and detective occlusion.The special prosthetic designs on certain cases were also summarized.Some cases were followed-up.Results Removable partial dentares(RPD)with cast framework were prescribed to the geriatric odontoptosis patients.According to the site and type of odontoptosis,four special designed frameworks include casting fence-wall enforced artificial tooth prosthesis for lower clearance cases,metal strengthened plastic occlusive pad or metal occlusive pad for severe attrition cases,casting splint prosthesis for periodontal and food impaction with impaction preventive denture.36 cases were followed up for two years with satisfactory result in 31 cases,but in four cases the clasp was broken.In the cases with failure the dentures were redesigned and fabricated with cast framework,and better results were accomplished.Generally,the patients were accustomed to the new RPD quickly and revisit times were less frequent.The strength of prosthesis was enhanced.It was proved that custom designed framework could solve the clinical dilemma of severe dentition attrition,food impaction and periodontitis,and the odontoptosis was repaired.Conclusion The designed fence-wall prosthesis,metal strengthened plastic occlusal pad and metal occlusal pad,casting splint prosthesis and casting food impaction stop are effective prosthetic procedure for certain cases.

Objective To assess the efficacy and safety of target-controlled infusion of propofol and remifentanil in geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation. Methods Thirty geriatric patients with primary hepatocellular carcinoma of ASA Ⅱ-Ⅲ scheduled for percutaneous radiofrequency ablation under monitored anesthesia care (MAC) were randomly allocated to two groups: target-controlled infusion of propofol and remifentanil group (PR group, n= 15) and intravenous injection of midazolam and fentanyl group (MF group. n= 15). The mean arterial blood pressure (MAP), heart rate (HR) and pulse oxygen saturation (SpO2) of patients were recorded during the treatment. The Ramsay Score, Patient Cooperation Score, VAS Score and postoperative Patient Satisfaction Score were recorded as well. Results The Ramsay Score, Patient Cooperation Score, VAS Score and Patient Satisfaction Score were all higher in PR group than in MF group (all P<0.05). The maximum values of MAP and HR [( 108.7± 8.6) mm Hg, (83.8±7.1) times/min] were significantly higher than the baseline values [( 99.3 ± 8.5) mm Hg, (76.3±7.1) times/min] in MF group, and the degree of increment of MAP and HR were significantly greater in MF group than in PR group (both P<0.05). The minimum values of MAP and HR [(84.5±6.5) mm Hg, (66.6 ± 6.6) times/min] were significantly lower than the baseline values [(97.7±6.5) mm Hg, (75.4±7.3) times/min] in PR group, and the degree of decrement of MAP and HR were significantly greater in PR group than in MF group (both P<0.05). SpO2 of both groups decreased significantly (the minimum values of PR and MF groups were 95.1±2.0 and 95.5± 2.2, respectively), but there was no statistical difference between two groups (P>0.05) . Conclusions MAC with target-controlled infusion of propofol and remifentanil is more suitable for geriatric patients with hepatocellular carcinoma undergoing percutaneous radiofrequency ablation, as it can provide ideal analgesia and sedation, but the respiration and the change of hemodynamics of patients must be observed seriously.

Acute Disease ; Adolescent ; Adult ; Aged ; Ammonia ; poisoning ; China ; Environmental Exposure ; adverse effects ; Female ; Gas Poisoning ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Edema ; etiology ; therapy ; Respiratory Distress Syndrome, Adult ; etiology ; therapy ; Treatment Outcome

Objective To investigate the causes, diagnosis and treatment of infants with secondary methylmalonic aciduria due to maternal vitamin B 12 deficiency. Methods The clinical, laboratory data and treatment of 7 children with secondary methylmalonic aciduria and their mothers′ health and nutrition were retrospectively reviewed. Results All children were presented to the hospital with vomiting, seizures or mental retardation during 1 to 13 months after birth. Varied degrees of anemia was found in 6 infants and 5 with metabolic acidosis and liver dysfunction. Methylmalonic aciduria was found in all subjects. Four of the mothers had chronic gastritis, one with gallstones in liver and gallbladder and one was a vegetarian. Decreased serum level of vitamin B 12 and folic acid and elevated homocystine concentrations were found in all mothers. After vitamin B 12 and folic acid supplementation, significant improvement was observed in all patients. Six infants showed normal development and one had mild mental retardation. Conclusions Chronic gastritis, liver/gall bladder diseases or being a vegetarian might lead to maternal vitamin B 12 deficiency and then infantile secondary methylmalonic aciduria. Early diagnosis and vitamin B 12 and folic acid supplement are crucial in improving the prognosis.

Objective To establish the care model of vertical stratification, the safety and effectiveness of assisted reproductive technology has been made. Methods This study involved 708 infertile group from July 2014 to March 2015 of IVF treatment (control group) and 916 infertile group from April 2015 to December 2015 of IVF treatment (vertical stratification group). According to the clinical, the care works are divided into seven parts. Each part has three elements with the primary nurse, work instructions, regulations and quality control measures. Via the survey and test, to convey the awareness of patients, clinic visits, waiting times, the rate of clinical pregnancy, medical expenses. Results After the vertical stratification, compared with the control group, the score increased project of the observation group were causes of infertility, diagnosis, treatment choice, the treatment process, medication precautions, perioperative considerations, adverse reactions, follow-up requirements, the difference was statistically significant (χ2=7.39-159.94,P<0.01). Compared with the control group (10±2) times,(126± 20) min,(2.89±0.05) million,61.57%(564/916), the number of times to the hospital, the waiting time , the medical expenses and the percent of pregnancy were (15±5) times, (333±40) min, (3.21±0.08) million and 50.14%(355/708), the difference was statistically significant (t=-98.67-227.81, P<0.01). Conclusions To establish the care model of vertical stratification has help to improve work efficiency.

Objective:To investigate the effects of extracts of aqueous joint during CIA development on the HUVEC proliferation in vitro and expression of VEGF Methods: 3H TaR incorporation was used to estimate the HUVEC proliferation by extracts of aqueous joint and VEGF, and was used cultured in an absolutely serum free medium Results:Extracts of aqueqous joint during CIA development stimulated proliferation of HUVEC and this proliferation was inhibited by the anti VEGF neutralizing antibody Conclusion:The expression of VEGF in the extracts of the aqueous joint during an early stage of CIA development increased and expressed biologically active

To observe the morphological changes in photoreceptor after experimental retinal detachment in cats. Twenty eight cats were divided into experimental group and control group. Retinal detachment was produced by injecting 0 25% solution of Healon into the subretinal space with the aid of a micropipette. Histologic sections of retina were processed for light and electron microscopy at detachment intervals ranging from 0 5 days to 3 months. At 24 hours postdetachment, the outer segments were distended and disrupted, but the inner segments and photoreceptor cell bodies were only slightly affected. 3-14 days after detachment, the inner segments were affected at multiple sites, albeit to varying degrees. Some of them were vacuolizated at the tip, with mitochondria swollen and cristae fragmented. At the same time, the photoreceptor cell bodies often showed a distension of endoplasmic reticulum, deterioration of mitochondria, and the presence of multivesicular bodies. 1-3 months after detachment, large empty spaces in the outer nuclear layer and a progressive loss of cytoplasmic ground substance and organelles appeared in some photoreceptors as detachment duration lengthened. Necrosis of the inner segments and cell bodies were more marked in the more serious detachment than those in shallow ones. Degenerative changes occured in the photoreceptor very soon after experimental retinal detachment, and these changes were correlated with both the depth and duration of retinal detachment.

Objective To introduce and analyze the design, manufacture and clinical effect of the casting full dentition splint in treatment of periodontal disease with or without dentition defect. Methods 148 patients with periodontal disease during 1995 to 1998 were treated with casting full dentition splint after a thorough basic periodontal treatment. The patients were composed of 81 men and 67 women aged 40-69y. The patients were followed up for 1 to 3 years after restoration. General effects of the prosthesis were evaluated based on the chief complain of patients, clinical examination and X-ray examination. Results Among 148 patients, 140 (94.59%) were satisfied with the prosthesis and stable periodontal status, 6 (4.05%) were improved, 2 (1.35%) showed no clinical effect. Conclusion Casting full dentition splint can improve the mastication efficiency in periodontal disease patients. It is an effective and reversible therapeutic method on treatment of the periodontal disease with or without dentition defect.