Objective:To explore the effect of virtual reality (VR) on the emergency management of pediatric anesthesia.Methods:Four kinds of perioperative critical events were selected as VR training content, and the training objects were 60 residents who took part in the standardized residency training in Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine. Through theoretical examination and questionnaire survey, the training effect and the anxiety of residents after critical events were evaluated. The data were input into Graphpad Prism 5 software, and the quantitative data conforming to normal distribution were expressed as (mean ± standard deviation), and compared by nonparametric test and t test of two independent samples between groups. Qualitative data were expressed in terms of rate, and the 2× k trend chi-square test was used to compare the scores of the two groups. Results:All the residents took part in the theoretical assessment of the management of pediatric anesthesia emergencies. Compared with the offline theoretical teaching, the average scores of the students who underwent VR training were higher, and the incidence of anxiety was significantly reduced.Conclusion:VR simulation teaching in the department of anesthesiology can fully arouse the enthusiasm of residents and make them overcome the fear of dealing with pediatric anesthesia emergencies.

Objective:To identify risk factors associated with mandibular osteoradionecrosis (ORN) in oral and maxillofacial cancer patients following radiotherapty and to provide scientific basis for the etiological research and clinical prevention of mandibular ORN.Methods:A retrospective study was conducted in patients with oral and maxillofacial-head and neck cancer during the period from January 2013 to December 2015. Influential factors related to mandibular ORN were screened by single factor analysis, Lasso and Logistic regression analysis.Results:A total of 757 patients were analyzed, and the total incidence of mandibular ORN was 12.0%(91/757). There were 443 males and 314 females, aged (51.8±13.7) years. Thirty-five related factors were screened to 28 by single factor analysis. It was determined by Lasso regression analysis that, radiation doses ( OR=1.135, P=0.034, 95% CI: 1.089-1.232), T classification ( OR=2.586, P=0.001, 95% CI: 1.482-4.512), mandibular surgery ( OR=9.101, P<0.001, 95% CI: 2.796-29.630), periodontitis ( OR=6.089, P<0.001, 95% CI: 2.708-13.693), diabetes ( OR=4.467, P=0.002, 95% CI: 1.705-11.704), tooth extraction after radiotherapy ( OR=3.228, P=0.001, 95% CI: 1.640-6.350), dental caries ( OR=2.911, P=0.009, 95% CI: 1.300-6.516), periapical periodontitis ( OR=2.726, P=0.016, 95% CI: 1.209-6.145), smoking ( OR=4.438, P=0.002, 95% CI: 1.702-11.571) and unilateral/bilateral radiotherapy ( OR=2.225, P=0.028, 95% CI: 1.090-4.545) were significantly associated with developing mandibular ORN. Conclusions:Ten main risk factors for mandibular ORN were identified through the single center, large sample, retrospective analysis, which has a certain value for clinical prevention of mandibular ORN. Prospective, randomized controlled trials and long-term follow-up are still needed.

Mitochondria are morphologically dynamic organelles which undergo fission and fusion processes. Our previous study found that arterial constriction was always accompanied by increased mitochondrial fission in smooth muscle cells, whereas inhibition of mitochondrial fission in smooth muscle cells was associated with arterial relaxation. Here, we used the typical vasorelaxants, verapamil and phentolamine, to further confirm the coupling between arterial constriction and mitochondrial fission in rat aorta. Results showed that phentolamine but not verapamil induced vasorelaxation in phenylephrine (PE)-induced rat thoracic aorta constriction. Verapamil, but not phentolamine, induced vasorelaxation in high K(KPSS)-induced rat thoracic aorta constriction. Pre-treatment with phentolamine prevented PE- but not KPSS-induced aorta constriction and pre-treatment with verapamil prevented both PE- and KPSS-induced aorta constriction. Transmission electron microscopy (TEM) results showed that verapamil but not phentolamine inhibited KPSS-induced excessive mitochondrial fission in aortic smooth muscle cells, and verapamil prevented both PE- and KPSS-induced excessive mitochondrial fission in aortic smooth muscle cells. Verapamil inhibited KPSS-induced excessive mitochondrial fission in cultured vascular smooth muscle cells (A10). These results further demonstrate that arterial relaxation is coupled to inhibition of mitochondrial fission in arterial smooth muscle cells.