Objective To investigate influence of different usage of dyclonine hydrochloride mucilage on hemodynamics and postoperative throat pain of laryngeal mask anesthesia patients.Methods Sixty patients in flexible ureteroscopic holmium laser lithotripsy with laryngeal mask anesthesia were randomly divided into three groups according to different usage of dyclonine hydrochloride mucilage (n =20).Group A was coated laryngeal mask with paraffin oil.Group B was coated laryngeal mask with dyclonine hydrochloride mucilage.Group C was coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.The indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask were recorded.Heart rate (HR), mean blood pressure (MBP) index at T1 (pre-anesthesia induction), T2 (1 min before pulling out the laryngeal mask), T3 (pulling out the laryngeal mask), T4 (5 min after removing the laryngeal mask), and T5 (10 min after removing the laryngeal mask) were recorded.The complications of throat after removing laryngeal mask were observed.The pain degree of sore-throat at the time of 30 minutes after removing the laryngeal mask was observed.The adverse reactions of the usage of dyclonine hydrochloride were observed in three groups.Results There were no statistically significant differences in indwelling time of laryngeal mask, postoperative recovery time of spontaneous breathing, time of hearing the call to open eyes, and the time of pulling out the laryngeal mask among three groups (P ＞ 0.05).There were no statistically significant differences in HR, MBP at T1 , and T5 (P ＞ 0.05).HR and MBP were higher in group A than in groups B and C at T2 ～ T4, and HR and MBP were higher in group B than in group C at T2 ～ T4, with statistically significant difference (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in groups B and C than in group A (P ＜ 0.05).The incidences of sore throat and swallowing discomfort were significantly lower in group C than in group B (P ＜0.05).No statistically significant difference were found in incidence of hoarseness among three groups (P＞ 0.05).The pain degree of sore-throat in group C were significantly lower than in group B, and the pain degree of sore-throat in groups B and C was significantly lower than in group A (P ＜ 0.05).There were no allergic reactions and local anesthetic poisoning for three groups.Conclusions Dyclonine hydrochloride mucilage can reduce hemodynamic fluctuations during recovery period, and prevent or relieve effectively the patient's throat pain after laryngeal mask anesthesia.At the same time, dyclonine hydrochloride mucilage can improve the patient's postoperative physical comfort without adverse reactions, especially coated laryngeal mask with dyclonine hydrochloride mucilage and dyclonine hydrochloride mucilage gargle.

The purpose of this study was to investigate the function of stereo visual acuity in patients after phacoemulsifications and intraocular lens implantation. Mensuration of stereopsis with laser holographic stereovision test chart was done in 80 cases who had undergone phacoemulsifications and intraocular lens implantation. In this group, 43 patients were male, 37 were female .Ages of the patients were 52 to 81 years. Single eye operation was done in 18 cases, while both eye operation in 62 cases. The corrected vision was all over 0 4 in both eyes.In the 80 cases 67 (83 7%) had near stereopsis and 13 cases (16 3%)did not have; 71 cases (88 8%) had distance stereopsis and 9 cases (11 2%)did not have. Function of stereopsis weakens gradually following aging and is closely related with vision. The function of sterovision would recover to varying degrees after phacoemulsifications and intraocular lens implantation. Recovery of distance stereopsis was better than that of near stereopsis.The results of this study show that the status of stereopsis is an important index to evaluate the curative effect in patients after phacoemulsifications and intraocular lens implantation.

Objective To assess the efficacy of oral erythromycin on the functional gastrointestinal dysmotility in neonates.Methods In this double-blind,randomized,placebo controlled trial,90 neonates consecutively admitted to the neonatal intensive care unit of Shenzhen Children's Hospital from Jan 2009 to Dec 2011 were enrolled and randomly divided into low-dosage erythromycin group ( LE group,n =30 ),highdosage erythromycin group ( HE group,n =30 ) and control group ( n =30).Patients received either erythromycin ( 3 mg/kg or 10 mg/kg) or equivalent normal saline with oral or nasal feeding every 8 hours one time for 14 d.The time to achieve half,three-quarters,and full enteral nutrition,the time of parenteral nutrition,and hospital length of stay were compared among each group.Results The time to achieve half,three-quarters,and full enteral nutrition in HE group [ ( 3.0 ± 0.5 ) d,( 6.2 ± 0.7 ) d,( 8.2 ± 1.0 ) d ] and in LE group [(6.2±0.5) d,(8.3 ±0.6) d,(10.6 ±1.1) d] were shorter than that in control group [(8.1 ±0.4) d,( 13.5 ± 1.0) d,( 15.7 ± 1.2) d] ( P ＜ 0.05 ).The duration of parenteral nutrition [ ( 14.2 ± 1.4) d vs (9.3 ± 1.2) d vs (7.8 ± 1.1 ) d ] and hospital length of stay [ ( 13.0 ± 1.4 ) d vs ( 8.1 ± 0.8 ) d vs ( 6.8 ±0.7) d] were significantly prolonged in control group compared with LE and HE groups,and there were significant differences among the three groups ( P ＜ 0.05).The incidence of liver injury and septicemia during the treatment of erythromycin were similar between HE group and LE group,but it was significantly lower than control group.No serious adverse effect such as prolongation of QT intervals,dysrhythmia associated with erythromycin treatment was found.Conclusion Oral erythromycin can be considered as a treatment for neonates with functional gastrointestinal dysmotility who fail to establish adequate enteral nutrition,and highdosage oral erythromycin is more effective than low-dosage.

Objective To compare the surgical effects of transurethal enucleation of prostate (TUEP)with transurethal resection of prostate (TURP) by a retrospective analysis of clinical data.Methods The patients in this study were divided into the groups of TUEP (enrolled in 2010 and 2011,n =77) and TURP (enrolled in 2009,n =27) with prostate larger than 60 g and smaller than 60 g respectively.Comparisons were made between the two groups in operation time,blood loss volume and weight of resected prostate.Results In the group of patients with prostate larger than 60 g,there was no significant difference in prostate weight ((88.5 ± 9.2) g vs.(107.0 ± 15.30) g,P =0.255),operation time ((91.5 ± 8.8) min vs.(118.3 ± 20.2)min,P =0.083),and weight of resected prostate ((48.0 ± 4.6) g vs.(58.4 ± 5.4) g,P =0.32) between the TUEP (53 patients) and the TURP (12 patients) groups.There was significant difference in blood loss ((110.0 ± 16.4) ml vs.(193.3 ± 22.3) ml,P =0.011) between the two groups.In the group of patients with prostate smaller than 60 g,there was no significant difference in prostate weight ((43.1 ± 3.2) g vs.(36.8 ± 3.4) g,P =0.072),operation time ((62.7 ±6.8) min vs.(69.3 ±6.2) min,P =0.431),blood loss ((56 ± 5) ml vs.(110±20) ml,P=0.082),and weight of resected prostate ((26.3 ±2.4) g vs.(23.6 ±2.1) g,P =0.291) between the TUEP (24 patients) and the TURP (15 patients) groups.Conclusion Compared with TURP,TUEP has the advantages of less blood loss in the treatment of patients with prostate larger than 60 g.With the improvement of surgeon' s experience and development of operation techniques,TURP will be replaced by TUEP.In the treatment of patients with prostate smaller than 60 g,the operation modality can be chosen by the surgeon based on his experience and proficiency.

Objective To explore the association between variation in genes related to lipid metabolism and the susceptibility of nonalcoholic fatty liver disease (NAFLD). Methods Obese children with fatty liver aged 6~18 years old were included. All of them got ultrasonic testing, routine examination and biochemical detection. In addition, the DNA of peripheral blood was extracted and the 36 target genes related to lipid metabolism were detected by next generation sequencing. Results In 368 obese children who met the inclusion criteria, 183 children (49.7%) were detected to have NAFL . 100 children with NAFLD and 100 children without NAFLD were randomly selected from obese children. The levels of body mass, waistline, alanine aminotransferase (ALT), triacylglycerol (TG), cholesterol, low density lipoprotein (LDL) and apolipoprotein B (ApoB) in NAFLD children were all higher than those in non-NAFLD children, and there were significant differences (P all<0.05). However, the levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP), apolipoprotein A1 (ApoA1), fasting blood glucose, insulin, high density lipoprotein (HDL), free fatty acid (FFA) and insulin resistance index (HOMA-IR) were not significantly different between the two groups (P all>0.05). The levels of bilirubine in the two groups were within normal range. Logistic regression analysis showed that the genes of MTTP rs2306986 (OR=2.70, 95%CI: 1.38~5.27) and MTTP rs3792683 (OR=7.34, 95%CI: 2.04~26.50) that encode microsomal triglyceride transfer protein (MTTP or MTP), and the mutation of rs738409 (OR=2.11, 95%CI:1.31~4.48) in gene PNPLA3 that encode patatin-like phospholipase domain-containing protein 3 are the independent risk factors for the occurrence of the disease. Conclusion Genovariation of MTTP rs2306986, MTTP rs3792683, and PNPLA3 rs738409 may increase susceptibility to NAFLD in children.

According to the World Report on Disability, compared with the normal children, the enrollment rate of the handicapped children is lower, as well as the rate of in-school children and their chances to get further study. A series of barriers limit the opportunities for these children to accept the mainstream education in such aspects as education policies, systems and services. To solve these problems, the education system and schools have to make some changes so that we could remove all kinds of hardware and software barriers and provide a reasonable adjustment and other support services. Only based on these improvements can we ensure the handicapped children have equal chances to accept education. And the report enlighten us that we should perfect the system construction as well as teacher cultivation and promote community inclusion to ensure the right of education of disabled children.

OBJECTIVETo investigate the accurate and individual treatment of temporomandibular joint(TMJ) injury based on 3D digital technology.

METHODSMaxillo-mandibular model was made using rapid prototyping technology based on the pre-operation 3D CT results. According to the 3D digital measurement results, TMJ concepts were ordered and the prosthesis was used to simulate the replacement surgery on the model. Then the joint replacement surgery was performed afterward.

RESULTS(1)After total replacement of TMJ, no pain happened and mouth open was not limited. Three months later, the joint position was normal and stable. The month open width was 4 cm. (2)After condyle replacement, primary healing was achieved with complete survival of bone graft. No edema was seen. Symmetric facial appearance was satisfactory.

CONCLUSIONSBilateral individual prosthesis for total TMJ or condyle replacement is an ideal method for TMJ injury.

Arthroplasty, Replacement ; methods ; Bone Transplantation ; Computer-Aided Design ; Humans ; Imaging, Three-Dimensional ; methods ; Joint Prosthesis ; Mandible ; Prosthesis Design ; methods ; Range of Motion, Articular ; Temporomandibular Joint ; anatomy & histology ; injuries

Objective To study the frequency of cystic fibrosis transmembrane conductance regulator(CFTR)mutations in patients with congenital bilateral absence of vas deferens(CBAVD).Methods Eighty-five CBAVD patients were collected from May 2007 to May 2009.The diagnosis of CBAVD included azoospermia,normal of 4 sex hormone items,absence of seminal vesicle,normal volume of testicular and epididymis dilated siltation.And 85 normal fertile men served as controls.Genomic DNA was isolated from peripheral blood.The mutations of CFTR exons 10,11 were detected by PCR-single strand conformation polymorphism,and direct sequencing was performed on 85 cases of CBAVD and the control males.Results Of the 85 CBAVD,10 cases(11.8％)exhibited an abnormal CFTR gene mutation,with 4 cases I556V,2 cases M469V,and 1 case of E527N,A F508,L558S,S485C.No mutations were detected in 85 controls.There was a significant difference between the 2 groups(x2 =8.606,P =0.003).Conclusions CBAVD might be caused by the CFTR mutations.The frequencies and the spectrum of CFTR mutations might be different from those Caucasian population in the west country.

Objective To explore the application value of liquid chromotography tandem mass spectrometry (LC-MS/MS) in screening of inherited metabolic disease risk children ,and to provide a reference for the scientific prevention and control .Methods 246 cases of patients with inherited metabolic children blood samples were collected through the blood spots ,LC-MS/MS was used to examine blood samples from high risk cases of inherited metabolic who came from general hospital of Ningxia medical university . Results 30 cases were confirmed with inherited metabolic disease by the LC-MS/MS ,the positive rate was 12 .2% ,including 9 ca-ses of methylmalonic academia ,4 cases of isovaleric acidemia ,6 cases of phenylketonuria ,2 cases of propionic acidemia ,2 cases of citrullinemia ,1 cases of very long-chain acyl-CoA dehydrogenase ,1 cases of mitochondrial trifunctional protein deficiency ,1 cases of maple syrup urine disease ,3 cases of homocystinuria ,2 cases of argininesuccinic aciduria .Conclusion Liquid chromatography tan-dem mass spectrometry(L-MS/MS) technology is highly efficient and high reliability method in screening inherited metabolic dis-ease .

Objective To evaluate the effect of multiple intervention measures on perioperative antimicrobial use in pa-tients undergoing typeⅠincision operation in a hospital,and provide basis for rational use of antimicrobial agents. Methods 9 823 patients with type I incision operation in April and October of 2005-2012 were surveyed retrospectively, data of 2005 was as baseline,from 2006 to 2012,multiple measures,including training,examination,supervision,feed-back,and cooperation of relevant departments were conducted,antimicrobial use before and after intervention was com-pared.Results The qualified rate of perioperative antimicrobial use in patients undergoing typeⅠ incision operation in-creased from 14.20% in 2006 to 92.30% in 2012;the rate of combined use of antimicrobial agents was relatively higher (7.00%-9.00%)in 2006-2009,had a downward trend in 2010- 2012,and decreased to 3.20% in 2012.Types of an-timicrobial agents for prophylactic use in typeⅠincision operation in 2006 and 2007 were similar to that of 2005,the main used antimicrobial agents were cephalosporins,penicillin and it’s compounds,and aminoglycosides;the major antimicrobial prophylaxis in 2008-2012 were the first and second generation cephalosporins,penicillin and it’s compounds.Multivariate non-conditional logistic regression analysis showed that age (40 - 59 years old),departments (orthopedics,general surgery,and ophthalmology),and years (2011 and 2012)were the main influencing factors for the qualified use of antimicrobial agents(all P<0.05).Conclusion Implementation of multiple intervention measures can improve the qualified rate of perioperative antimicrobial use in typeⅠ incision operation,reduce types of antimicrobial use and rate of combined antimicrobial use.