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.

Drug-induced liver injury(DILI) is one of the major causes of termination of drug development.The establishment of a high-throughput test system to predict potential clinical hepatotoxicity is a valuable approach in the pharmaceutical industry.The high-content imaging-based in vitro assays allow simultaneous detection of cellular multiple parameters in the system.The real-time monitoring of multiple signaling pathways can shed light on many mechanisms of cell injury,with high sensitivity and specificity.Many types of liver cell models have been applied to high-content screening(HCS) so far.This paper introduceds the HCS technology and reviews the data of hepatotoxicity obtained from HCS technology in recent years.At the same time,we discuss the application of this technology in exploring the mechanism of hepatotoxicity and the potential of HCS technology in studying DILI and mechanisms.

Objective To investigate the effects of supreme laryngeal mask airway (SLMA) and endotracheal intubation on the elderly hypertensive patients treated with knee arthroplasty. Methods Forty cases of elderly hypertensive patients ASA Ⅰ-Ⅲ treated with knee arthroplasty in our hospital were selected and randomly divided into laryngeal mask airway group (group LMA)and endotracheal intubation (group TT),20 cases for each group.The same protocol for induction and maintenance of general anesthesia was used.After the patients entering,the changes of SpO2 and ECG were performed continuous noninvasive monitoring and SBP,DBP and HR were performed con-tinuous invasive monitoring.SBP,DBP and HR of two groups were recorded at different time points:before anesthesia induction (T0 ,based value),at intubation immediate (T1 ),5 mins after intubation (T2 )and 1 5 mins after intubation (T3 ).At the same time,the content of cortisol (Cor),atrial natri-uretic peptide (ANP)and the concentration of epinephrine (E)and norepinephrine (NE)were meas-ured at the corresponding time points above.Results Compared with T0 ,SBP and DBP at T1-T3 in group LMA were decreased(P <0.05 or P <0.01);SBP and DBP at T1 in group TT were increased while decreased at T2 ,T3 ,HR at T1 were increased(P < 0.05 or P < 0.01 ).Compared with group LMA,SBP and DBP at T1-T3 and HR at T1 ,T2 in group TT were increased (P <0.05 or P <0.01). Compared with T0 and group LMA,the content of E,NE and Cor at T1-T3 increased(P <0.05 or P <0.01).The level of ANP in both groups at T1-T3 were higher than those at T0 ,and group TT were higher than group LMA(P <0.01).Conclusion Compared to endotracheal intubation,SLAM can ef-fectively reduce the stress reaction of elderly hypertensive patients treated with general anesthesia in knee arthroplasty.

It's difficult to diagnose precancerous lesion and early cancer for a long time, because both of them haven't typical morphological characteristics. As a novel diagnostic modality, fluorescence endoscopy can accurately reflect minimal changes in human's tissue, thus making a meaningful progress for cancer diagnosing. 200 patients were examined by fluorescence endoscopy to evaluate the diagnostic value. The overall accuracy, sensitivity and specificity for detecting malignant gastrointestinal tumor was 94.0%, 94.6% and 93.5%, respectively. Thus, fluorescence endoscopy can be used to diagnose malignant gastrointestinal tumors with high validity and reliability, and is advantageous over conventional white light endoscopy especially in detecting the atypical and suspicious lesions. Furthermore, fluorescence endoscopy can also guide target biopsy, is significant to improve the early cancer detection rate, has a broad development prospect.
Endoscopy ; instrumentation ; Fluorescence ; Gastrointestinal Neoplasms ; diagnosis ; Humans ; Sensitivity and Specificity

The liver being an “evil” of Zang-organ has been mentioned repeatedly in ancient medical books and is thought-provoking. The author believes that the ”evil” nature of the liver lies in the diversity, complexity, and latency of diseases caused by liver disorders, which is closely related to the physiological characteristics and pathological changes of the liver. This article discusses the liver itself and its relationship with other organs, meridians and collaterals, and qi-blood and body fluid and elaborates on the three pathogenic characters of the liver being an “evil” of Zang-organ. A correct understanding of the ”evil” nature of the liver plays an important role in guiding clinical diagnosis and treatment.

Objective To explore the risk factors of skeletal related events (SREs) in non small cell lung cancer with bone metastases and its effect on the prognosis .Methods Totally 223 cases of NSCLC patients with bone metastasis were retrospective studied from January 2010 to December 2012 in our hospital .The clinical features ,predictive factors for SREs were analysed by sin‐gle factor and multifactor analysis .Results Among 223 cases of NSCLC patients with bone metastasis ,119 cases occured with SREs(53 .4% ) .Univariate analysis showed that the occurrence of SREs in female ,no smoker ,adenocarcinoma ,solitary bone metas‐tasis lesions were less than the male ,smoker non‐adenocarcinoma ,and multiple bone metastases (P<0 .05) ,but the rost without statistically significant(P>0 .05) .The multivariate analysis revealed only multiple bone metastases was an independent risk factor for SREs .The median survival time of the NSCLC patients with bone metastasis was 15 .3 months .Moreover ,survival analysis showed that SREs had no statistical significance on the prognosis of bone metastasis in NSCLC patients (P>0 .05) .Conclusion The female ,adenocarcinoma ,smoking history ,solitary bone metastasis lesions occurred in patients with lower risk SREs .Multiple bone metastasis is an independent risk factor for SREs ,attention should be paid to monitoring and prevention .

Objective:To construct an early comfort assessment and management plan for ICU patients with high flow nasal cannula, and to provide reference for clinical nursing practice and management.Methods:The domestic and foreign databases were retrieved, and the literatures on high flow nasal cannula were obtained and evaluated. The first draft of the early evaluation and management scheme of nasal high-flow humidification oxygen therapy was developed. Two rounds of expert consultation were conducted by Delphi method.Results:The early comfort assessment and management plan for ICU patients with high flow nasal cannula was formed, including 3 primary indicators, 12 secondary indicators, and 32 tertiary indicators. The authoritative coefficients of 2 rounds of expert consultation were 0.915 and 0.931, respectively. The coordination coefficients were 0.221, 0.130 and 0.278( χ 2 values were 8.000, 27.140, 163.824, P<0.05 or 0.01). Conclusions:The early comfort assessment and management plan of ICU patients with high flow nasal cannula are consistent with the advice of experts at all levels. The enthusiasm and authority of the experts is high, which provides a basis for the scientific management of ICU patients with nasal high-flow humidification oxygen therapy.

Objective:The paper aims at developing a method of defining and visualizing the scope of the basic medical insurance pharmacy service, and provides a new way of thinking for the designated pharmacy planning. Methods:Collecting the basic data and information on administrative divisions in the planning area taking equity and efficiency as the guidance, using ArcGIS and its function modules to define and visualize the scope of the medical in-surance pharmacy service. The procedure of issue focus, method improvement, data simulation, expert consultation, methodology perfecting were followed to define and visualize the scope. Results:Forming a whole set of operative pro-cedures of defining and visualizing the scope of the medical insurance pharmacy service based on medical resources allocation standard, and the operation commands and procedures in ArcGIS were clarified. Conclusion:Operating ac-cording to the appropriate method steps, the following can be achieved:(1) The adjacent scope of medical insurance pharmacy service are adjacent to each other but do not overlap or cross;(2) Spatial relations can be clearly and ef-fectively expressed;(3) The shape is flat and regular;(4) The data collected at different times can be comparable in space, providing good prerequisites for medical insurance designated pharmacy planning.

OBJECTIVETo research the efficacy and feasibility for unstable fracture of thoracolumbar with AF spine internal fixation device.

METHODSThirty-two patients with unstable fractures of T11-L3 were treated with AF spine internal fixation device and autograft between vertebral lamina vertebral body transverse process from January 2002 to June 2006. There were 21 female and 11 male, aging from 58 to 72 years with a mean of 62 years. All these patients were examined with x-ray and CT preoperative and postoperative respectively. They were followed-up thirteen months averagely, observing the stability of spinal column, bone grafting fusion, the height of vertebra and recovery of anterior bone fragment herniation.

RESULTSAll these AF spine internal fixation devices treated for the unstable fractures of thoracolumbar had not removed because of internal fixation failure or pain. Fracture healing and grafting fusion appeared after operation three months averagely. X-rays revealed post-protrusion angle were recovered from 22 degrees to 8.5 degrees, the heights of anterior were recovered from 50% to 86%, the angle of posterior were recovered from 94% to 98%. The postoperative CT scan showed that six cases with herniation to canal gained a completely recoveries.

CONCLUSIONAF spine internal fixation device used in early stage for unstable fracture of thoracolumbar is a simple and effective method. It has advantages such as providing early substantial fixation, maintaining a well three column stability. Bone grafting is a key factor in this operative technique.

Aged ; Female ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; surgery ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; surgery

A reliable UPLC-MS method was developed for the simultaneous determination of 4 chemicals (Sudan Ⅰ, tetrabromobisphenol A, tris ( 1, 3-dichloroisopropyl ) phosphate and tris ( chlorisopropyl ) Phosphate) in children products. The samples were ultrasonic extracted with acetonitrile, and then the four chemicals were separated on a C18 column in 3 min. Results showed that the limit of quantification of the method was between 5 and 500μg/kg. The calibration curves were linear within 2-3 orders of magnitude with typical correlation coefficient above 0 . 9995 . The recoveries ranged from 83 . 7% to 97 . 8% with three addition levels. The sensitivity, recovery and selectivity of the method could fully meet the requirements of practical work.