Objective To evaluate the effectiveness and advantage of the TruviewTM EVO2(R) optical laryngoscope in comparison with the commonly used laryngoscope for the endotracheal intubation in patients in the emergency setting. Method Thirty-six patients in need for emergency endotracheal intubation in our hospital from February to May 2009 were randomly assigned to give intubation by using a TruviewTM EVO2(R) optical laryngoscope (T group) or a commonly used laryngoscope(R group). Cormack and Lehane laryngoscope grade (the degree of exposure of glottis by using laryngoscope), IDS (Intubation Difficulty Scale) score, the time taken for successful intubation, lowest SpO2 and the complication during intubation were essential factors for comparison between two groups. Results Our data showed that there was no difference in duration of the successful endotracheal intubation attempts between these two groups (respectively 22.73 ± 7.66 s and 19.91 ± 8.03 s, P ＞ 0. 05). However, the glottis exposure condition was significantly improved with TruviewTM EVO2(R) optical laryngoscope (P ＜ 0.01). The average IDS score for patients in T group was 0.33 ± 0.49, which is much lower than those in the R group (4.11± 0.90, P ＜ 0.01). In addition, the average SpO2 value measured in T group during the intubation operation was significantly higher than that in R group (98.87±0.74% and 91.45 ±4.86% respectively, P ＜0.01) and there was less complication observed in patients of T group. Conclusions Using TruviewTM EVO2(R) optical laryngoscope for emergency endotracheal intubation could help to expose the glottis in an ideal view, predominately lower the C/L grade and thus decrease the difficulty in intubation for clinicians. Its specially designed oxygen supplier allows the SpO2 to be maintained at a high level during the operation as well as reduce the incidence of complication. It is therefore extremely useful for emergency tracheal intubation, particularly a difficulty intubation situation.

The important meaning of the construction of an economical-type mode of health economy management is expounded, and the measure and principle of it should be taken and followed. This management mode can relieve the social problem of "high expense and difficulties in medieine.

Acetyltransferases ; genetics ; Breast Neoplasms ; genetics ; Female ; GPI-Linked Proteins ; Gene Expression Regulation, Neoplastic ; genetics ; Humans ; Membrane Glycoproteins ; genetics ; Neoplasm Metastasis ; genetics ; physiopathology ; S100 Proteins ; genetics ; Transcription Factors ; genetics

BACKGROUND:Presently,cartilage defect is mainly treated by autologous cartilage transplantation,which cannot be accepted by patients.With development of tissue engineering,mesenchymal stem cells have been a hot focus in research.Most scholars believed that dynamic stress,hypoxia and some growth factors are advantageous factors for differentiation of bone marrow mesencymal stem cells into chondrocytes,which suggest microenvironment of the joint cavity.OBJECTIVE:To establish a method for isolating bone marrow mesenchymal stem cells,to found a microenvironment of the joint cavity,and to observe outcome of injure repair by transplanting autologous bone marrow mesenchymal stem cells into cartilage injured region of rabbits,which is covered by periosteum.DESIGN,TIME AND SETTING:The randomized,controlled animal experiment was performed at the Laboratory of Department of Orthopaedics,Second Hospital,Shanxi Medical University from July 2005 to July 2007.MATERIALS:A total of 24 New Zealand rabbits were selected for creating models of articular cartilage injury.METHODS:Rabbit bone marrow mesenchymal stem cells were collected and purified using density gradient centrifugation,and amplified by in vitro adherence method.Twenty-four rabbits were randomly assigned into three groups(n=8).In the non-induced bone marrow mesenchymal stem cells + periosteal flap group,bone marrow mesenchymal stem cells were implanted into articular cartilage defects of rabbit knees and covered by autologous periosteal flap.In the periosteal flap group,periosteal flap was used to cover the injured region.Rabbits in the blank control group were left intact.MAIN OUTCOME MEASURES:Repair tissues of rabbits were examined at 6 and 12 weeks after surgery.RESULTS:In the non-induced bone marrow mesenchymal stem cells + periosteal flap group,the defects were filled with hyaline-like cartilage at 6 weeks.Cartilage and the subchodral bone were remodeled at 12 weeks after surgery.The expression of type Ⅱ collagen in the repair tissues was verified by immunohistochemistry.In the periosteal flap group,the defects were partly filled with chondrocytes-like in the surface and basement.In the blank control group,fibrous tissue repair was presented,with a few cartilage-like cells in the basement.CONCLUSION:Following comparison of results from three groups,in vitro cultured rabbit bone marrow mesenchymal stem cells and periosteal transplantation can enhance repair of articular cartilage injury.This method can be an effective way for repairing injured articular cartilage,presently.

Objective To study the diagnostic value of endoscopy assisted by laparoscopy in patients with small intestinal bleeding. Methods In case of small intestinal bleeding it is hard to define the accurate etiological factor by routine examination. From 1994 to 2002 there were 14 patients with chronic me-lena or persisted melena complicated with chronic anemia and 2 cases of acute alimentary tract hematorrhea complicated with obvious hypovolemia. Results Endoscopies assisted by laparoscopy were accomplished in all of the 16 cases. Lesions were detected in 5 cases with laparoscopy directly, and in 11 cases the pathological changes were discovered by endoscopies assisted with laparoscopy . The pathologic results were leiomyo-sarcoma 1 cases, leiomyoma 4 cases, adenoma of small intestine , hemangioma , vascular malformation and capillary telangiectasia 2 cases each, and Meckels diverticulitis with hemorrhage 3 cases. Conclusion The diagnostic value of endoscopy assisted with laparoscopy is superior to the routine examination in detecting the small intestinal bleeding. This technique has the advantage of simple, less-traumatic and high sensitivity. It is worthy to popularize in clinical practice.

Objective To investigate the effect of heme oxygenase-1 ( HO-1) on brain edema in a rat model of asphyxial cardiac arrest and resuscitation. Methods Forty male SD rats weighing 250-300 g were randomly divided into 4 groups ( n = 10 each) : group I sham operation; group II cardiac arrest (CA); group Ⅰ Hemin (HO-1 inducer) and group IV SnPP (HO-1 inhibitor). Asphyxial cardiac arrest and resuscitation were performed in CA, Hemin and SnPP groups (group Ⅰ ,Ⅲ, Ⅳ) . Hemin and SnPP groups received hemin 15 mg/kg intraperitoneally (IP) at 12 h before CA and SnPP K 30 μmol/kg IP at 1 h before CA respectively. The animals were sacrificed at 1 and 6 h after recovery of spontaneous circulation (ROSC) . The water content of the cortex, hippocampus and brain stem and the expression of HO-1 and aquaporin-4 (AQP4) mRNA in cortex and hippocampus ( by RT-PCR) were determined. Results Water content of cortex and hippocampus was significantly higher at 1 h after ROSC in CA and SnPP groups than in sham operation group and was significantly lower in Hemin group than in CA group. There was no significant difference in water content of brain stem at 1 and 6 h after ROSC among all 4 groups. The expression of AQP4 mRNA was significantly higher in cortex and hippocampus at 1 h after ROSC in CA and SnPP groups than in sham operation group and was significantly lower in Hemin group than in CA group.Conclusion HO-1 can reduce brain water content at early stage after cardiac arrest and resuscitation by regulating the expression of AQP4.

Objective To investigate the clinic effect of trans-artery intrahepatic transplantation of porcine islet in type 1 diabetic patients. Methods Four patients with type 1 diabetes were perfused newborn porcine islets through the hepatic artery.Fasting blood glucose(FBS), postprandial blood glucose (PBS), HBA1,dose of insulin and function of liver and kidney were measured before and after the transplantation.Results The levels of FBS,PBS and HBA1 were 7 4～13 5mmol/L,7 8～18 6mmol/L and 7 8～12 0mmol/L respectively before the transplantation. During one and half years after transplantation, the levels of FBS,PBS and HBA1 were 3 3～7 1mmol/L,6 0～8 8mmol/L and 6 4～7 6mmol/L respectively with notably reduced dosage of insulin(32～58%).The function of liver and kidney of the patients remained normal.Conclusions Trans-artery intrahepatic transplantation of porcine islet is effective and safe for type 1diabetic treatment.

ObjectiveTo observe the effect of muscle stimulating instrument on patients with spasticity of lower limbs after surgical treatment.Methods49 adults with spasticity of lower limbs after surgical treatment were divided into the treatment group (21 cases) and the control group (28 cases). Patients of two groups were treated with routien rehabilitation training, but muscle stimulating instruments treatment was added to patients of the treatment group. The muscle strength and motor ability of patients of two groups were followed up and compared.ResultsThe muscle strength and motor ability of the treatment group were better than that of the control group during follow-up period (P<0.05,P<0.01).ConclusionMuscle stimulating instrument can accelerate the recovery of muscle strength and motor ability in adults with spasticity of lower limbs after surgical treatment.

BACKGROUND:The post-core crown system is an effective method for dental defect repair, but its repair outcomes are influenced by various factors;thereby, a further study is needed to optimize this method.OBJECTIVE:To investigate the stress distribution in different degrees of dental defect after post-core crown restoration under different occlusal contacts. METHODS:Three-dimensional models of the mandibular first molar were established by CT images, and models of complete natural teeth, six different defected teeth (total maxil ofacial slight and severe defects, distal middle maxil ofacial slight and severe defects, proximal middle maxil ofacial slight and severe defects) and two different post-core crowns (fiber post and zirconia post) were created by software. These models were imported into ANSYS software to analyze the stress distribution in dentin and periodontium under stable occlusal contact (ABC) and unstable occlusal contact (AC), respectively. RESULTS AND CONCLUSION:The stress in dentin and the periodontium after post-core crown restoration under AC was obviously higher than that under ABC, and AC affected the restored teeth more markedly. The post-core crown material with higher elastic modulus could induce higher stresses, and severe defected teeth showed higher stress distribution. Different defected types made no overt effects on the stress distribution in the periodontium. These results suggest that the B area contact is critical in regulating occlusal contacts of restoration.

Objective To explore the effect of different temperature of the forced- air warming system on the prevention of hypothermia during laparotomy of infants. Methods A total of 60 infants undergoing laparotomy under general anesthesia were recruited and divided into three groups by random digits table method with 20 cases each according to admitting time; when used the force- air warming system intraoperatively, the three groups were respectively setting on 45℃(automatic adjustment for 43 ℃ after 45 minutes), 43 ℃ and 38 ℃.The core temperature were respectively recorded before anesthesia and 15, 30, 45, 60 minutes after anesthesia (every 30 minutes after 1 hour).The hypothermia incidence and anesthesia recovery conditions were recorded simultaneously. Results There was no significant difference on the core temperature among three groups before anesthesia (P > 0.05). 30 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.31±0.20) ℃,43 ℃ group was (36.32±0.24) ℃ and 38 ℃ group was (36.08±0.21) ℃.The differences among three groups was statistically significant (F=8.12, P < 0.01), but there was no significant difference between 45 ℃ group and 43 ℃ group (P > 0.05). 60 minutes after the anesthetic, the core temperature of 45 ℃ group was (36.39±0.26) ℃,43 ℃ group was (36.19±0.22) ℃ and 38 ℃ group was (35.92±0.15) ℃. The differences among three groups was statistically significant(F=25.19, P<0.01).The hypothermia incidence of 45℃group, 43℃ group,38℃ group was 10.0%(2/20), 25.0%(5/20), 50.0%(10/20)respectively and the differences among three groups was statistically significant( χ2=8.04, P<0.05). The time to complete consciousness of 45 ℃ group was (15.40±5.09) minutes,43 ℃ group was (19.80±4.10) minutes and 38 ℃ group was (22.00±4.36) minutes. The differences among three groups was statistically significant (F=10.96, P<0.01). The time to tracheal extubation of 45 ℃ group was (18.10±5.97) minutes, 43 ℃ group was (21.85±4.02) minutes and 38 ℃ group was (24.90±5.54) minutes.The differences among three groups was statistically significant (F=9.83, P<0.01). Conclusions The forced-air warming system can increase the infants′peripheral tissue heat content and reduce the heat losing.So that it will help decrease the intraoperative hypothermia incidence and shorten the anesthesia recovery period.Meanwhile the higher temperature of the forced-air warming system is setted ,the better effect it is.