ObjectiveTo investigate the feasibility,safety and efficacy of tracheal extubation with directly connected negative pressure suction. Methods86 patients with Ⅰ or Ⅱ degree of ASA,aged 18～65 years old,without history of respiratory disease,difficult airway and ventilation problems were involved in this study.All patients undergoing endotracheal general anesthesia were randomly divided into group A and B with 43 cases in each group.Group A used negative pressure directly connected to external side of the endotracheal tube before extubation.Group B used suction tube putting into the endotracheal tube before extubation.MAP,HR,ECG,SpO2,the condition of cough and expectoration and complicatons after extubation were recorded. ResultsIn group A the MAP,HR slightly increased,SpO2 slightly decreased,ECG showed no significant change,but the differences were not significant.In group B,MAP,HR,SpO2 showed significant difference compared with those before extubation and the corresponding period of group A. ConclusionsThe method that connecting negative pressure suction with endotracheal tube can effectively reduce the cardiovascular response during extubation,It also can avoid hypoxia,reduce the tracheobronchial injury and pulmonary complications.It's a practical good method in tracheal extubation.

Objective To establish a subcutaneous and orthotopic transplatation tumor model of human esophageal cancer in nude mice .Methods Fresh tissues of human esophageal cancer were collected and transplanted into subcutaneous places of nude mice .The successfully transplanted primary generation tumor was passed down three times .Then tumor were implanted into the subcutaneous and esophageal submucous tissues of nude mice .The formation rate ,morphology ,invasion and metastasis of tumor were observed .Results The tumor formation rate of subcutaneous transplatation model was 60% ,it was low grade squamous cell carcinoma without lymph node and distant organ metastasis .The tumor formation rate of orthotopic transplatation model was 80% , the morphological characteristics were consistent with human original tumor .Lymph node and organ metastasis could be found ex-tensive .Conclusion We preliminary established effective subcutaneous and orthotopic transplatation tumor model of human esopha-geal cancer in nude mice .It might be an available model for further research of esophageal cancer .

pneumococcal infections for children. S. pneumoniae was sensitive to penicillin, which was still the first choice of treatment for S. pneumoniae infections. All the isolates were resistant to erythromycin, and ermB was the dominant mechanism of macrolide-resistance.

Objective To observe the changes and clinical significance of plasma heart fatty acid-binding protein(H-FABP)in children after open heart surgery. Methods Forty patients with congenital heart disease(CHD) who had undergone cardiac operation with cardiopulmonary bypass(CPB) were selected in this study,and were randomly divided into two groups (each 20 cases): cold crystalloid cardioplegia perfusion group (Ⅰ group) and cold blood cardioplegia perfusion group(Ⅱ group). Blood samples were taken to check the plasma H-FABP concentration before CPB and different time after CPB. Plasma H-FABP concentration was estimated by enzyme-linked immunosorbent assay (ELISA). Results The difference of plasma concentration of H-FABP before operation was not obvious between Ⅰ group and Ⅱ group. The plas-ma concentration of H-FABP intraoperation and different time after operation was higher than that before anesthesia induction obviously in two groups, and Ⅰ group rose more significantly [(50.13±3.98) μg/L vs (39.27±4.22) μg/L, P<0.01]. Conclusions H-FABP concentration after operation is higher than that before operation significantly. H-FABP can be used to judge myocardial damage earlier as a sensitive index, because plasma concentration of H-FABP increases significantly after open heart surgery, and its peak emerges early. Compared with cold crystalloid cardioplegia,the myocardial protection of cold blood cardioplegia is better.

Objective To detect the immune effect of FbaAmAb2 against the surface protein of group A Straptococcus (GAS),and explore the pathogenesis and therapy of GAS infections.Methods By subclonal and bacterial ELISA,the positive hybridoma cells were screened that can produce better titers of FbaAmAb2 against GAS-surface FbaA protein,and were injected into the peritoneal cavities of BALB/c mice to produce ascites.The collected ascites were performed to dilute,as follows,original ascite,1:2,1:4,1:8,and 1:16 to test tube agglutination.Based on the results,we selected appropriate dilution to passively immunize mice,and then challenged the mice with GAS,evaluating FbaAmAb2 neutralizing ability with GAS in mice by the survival rate of the immunized mice.Whether FbaAmAb2 could inhibit the binding of factor H to GAS was confirmed by the invasive inhibition assay.Results The IgG titer of bacteria solution ELISA is 1:160 and the titer of tube agglutination is 1∶8.The protect rates of FbaAmAb2 on preventing mice with GAS infections are as follows:66.67％ in original ascite and 1:2 diluted groups,and 50％ in 1:4 diluted group.Mice in each experimental group were evoked significantly protective immune responses compared with the PBS control by SPSS analysis.FbaAmAb2 can competitively inhibit factor H binding to the surface proteins FbaA of GAS,which decreased the entry of GAS into the cytoplasm of human epithelial cells through the binding of factor H.Conclusion FbaAmAb2 is promising to be used in emergent prevention or the clinical therapy for GAS infection and it is promising starting points for pharmacologic targeting and further development of new therapeutic agents for GAS.

With the rapid development of imaging and percutaneous coronary intervention, the application of contrast media has become more and more widespread, and contrast-associated AKI has become one of the most common causes of acute kidney injury. Contrast-associated AKI seriously threatens patients' health and brings greater economic burden to patients, so it is particularly important to prevent the contrast-associated AKI. Nicorandil is a common vasodilator drug in clinical practice, widely used in the treatment of angina pectoris, with the effects of anti-oxidative stress, anti-apoptosis, anti-inflammatory and vasodilation, and is considered to be effective in preventing contrast - associated AKI. However, there is still a lack of further research on the efficacy of nicorandil in preventing contrast-associated AKI.

Objective To investigate the clinical and epidemiological characteristics of osteosarcoma in China and analyze the incidence and clinical treatment of osteosarcoma.Methods The clinical data of 1 593 patients with osteosarcoma in 7 bone cancer treatment centers from January 2000 to February 2017 were analyzed.We retrieved large samples of documents in the database,extracted the relevant data and compared the data with this study.SPSS 13 software was used for statistical analysis and each factor was tested by x2.Results Of 1 593 patients,984 were males and 609 were females.The ratio of male to female was 1.62∶ 1.The average age was 23.2 years (range from 3-80 years).The peak age of onset was 11-20 years (52.4％).There were 217 elderly patients (＞ 40 years old).The tumors occurred in 1 524 limbs and 69 in axial bone.The most common sites of disease were distal femur 706 cases,proximal tibia 375 cases,distal humerus 117 cases and others 395 cases.There were 1 154 cases (71％) around the knee joint.The axial bone included 18 cases of spine,49 cases of pelvis and 2 cases of rib.Preoperative biopsy was performed in 1 111 cases and incisional biopsy in 280 cases.Preoperative diagnosis could be made in 1 345 cases (84.4％ of all patients,accounting for 96.7％ of biopsy patients).There were 79 cases with metastasis at first visit,accounting for 5％.Preoperative chemotherapy was performed in 1 185 cases (74.4％).With the DIA preoperative chemotherapy 271 cases,DIA+MTX 251 cases,AP 149 cases.220 cases of tumor cell necrosis rate was evaluated after operationaccording to the Huvos classification.There were78 cases of grade Ⅰ,105 cases of Ⅱ grade,35 cases of Ⅲ and 2 cases of grade Ⅳ.There were 1 299 cases undergoingpostoperative chemotherapy (81.5％),1 306 patients undergoinglimb salvage surgery (82％).Thespecific operation with prosthetic replacement is the most common (911 cases,69.8％).The postoperative chemotherapy included DIA+MTX regimen 471 cases,DIA regimen 266 cases and AP regimen 98 cases.Before and after the operation,379 cases were treated with the same chemotherapy regimen and 666 cases were changed.A total of 18 large sample documents were retrieved in Chinese data base (5 684 cases).The sex ratio,age range,peak incidence and location of the disease were similar to those of this study.The average age was 1-2 years old younger.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage waslowand the rate of tumor necrosis wasbetter after chemotherapy.A total of 22 large sample literatures were searched in foreign database (12 850 cases).The ratio of men and women is 1.30∶1 and the proportion of women is higher than the domestic data.The average age was 1-2 years older.The ratio of the knee joint was lower.The percentage of lung metastases associated with initial visits washigher.The rate of preoperative and postoperative chemotherapy and limb salvage were similar to that of this study and the rate of tumor necrosis was better after chemotherapy.Conclusion The general situation of the incidence of osteosarcoma (sex,age,location of the disease) is not significantly different from the previous reports both at home and abroad.In the treatment,preoperative and postoperative chemotherapy rate and limb salvage surgery rate have improved significantly compared with the past.The chemotherapy program from the coexistence of various programs,gradually to the DIA+MTX and DIA program as the mainstream program.