Objective To investigate the effect of head extension angle to glottis exposure by using three-dimensional CT reconstruction sagittal plane images of upper airway.Methods There were 80 patients,aged 7-78 years old,who had been scanned by helical CT in the head and neck.Reconstructed images were obtained by AW4.4 workstation and the following parameter was measured:angle α(A0 group),the angle created by the upper central incisor and root of epiglottis(angular vertex) and midpoint of glottis.Reconstructed images were printed according to the actual size of human body in a ratio of 1∶ 1,then the images were cut off from the upper central incisor to root of epiglottis by a section of arcs.Increasing the degree of angle α by clockwise to hypothetically increase the angle of head extension.The glottis was exposed by using a paper-made laryngoscope(Macintosh) model,and the success rate of glottis exposure was recorded when the degree of angle α was respectively increased 10°(A10 group),20°(A20 group),and 30°(A30 group).Results Compared with A0 group,the success rate of glottis exposure increased significantly in A10 group,A20 group and A30 group.The success rate of glottis exposure in A20 group and A30 group was significantly higher than A10 group.Compared with A20 group,the success rate of glottis exposure obviously increased in A30 group.Conclusion Based on CT reconstruction images of upper airway,we can analog study the effect of head extension angle to glottis exposure.

Objective To investigate the relationship between hepatic potential capacity and the pharmcodynarnics of rocuroniurn.Methods The indocyanine green (ICG) excretion test waspertormed one day before operation in 71 patients with decompensated hepatic cirrhosis scheduled to receive devascularization combined with splenectomy.On the basis of ICG retention at 15 min(ICGR_(15)),the patients were divided into groups of I_1(22 cases,ICGR_(15)≤10),I_2(35 cases,1020).Another 20 healthy people(group C)were taken as thecontrols.Rocuronium 0.6 mg/kg was intravenously infused and 0.3 mg/kg rocuronium、was addedwhen T_1 value recovered to 25%control value.The twitch high of adductor pollicis muscle wasrecorded.The time of onset,T1 maximum depression,the clinical duration of initial dose,and thespontanous recovery index were recorded.The clinical duration of repeated maintenance doses and themean dosage of each group were recorded as well.Results The onset time,25% TOF responsePeriod and the recovery index after operation were significantly prolonged in groups of I_2 and I_3compared with those in groups of C and I_1(P<0.05 or P<0.01).No response period of grouP I_3was longer than that of other three groups(P<0.0 1).When the maintenance dose of rocuronium wasadded for more than four times,the clinical action time also showed to be prolonged in an older of I_3>I_2＞I_1 and mean dose reduced in an order of I_3

Objective To explore the accuracy rate of classical anatomical landmark technique ( anterior , central , and posterior ap-proach) for internal jugular vein (IJV) by ultrasound technique.Methods Sixty-four patients with selective operation were included in this study.The anesthetist marked the anterior approach , central approach, and posterior approach for internal jugular vein at 0°(neu-ral), 30°,and 80°of head rotation, respectively.The accuracy of each anatomical landmark were examined by other anesthetist with ul -trasound technique .Results The accuracy rate of anterior approach and central approach were significantly higher than posterior ap -proach at 0°of head rotation, respectively.The accuracy rate of anterior approach was higher than posterior approach at 30°of head rota-tion.The accuracy rate was similar among anterior , central, and posterior approach at 80°of head rotation.Conclusion The accuracy rate was different in different approach of anatomical landmark for internal jugular vein .

Forty rats were randomly divided into four groups and intraperitoneal injection of 1%lidocaine 400mg/kg (group Ⅰ)、1%lidocaine-?-cyclodextrin 400mg/kg (group Ⅱ)、1%alkalinized lidocaine 400mg/kg(group Ⅰ)and 1% alkalinized lidocaine-?-cyclodextrin 400mg/kg(group Ⅳ) respectively. The results showed that there was a significant difference of lethal time between group Ⅰ and Ⅱ, and no significant difference between gronp Ⅲ and Ⅳ; the times of toxic and lethal effects of group Ⅲ and Ⅳ were shortened markedly as compared to group Ⅰ and Ⅱ. It is concluded that ?-cyclodextrin can postpone the release and absorbance of lidocaine,and alkalizer can weaken this action of ?—cyclodextrin.

Objective To observe the effect of propofol of dento-anaesth dosage on prevention of emergence ngitatian(EA). Methods Forty ASA Ⅰ-Ⅱ patients, aged 32-56 years old and undergoing elective laparoscopic cholecystectomy, were randomly divided into two groups, propofol group (group P, 20 cases) and control group (group C, 20 cases). Anesthesia was induced intravenously with 0.1 mg/kg midaxolam, 1.0 mg/kg propofol, 2 μg/kg fentanyl and 0.15 mg/kg vecuronium. Anesthesia was maintained by intravenous and inhalation combined anesthesia. Vecuronium was discontinued about 15 min before the end of sur gery. After entered the postoperative care unit, patients in group P received propofol (0.5 mg/kg) and those in group C were administrated with normal saline (0.05 ml/kg). Time to recovery of spontaneously breathing, duration of opening eyes on verbal command, extubation time were recorded. Incidence of EA in both groups was calculated. Results Time to recovery of spontaneously breathing, duration of opening eyes on verbal com-mand and extubatian time in group P [(15.6±4.5), (18.2±6.5), (22.6±5.5) min, respectively] were sig-nificantly longer than those in group C[(13.2±5.4), (15.7±6.2), (18.4±6.8) min, respectively ]. In-cidence of EA in group P(5% ) was significantly less than that in group C(30%). Conclusion The propofol of dento-anaesth dosage can obviously decrease the incidence of EA in patients undergoing elective laporo-scopic cholecystectomy.

Objective To explore the effects of compound lidocaine cream applied to postoperative wound and nasal packing on postoperative sinus pain after endoscopic sinus surgery . Methods From April 2015 to June 2016, 100 cases of endoscopic sinus surgery were carried out in our hospital under general anesthesia .The patients were randomly divided into two groups , with 50 cases in each group .The group A was given compound lidocaine cream 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing;the group B was given saline 4 g on the nasal surgery wound and medical inflation sponge for intranasal packing . The heart rate (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured at the time of extubation (T0), 1 h after extubation (T1), 4 h after extubation (T2), 10 h after extubation (T3), and 12 h after extubation (T4), respectively.The visual analogue scale (VAS) of pain after extubation was recorded . Results The HR, SBP and DBP at T0, T1, T2 and T3 in the group A were significantly lower than those in the group B (P<0.05).The HR and SBP were not significantly different at T4 between the two groups (P>0.05), while the DBP was significantly lower in the group A than that in the group B (t=-2.562, P=0.012).The VAS scores were significantly lower in the group A than those in the group B at T 0, T1, T2 and T3 (P=0.000).No statistical difference was seen in VAS scores at T4 between the two groups (t=-1.199, P=0.233). Conclusions Application of compound lidocaine cream on nasal endoscopic wound and intranasal packing can effectively relieve the pain after endoscopic sinus surgery .The method has good analgesic effects and is worthy of popularization and application .

A novel method for DNA detection was developed based on the excellent fluorescence properties of cationic conjugated polymer ( CCP)and the target DNA enrichment,separation function of nanoparticles. First,the quencher-labeled DNA capture probes were modified on the surface of Au nanoparticles,and complementary DNA strands were captured. Second,S1 nuclease was added,and the capture probes that had not captured the complementary DNA were removed from the nanoparticles.Finally,the complementary double-stranded DNA was cut by Dnase I,the quenchers were dissociated from nanoparticle and the fluorescence of CCP was quenched by means of combination of quenchers and CCP.The results showed that this method is specific.In the range of 5. 0 -40 nmol/L,the concentration of target DNA was proportional to the fluorescence quenching and the detection limit was 3.7 nmol/L(S/N = 3).

Objective To learn the influence of PALL BB25S and Tyco Hygroboy breathing filter (BF) to Ppeak and Pmean. Methods The changes of Ppeak and Pmean were detected by using PALL BB25S and tyco Hygroboy in simulation ventila- tion. Results (1)When BFs (PALL or tyco, adult or child) were applied and Vt from 100ml/T to 800ml/T, the effect of breathing filter can be no significant changed, but Pmean was raised and Ppeak no change. (2)To compare the tyco BFs, the Pmean of child BF and adult BF, Pmean was significant increased. Conclusion Both of PALL BF and Tyco BF only significantly increase Pmean.

Objective To observe the oxygenation and heartbeat duration effect of peritoneal ventilation with oxygen on a rabbit asphyxia model so as to provide a basis for treatment of severe respiratory damage with peritoneal oxygenation technique. Methods Twenty-four New Zealand rabbits were randomized into control group,air group and oxygen group,eight rabbits per group.Trachea dissection and intubation,carotid artery and vein catheter and placement of peritoneal cavity in and out of air duct were performed.An asphyxia model was built by clamping the tracheal catheter and was administered with peritoneal ventilation (with air in air group and oxygen in oxygen group).Indices including blood gas and mean arterial pressure (MAP) before and at an interval of one minute after asphyxia and heartbeat duration were observed,and their differences between groups were compared. Results The arterial partial pressure of oxygen ( PaO2 ) in the oxygen group was higher than that in the control group within four minutes after asphyxia.The partial pressure of carbon dioxide ( PaCO2 ) [ (77.6 ± 11.2) mm Hg] in the oxygen group was significantly lower than (89.1 ± 10.1 )mm Hg in the control group at four minutes after asphyxia.The heartbeat duration [ (6.48 ± 0.89 ) minutes ] in the oxygen group was longer than (5.03 ± 0.51 ) minutes in the control group.MAP had no obvious changes in the three groups. Conclusion The transperitoneal ventilation with gaseous oxygen can alleviate the decrease of PaO2,increase of PaCO2 and prolong the duration of heartbeat in an asphyxia rabbit model.

Objective To analyze retrospectively the correlation between the difficult airway and thyromental height by three-dimensional reconstruction among the Chinese. Methods Eithty patients who had been scanned by helical CT in the head and neck were allocated into two groups according to Cormack-Lehane grading:paients with Ⅰ-Ⅱ grade were allocated into group 1, and paients with Ⅲgrade were allocated into group 2. Reconstructed images were obtained by AW4.4 workstation and the following parameters were recorded and analyzed:the length from the oral to the under jaw(a), the length from the under jaw to the skin of the neck (b), the vertical distance from the under jaw to the neck was equal to thyromental height(c), the vertical distance from the oral to the cervical vertebra(d), the angle with the under jaw as the vertices and with two lines (a and b) for edge (angle ofα). Results The c value in two groups had no significant difference:(3.97 ± 0.82) cm vs. (3.64 ± 0.62) cm, P>0.05. The d value in group 2 was significantly higher than that in group 1:(8.69 ± 0.48) cm vs. (8.25 ± 0.80) cm, P<0.05. The c/d value and c/a value in group 2 were significantly lower than those in group 1: 0.42 ± 0.07 vs. 0.48 ± 0.12, 0.80 ± 0.18 vs. 0.95 ± 0.25, P<0.05. Conclusions Thyromental height by three-dimensional reconstruction has no significant differences in evaluating the difficult airway among the Chinese. The ratio of the vertical distance from the under jaw to the neck and the vertical distance from the oral to the cervical vertebra, and the ratio of the vertical distance from the under jaw to the neck and the length from the oral to the under jaw shows negative correlation with difficult airway.