Objective To observe the ventilation effect of I-gel laryngeal mask in endoscopic thyroid surgery under general anesthesia. Methods A total of 60 cases of endoscopic thyroid surgery under general anesthesia, were randomly di?vided into 3 groups (n=20):the group that patients used endotracheal intubation (Group Q);the group that patients employed Supreme laryngeal mask (Group S);the group that patients wore I-gel laryngeal mask (Group I). Success rate of insertion, du?ration of insertion, endotracheal pressure of Group S and Group I worerecored, and fiberoptic bronchoscopy was performed in Group S and I to evaluate the position of laryngeal mask. Mean arterial pressure(MAP), heart rate(HR), pulse oxygen satura?tion (SpO2) at time points of before insertion (T0), 1 min after insertion (T1), 3 min after insertion (T2), before the establishment of CO2 operating space (T3), 30 min after the establishment of CO2 operating space (T4), 10 min after the resection of speci?mens (T5), 1 min before removal of laryngeal mask (T6) and 1 min after the removal of laryngeal mask (T7) were recorded and the end-tidal carbon dioxide pressure [ p(CO2) ]and peak airway pressure (Ppeak) form T1 to T5. were also recorded. Occur?rence of nausea and vomiting, sore throat and other adverse reactions after removal of laryngeal mask were also noted. Re?sults The successful rate of insertion was not significant different among all three groups. Compared with Group Q, inser?tion time was significantly shorter in Group I and S (P<0.05). Endotracheal pressure and fiberoptic bronchoscopy score are not statistically different between Group S and I. Compared with Group Q, MAP and HR in T1, T6 and T7 were significantly lower in Group S and I (P<0.05). SpO2,p(CO2) and Ppeak show no statistical difference between three groups. Compared with Group S and Q, the occurrence of sore throat, painful swallowing and bleeding which is indicated by the appearance of blood in laryngeal were all significantly lower in Group I (P<0.05). Conclusion Both I-gel laryngeal mask and Supreme laryngeal mask can be used safely and effectively in airway management of endoscopic thyroid surgery patients while I-gel laryngeal mask is less hurting and more comfortable than Supreme laryngeal mask.

Objective:To observe the effect of stereotactic aspiration combined with corresponding drug therapy in the treatment of cerebral hemorrhage induced by different drugs. Methods:Totally 66 patients with hemorrhage induced by antithrombotic drugs were randomly divided into the control group and the treatment group with 33 cases in each. The control group was given corresponding drug therapy according to the pathogenesis of cerebral hemorrhage, and the treatment group was treated by stereotactic hematoma aspiration additionally. Daily life ability, NIHSS and prognosis improvement were compared between the two groups before and after the treat-ment. Results:After the treatment, NIHSS of the treatment group was ( 10. 17 ± 2. 97 ) and Barthel index score was ( 59. 97 ± 12. 10), which were both better than those of the control group (P<0. 05). The prognosis of the treatment group was also better than that of the control group (P<0. 05). There was no severe adverse drug reaction in the two groups. Conclusion:For different drug in-duced cerebral hemorrhage, corresponding drug therapy should be carried out, and combining with stereotactic hematoma aspiration, the therapeutic regimen can effectively improve neurological deficits and activities of daily living of the patients, and then improve the prognosis of the patients with promising safety.

Objective To investigate the relationship between interleukin (IL)-28B gene polymorphisms (rs12979860 and rs8099917) and treatment response in patients with chronic hepatitis C in China.Methods Taqman probes single nucleotide polymorphism genotyping methods were used to detect the genotypes of rs12979860 (C/T) and rs8099917 (T/G) located at IL-28B gene in 105 included patients.The patients were treated with standard doses of pegylated interferon plus ribavirin and were followed up regularly for therapeutic response and adverse reaction.The relationship between IL-28B gene polymorphism and antiviral treatment response of patients were analyzed.Categorical data were analyzed using Pearson chi-square test or Fisher exact test.Results Totally 105 cases were included in our study and 2 cases lost to follow-up because of moving away.Eight-one cases (78.6%) of the remaining 103 patients were CC/TT genotype (CC/TT group) at rs12979860 and rs8099917, 19 cases (18.4%) were CT/TG (CT/TG group) and 3 cases (2.9%)were TT/TG (TT/TG group).No other genotypes were detected and linkage disequilibrium was discovered at the two polymorphism loci (r2=0.11).After 4 weeks of treatment, 35 cases (43.2%) in CC/TT group, 3 cases (15.8%) in CT/TG group and non in TT/TG group achieved rapid virological response (RVR).There were statistically significant differences among three groups (P=0.033).After 12 weeks of treatment, 45 cases (55.6%) in CC/TT group, 6 cases (31.6%) in CT/TG group and none in TT/TG group achieved early virological response (EVR).There were statistically significant differences among three groups (P=0.025).At the end of the treatment, 68 cases (83.9%) in CC/TT group, 10 cases (52.6%) in CT/TG group and only 1 case (33.3%) in TT/TG group achieved end-of-treatment response (ETR).There were significant statistical differences among the three groups (P=0.003).After 24 weeks of follow-up, 62 cases (76.5%) in CC/TT group, 9 cases (47.4%) in CT/TG group and 1 case (33.3%) in TT/TG group achieved sustained virological response (SVR).There were statistically significant differences among the three groups (P=0.014).One hundred and one cases in CC/TT group developed adverse events, among them 19 cases needed clinical treatment.There were 43 cases in CT/TG group developed adverse events and 9 cases needed treatment.Seven cases in TT/TG group developed adverse events and only 1 case needed treatment.There were no statistically significant difference among three groups (χ2=0.139,P>0.05).Conclusions The genotype of rs12979860 (C/T) and rs8099917 (T/G) at IL-28B gene could affect the treatment response in patients with chronic hepatitis C.RVR and SVR are higher in patients with genotype CC/TT, which might help to guide HCV treatment.

[Objective] To explore the clinical effects of three methods in the treatment of cesarean scar pregnancy.[Method]All the patients with cesarean scar pregnancy accepted treatment at 2 affiliated hospitals of Sun Yat-Sen University from May 2006 to September 2016 were retrospectively analyzed.According to their different therapies,186 of them were divided into three groups:surgery group (undergone transvaginal removal of ectopic pregnancy tissue and repair of uterine defect,73 cases),medical treatment group (treated with medical and combined with curettage,51 cases),UAE group (treated with UAE and combined with suction curettage,62 cases).The success rate,hospitalization time,hospitalization expenses and treatment side effects of the three groups were compared.[Result] The success rates of the three groups were 98.6％,54.9％,and 80.6％;The hospitalization days of the three groups were (7.3 ± 3.3) days,(16.2 ± 11.2) days,(12.6 ± 10.4) d.The hospitalization expenses of the three groups were (7 967 ±1 987) yuan,(5 499-± 1 965) yuan,(15 863 ± 5 941) yuan.The treatment side effects of the three groups were 15.1％,23.5％,and 37.1％.The success rate,hospitalization days,hospitalization expenses and treatment side effects of the three groups were statistically different (P ＜ 0.05).The surgery group has a highest success rate,shortest hospitalization time,lower hospitalization expenses,and less complication.[Conclusions] Transvaginal removal of ectopic pregnancy tissue and repair of uterine defect is a reliable treatment for CSP.

Objective To analyze the clinical features of,concurrence of allergic diseases in,as well as serum levels of total immunoglobulin E (IgE) and specific IgEs in,232 patients with alopecia areata (AA),and to estimate their relationship.Methods Serum samples were obtained from 232 patients with AA and 110 healthy controls from a health check-up center.Turbidimetric immunoassay and fluorescence-based enzyme-linked immunosorbent assay were performed to measure total IgE and specific IgEs to common antigens in these serum samples,respectively.Statistical analysis was carried out by t test,rank sum test,and chi-square test.Results The patients showed a male/female ratio of 127 ∶ 105 with an average age of (26.4 ± 13.8) years and clinical course of (25.3 ± 42.3) months.Among these patients,89 (38.4％) suffered from severe AA,and 67 (28.9％) reported at least one allergic disease.No significant difference was found in the positive rates of serum total IgE (30.2％ vs.21.8％,P ＞ 0.05),anti-Dermatophagoides pteronyssinus and-Cockroach specific IgEs or the serum levels of antiDermatophagoides pteronyssinus or-Cockroach IgE between the patients and healthy controls.The three most common specific IgEs were anti-Dermatophagoides pteronyssinus IgE (34.1％),anti-Dermatophagoides farinae IgE (31.9％) and anti-Cockroach IgE (22.5％) in patients with AA,whose serum levels were positively correlated with the level of serum total IgE separately.A significant increase was observed in the positive rates and serum levels of anti-Dermatophagoides pteronyssinus and-Cockroach specific IgEs in patients with severe and diffuse AA compared with the healthy controls and patients with mild AA,as well as in those of anti-Dermatophagoides pteronyssinus specific IgE in child patients with AA compared with the healthy controls and adult patients with AA (P ＜ 0.05 or 0.01).Conclusions Dust mite allergy may be not only a pathogenic factor for severe,diffuse and childhood AA,but also a risk factor for early onset and severe type of AA.

Objective To study the value of copeptin and APACHE Ⅱ used for assessing acute paraquat poisoning (APP). Methods One hundred and twenty six APP patients were divided into survival group (n = 58) and death group (n = 68), with clinical death as the endpoint of observation. 3 mL blood was obtained from each subject at 2 h , 24 h and 7 d after admission for detecting the levels of copeptin , and APACHE Ⅱ scores were recorded at the same time. Results There was significant difference in dosages of paraquat taken in the death group and the survival group , but the differences were significant in the rescue time , the first time for hemoperfusion and the times for hemoperfusion. 2 h after admission , the death group and survival group had significant difference in elevated copeptin but no significant difference in scores by APACHE Ⅱ. 24 h after admission copeptin decreased to normal level in the survival group but maintained at a higher level in the death group, while the scores by APACHE Ⅱ had insignificant difference between two groups. 7 d after admission, copeptin kept at a higher level and the scores by APACHE Ⅱwere significantly increased in the death group , with significant differences compared to the survival group. The oral doses of pesticides the patients took were positively correlated with copeptin level and scores by APACHE Ⅱ. Conclusion Repeated detection of copeptin and APACHE Ⅱ score are of clinical importance for the assessment of prognosis of APP patients and reasonable distribution of medical resources.

Objective To evaluate fluid responsiveness by stroke volume variation (SVV) in mechanically ventilated patients with refractory septic shock.Methods Forty-two refractory septic shock patients were enrolled in the study.According to the responsiveness of fluid loading, the patients were divided into responsive group and non-responsive group.The SVV values of two groups were retrospectively analyzed.The receiver operating characteristic curve was drafted to determine the cut-off value of SVV for predicting fluid responsiveness.Results Among the 42 refractory septic shock patients, 24 were found responsive to fluid loading, 18 were not;before the fluid loading, central venous pressure, heart rate, mean arterial pressure and global end-diastolic volume index in the both groups showed no significant differences whereas the SVV in the responsive group was much higher than that in the nonresponsive group (P =0.006).Using SVV ≥ 12% as the threshold to predict fluid responsiveness, the sensitivity was 77%,specificity was 85%.Conclusion SVV can accurately predict fluid responsiveness in refractory septic shock patients.

BACKGROUND: Stromal cell-derived factor 1 (SDF1), a potential inhibitor of infection by lymphophilic HIV-1 strains, can help to block the pathway of HIV-1 invasion into the human body.OBJECTIVE: Genotype and polymorphism of SDF1-3 'A allele associated with HIV-1 infection were investigated in She Ethnic Group in the south of China so as explore the possible causes of uninfection by HIV-1 strains among this population.DESIGN: Single sample study.SETTING: Department of Biochemistry and Molecular Biology, Gannan Medical College.PARTICIPANTS: Totally 186 She Ethnic subjects without HIV-1 infection collected randomly from those whose three generations belonged to She Ethnic Group, and inhabited in Qianshan County of Jiangxi Province,Ningde area of Fujian Province and Jingning She County of Zhejiang Province, from January to December 1995.METHODS: The whole blood samples from 186 She Ethnic subjects were collected randomly, and then their genomic DNA samples were extracted respectively. Allelic polymorphism was examined by the polymerase chain reaction and restriction-fragment-length polymorphisms (PCR-RFLP).MAIN OUTCOME MEASURES: The distribution of SDF1-3'A allele in She Ethnic Group in the south of China.RESULTS: The data of 186 She Ethnic subjects entered the result analysis without any loss in the midway. The frequency of SDF1-3 'A allele in She Ethnic Group samples was 19.6%, and the allelic distribution of the gene was in accordance with Hardy-Weinberg equilibrium. No difference was found between male and female individuals.CONCLUSION: The frequency of SDF1-3 'A allele of She Ethnic Group in the south of China was similar to that of Dai Nationality in Yunnan.Based on its slow-down effect on clinical course of AIDS, the mutation of SDF1-3'A is significant in the prevention and treatment of AIDS in She Ethnic Group in the south of China.

ObjectiveThe purpose of the study was to observe and analysis the actual dosage of patients with breast cancer using metal oxide semiconductor field effect transistor (MOSFET) detector.MethodsFirst, Phantom measurements were performed to investigate dose distribution in the area of the junction in a half-field matching method and the influence of factors related to the accelerator. In vivo dose measurements were performed for patients with breast cancer to investigate the skin dose and the junction of supraclavicular-axillary field and tangential field in 6 MV X-ray beams. ResultsPhantom measurements showed that the relative deviation in the junction were within + 3％, and the dose distributions in the junction area depended on the matching field direction (x or y). In vivo measurement of tangential region for patients showed that, the maximum dose deviation between measurement and calculation was -30. 39％,the minimum deviation was - 18. 85％, the average dose deviation was -24. 76％. The dose deviation of tangential fields for patients with breast-conserving surgery was larger than that patients with radical surgery (t =2. 40 ,P＜0. 05), while dose deviation of supraclavicular-axillary fields was not significantly different. The average values of 15 fraction in the junction area showed more stable than one individual measurement.ConclusionsIt is important to real-time, in vivo measurement of radiation dose during radiotherapy in patients with breast cancer, and change treatment plan in time, to ensure the accuracy of target dose.

Objective To evaluate the usefulness of serum galactemannan(GM) for the diagnosis of invasive pulmonary aspergillosis (IPA) in critically ill patients. Methods Study was conducted between February 2007 and July 2008. Included patients on admission ICU who suffer from suspected IPA. GM test and culture were collected 2 weekly. Chnical feature, mycological evidence and optical density index (ODI) were noted. Clinically invasive fungal infection(IFI) were defined proven, probable and possible. The patients were classified into neutropenia, non-neutropenia and treated with immunosuppressive agents, non-neutropenia and non-immunosuppressive agents. To compared of the sensitivity and specificity of GM in different patients. Results 94 patients were included, 4 patients were proven, 29 patients were probable, 34 patients were possible IFI, 27 patients were non-IPA. The positive rate of the GM was 31.9% (30/94). The sensitivity and specificity of GM in proven cases and probable cases are 66.7% and 92.6%. GM assay tended to become positive earlier than the culture 2-10(5.33±2.17)d. We found that differences in patient diagnosis and selection might account for the disparities seen for positive rate for the GM test. There was positive in three of the four patients with proven, the positive rate of GM was 65.5% for probable cases, for possible cases was 17.6%, for non-IPA cases was 7.4% (P=0.001). For patient with neutropenia , treated with immunosuppressive agents and without immunosuppressive agents, the positive rate of GM was 52.9%vs 41.7% vs 34. 6% (P=0.015) ;the sensitivity was 80.0% vs 70. 0% vs 53.8% (P=0.011), the ODI was 1.365 (0.582-6.736) vs 1. 123 (0. 623-6.868) vs 0.554 (0.522-0.823), P=0. 005, respectively. Conclusion These results show that GM test is useful for early diagnosis IPA in critically ill patients. Differences in patient selection and diagnosis might account for the disparities seen for positive rate and sensitivity for the GM test. It has been higher sensitivity and ODI in the patient treated by immunosuppressive agents.