Objective To evaluate and compare the clinical applications of Disposcope (DS)en-doscope and GlideScope (GS)video laryngoscope in double-lumen endobronchial tube (DLT)intuba-tion of the patients with difficult airway.Methods Forty patients scheduled for elective thoracic sur-gery after failure to place the DLT with modified general laryngoscope 2 attempts were randomly dev-ided into 2 groups,20 cases in each group.Patients underwent DLT with DS (group DS)or GS (group GS)intubation after failure to intubation.The causes of the failure of intubation,the intuba-tion of the video laryngoscope,the time of intubation and the location of left double lumen tube were recorded.And the postoperative injury of oral mucosa,teeth and respiratory tract were observed. Results The causes of the difficulty for DLT intubation included:long,high arched palate,large epi-glottis,reduced jaw opening,protruding or loose incisors,over bite,reduced neck extension.The in-tubating achievement ratio was significantly higher in group DS than in group GS (P < 0.05 ).But there was no obvious difference between the two groups in the location success rate and intubation time.The postoperative incidence of tooth loss and oral mucosal injury was significantly higher in group GS than in group DS (P <0.05).Conclusion Both DS and GS were great helpful to intubation and location of DLT in the patients with difficult airway.But DS was more superior than that of GS in the difficult airway of reduced jaw opening,protruding or loose incisors,over bite and reduced neck extension.

Adult ; Aged ; Aged, 80 and over ; Humans ; Male ; Middle Aged ; Occupational Health ; legislation & jurisprudence ; Pneumoconiosis ; diagnosis

Objective To evaluate the perinatal outcome of three types of monochorionic diamniotic (MCDA) twins with selective intrauterine growth restriction (sIUGR).Methods From January 2005 to June 2012,clinical data of 42 pairs of MCDA twins (84 fetuses) with sIUGR and 71 pairs of normal MCDA twins (142 fetuses) in the same period were analyzed retrospectively in the First Affiliated Hospital of Sun Yat-Sen University.Fetuses with sIUGR were classified into three groups based on umbilical artery Doppler flow.There were 25 cases of type Ⅰ,11 cases of type Ⅱ and 6 cases of type Ⅲ.The perinatal outcome was compared between sIUGR and normal MCDA twins,and among the three types of sIUGR as well.Perinatal outcomes included gestational age at delivery,rate of intrauterine fetal death (IUFD),birth weight,intertwin discordance of birth weight,neonatal death and survival rate at 6 months.Results (1) The gestational age of sIUGR at delivery was significantly earlier than the control group [(34 ± 3),(36 ±2) weeks,respectively],and the rate of IUFD of both fetuses of sIUGR was significantly higher (4.8％,0,respectively).In the sIUGR group,the average birth weight of large or small twins[(2130 ±.350),(1520 ±400) g,respectively] was smaller than those in the control group [(2470 ± 500),(2340 ± 460) g,respectively].The difference was statistically significant (P ＜ 0.05,P ＜ 0.01,respectively).The intertwin discordance of birth weight in sIUGR group was significantly larger (27.6％) than the control group(4.0％,P＜0.01).(2) The gestational age at delivery in type Ⅱ and type Ⅲ [(34 ±5),(34 ±2) weeks,respectively] was significantly earlier than the control group (P ＜ 0.05).The rate of IUFD of both fetuses in type Ⅱ (18％) was significantly higher than in type Ⅰ (0) and the control group (0,P ＜ 0.05).In sIUGR group,the average birth weight of small twins in type Ⅰ,type Ⅱ and type Ⅲ was (1640 ±430),(1330 ±310) and (1500 ±380) g respectively,all of which were significantly smaller than that in the control group (P ＜ 0.05).The average birth weight of small twins in type Ⅱ was smaller than in type Ⅰ and the difference was statistically significant (P ＜ 0.05).In sIUGR group,the intertwin discordance of birth weight in type Ⅰ,type Ⅱ and type Ⅱ was 24.1％,34.6％,31.3％ respectively,all of which were significantly larger than that in the control group(4.0％,P ＜ 0.05).There were no statistically significant differences of the intertwin discordance of birth weight among the three types of sIUGR(P ＞0.05).Survival rate at 6 months in type Ⅱ (64％) was significantly lower than in type Ⅰ (92％) and the control group (91.5％,P＜0.01).Conclusions The perinatal outcome of MCDA twins with sIUGR is poor.The outcome is different among the three types of sIUGR,and type Ⅰ is the worst.Type Ⅱ is associated with a high risk of intrauterine fetal demise.It is important to monitor the intrauterine situation closely.

Purpose To explore the clinical value of color Doppler ultrasound in monitoring hemodynamic changes in main renal artery of neonatal asphyxia. Materials and Methods A total of 60 cases of neonatal asphyxia were divided into mild asphyxia (38 cases) and severe asphyxia (22 cases) according to Apgar score 1 min after born. Then the peak systolic velocity (Vs), the end diastolic velocity (Vd) and the resistance index (RI) of the main renal artery were obtained by color Doppler ultrasound on day 1 and day 3;the level of endothelin-1 (ET-1) was also recorded accordingly. The above results were compared with those of 20 cases of healthy full-term new born infants. Results On day 1, Vs and Vd of the main renal artery in the groups with mild asphyxia and severe asphyxia were both lower than those in healthy group (P<0.05), but RI was higher (P<0.05), with more dramatic changes in the group with severe asphyxia (P<0.05). On day 3, Vs and Vd in the groups with mild asphyxia and severe asphyxia reduced compared with those on day 1, whilst RI was higher than that on day 1. Vd and RI in the group with severe asphyxia changed more significantly (P<0.01). As to the value of ET-1, both groups with mild asphyxia and severe asphyxia showed higher level than healthy group (P<0.01). More dramatic increase appeared in the group with severe asphyxia (P<0.05). In the groups with mild asphyxia and severe asphyxia, the Vs and Vd of the main renal artery were negatively correlated with ET-1 on day 1 and day 3 (r=-0.823,-0.845;P<0.01), while the RI was positively correlated with ET-1 (r=0.785, P<0.01). Conclusion Both color Doppler ultrasound imaging and neonatal urine ET-1 test can reflect degree of renal injury after neonatal asphyxia dynamically and noninvasively, which can be used to evaluate the injury severity.

Objective To investigate the influence of smoking,drinking cognition and behavior among the officers and soldiers in South China War Zone after health management,and to explore the establishrent of appropriate health management model for the army.Methods Harmfulness cognition,rate,quantity,types of drinking and smoking were investigated and analyzed before and after health management among 1 102 officers and soldiers in South China War Zone by providing a set of health education,psychological counseling service,disease and lifestyle intervention of health management as a whole.Results The harmfulness cognition rate of smoking and drinking raised from 95.6％ and 94.1％ to 98.7％ and 97.8％,the smoking and drinking rate dropped from 64.7％ and 72.6％ to 37.2％ and 61.4％ after health management.The x2 values were 18,18.9,153,20.8,and had significant difference (P＜0.001).The rate of occasional smoking,a small amount of smoking,often smoking dropped from 28.3％,25.8％,45.9％ to 18.5％,12.2％,31.5％ as well as the rate of occasional drinking,a small amount of drinking,often drinking has dropped from 56.6％,32.3％,11.1％ to 49.8％,23.4％,4.1％.The x2 values were 26.8,62.1,31,9.61,8.06,19.4,and had significant difference (all P＜0.01).Conclusion The health management improves the harmfulness cognition of smoking and drinking,and decreases the rate and quantity of smoking and driking.It has a positive effect on improving the heahh literacy and developing health way of life in officers and soldiers.

Occupational Health Services ; methods ; organization & administration

Objective To investigate expression of the phosphatase and tensin homolog (PTEN) gene in breast cancer cell line and its effect on biologic characteristics.Methods The normal PTEN expression cell line MDA-MB-231 (M231) was used in this study.PTEN-shRNA plasmid was transected into M231 breast cancer cells to knock down the expression of PTEN.The changes of PTEN expression,proliferation,invasion and metastasis of PTEN knocked down cell were tested by RT-PCR,Western blot,CCK-8,scratch and Transwell.Results PTEN-shRNA was successfully transected into M231 cells.PTEN mRNA and protein expression was efficiently inhibited in M231-3001 cell lines than that in control group M231-scr(P ＜ 0.01),M231-3001 cell lines showed a greater capability of colony formation,migration and invasion than that in control group M231-scr (all P ＜ 0.05).Conclusions PTEN,as a suppression gene,its low expression can promote the proliferation,migration and invasion of breast cancer cells.

Objective To compare the clinical value of ultrasound and X-ray guided percutaneous nephrolithotomy ( PCNL) for treat-ment of kidney calculi. Methods We searched relevant clinical controlled articles in PubMed,EMBASE/Cochrane library and CNKI data-base. The outcome indicators included stone clearance rate, complication rate,puncture time,blood loss,and hospital days. All data were ana-lyzed by Revman 5. 0 software. Results There were 9 articles involved in 1693 patients. The results suggested that there was no significant difference in stone clearance rate between ultrasound group and X-ray group[OR=1. 11,95%CI(0. 83,1. 49),P=0. 47]. However,the complication [OR=0. 43,95%CI (0. 27,0. 69),P=0. 0004],time to puncture[WMD= -4. 54,95%CI( -0. 45,-8. 62),P=0. 03], blood loss[WMD= -22. 77,95%CI( -36. 57,-8. 97),P=0. 001],and hospital days[WMD= -0. 16,95%CI( -0. 28,-0. 03),P=0. 02] were better in ultrasound group than those in X-ray group. Conclusion Ultrasound and X-ray guided PCNL had an equal stone clear-ance rate,but it seemed that ultrasound was better than X-ray in time to puncture and hospital days after operation. However,the results of this meta-analysis should be treated carefully because of limitation of data and heterogeneity.

Objective To explore the correlation between cytomegalovirus pneumonia (CMV-IP) and viral load in renal transplant recipients and to find out the threshold value of viral load for predicting CMV-IP. Methods The blood samples of 56 renal transplant recipients were taken weekly for the first 2 months and every 2 weeks for 2-6 months after transplantation.Real-time PCR were used to quantify the plasma CMV DNA.The mean viral loads of CMV-IP group and non-CMV-IP group in each time were compared using Wilcoxon test.Different cut-off values were tested to find the suitable values to predict the CMV-IP. Results Of the 56 recipients,8 (14.3%) developed CMV-IP.The viral loads were near zero in the first 4 weeks in both groups;from week 5 the viral load of CMV-IP group increased gradually and reached the climax at week 8 and then declined,but the load of non-CMV-IP group fluctuated at a low level.During weeks 5-11,the viral loads of CMV-IP group were higher than those of non-VMV-IP group.At 5,7 and 9 weeks,the differences of the viral loads between the 2 groups were significant (P