Objective:To observe the effects of blind nasal intubation in maxillofacial anesthesia.Methods:The effects of 1000 cases with blind nasal intubation under NLA were analyzed.Results:The results showed that 736 cases(73.5%) were intubated within 10 minutes,212 cases(21.2%)within 11～20minutes and 45 cases(4.5%) within 21～30 minutes and only 7 patients(0.8%) were obliged to receive tracheostomy.There were neither obvious adverse effects of the cardiovascular system during intubation nor postoperative memory of the intubation in all patients.Conclusion:The results suggest that blind nasotracheal intubation is an useful and safe technique for maxillofacial surgery.

0.05),There were 2 cases of nausea and one case of vomit in Lornoxicam group,as compared with 8 cases of nausea and 4 cases of vomit in Tramadol group.The number of nausea is 2 vs 8(P

Objective:To investigate the diagnosis and treatment for incarceration of retroverted uterus in pregnant women.Methods:This study retrospectively recruited four gravidas with incarcerated retroverted uterus indicated by prenatal ultrasonography in Hunan Provincial Maternal and Child Health Care Hospital from August 2016 to February 2020. Clinical features, diagnosis, and treatment of these cases were described.Results:Vaginal bleeding or discharge were the main symptoms of the four cases and prenatal ultrasound suggested incarcerated retroverted uterus. Obstetric examination was performed for all cases, except one due to small gestational age, and bulging posterior fornix was found in one case. Three cases were diagnosed in the third trimester and one at 14 gestational weeks. In light of gestations, symptoms, and anterior uterine muscle thickness, three patients underwent planned cesarean sections with a median abdominal incision and a superior transverse uterine incision after fetal lung maturation acceleration. Uterus involution was good, and the incisions healed well in these three cases, with all neonates in good condition. Following a two-week knee-chest position treatment, the position of her uterus and bladder turned normal in case 4.Conclusions:Considering the atypical clinical presentations, clinicians should be aware of incarceration of retroverted uterus when related symptoms or signs were presented. Placenta previa might be the comorbidity and should be differentially diagnosed. The timing of a cesarean section is supposed to be determined based on multiple factors. Moreover, a median abdominal incision and a superior transverse uterine incision are recommended, and an anatomic landmark is often required for the latter's accurate position.

Objective To explore the potential association between HLA-DRB1 Alleles and systemic scleroderma (SSc) of the Zhuang Nationality in Guangxi region. Methods Polymerase chain reaction-special sequence primers (PCR-SSP) was used to study the HLA-DRB1 alleles in 58 patients with SSc and 50 healthy controls of the Zhuang Nationalty in Guangxi Province. Comparisons between groups were performed with χ2 test or exact probabilities. Results Sixteen HLA-DRB1 alleles were discovered from the specimens,including 14 in the SSc specimens, and 16 in the control specimens. Among them,the allele frequencies of HLA-DRB1 * 1301 (7.760%, OR=9.000, χ2=4.341, P=0.037), HLA-DRB1 * 1305 (11.207%, OR=3.322,χ2=4.206, P=0.040) and DRB1 * 15 (26.724%, OR=2.679, χ2=6.038, P=0.014) were significantly higher in SSc patients than those of the controls (respectively for 1.000%, 4.000%, 15.000%). Conclusion Our data suggest that the HLA-DRB1 * 1301, HLA-DRB1 * 1305 and HLA-DRB1 * 15 may be the susceptible genes of SSc in Zhuang nationality population.

Objective To investigate the effect of remifentanil and fentanyl on N-methyl-D-aspartate (NMDA) receptor currents in rat spinal cord dorsal horn neurons.Methods Whole-cell patch-clamp technique was used to record the NMDA receptor currents.The primary cultured E14SD rat spinal cord dorsal horn neurons (DH cells) were randomly divided into 3 groups (n =10 each):remifentanil group (group R),fentanyl group (group F) and control group (group C).DH cells were perfused with 4 nmol/L remifentanil (group R) or 10 μmol/L fentanyl (group F) for 60 min followed by washout.NMDA receptor currents were recorded immediately after administration (T0),at 15,30,45 and 60 min of action of drugs (T1-4),and at 15 and 30 min (T5-6) after washout.Results Compared with group C,no significant change in the peak NMDA receptor current was found at each time point in group F and at T0 and T1 in group R (P ＞ 0.05),and the peak NMDA receptor current was significantly increased at T2-6 in group R (P ＜ 0.01).The peak NMDA receptor current was significantly higher at T2-6 than at T0,while lower at T2-4 and T6 than at T5 in group R (P ＜ 0.01).Conclusion Remifentanil can increase NMDA receptor function in rat spinal cord horn neurons,and the peak effect is reached after washout,but fentanyl dose not have the effect.

Objective To investigate the clinical significance in monitoring the dynamic oxygenated parameters in full-term neonates with acute respiratory distress syndrome (ARDS) and its relationship with the prognosis. Methods Forty-one full-term neonates with ARDS from 3 hospitals were divided into two groups according to the clinical outcomes: the death group (n=17) and the survival group (n=24). The parameters of breathing machine and arterial blood gas analysis in these two groups at 2 h, 12 h, 24 h and 36 h after mechanical ventilation were analyzed retrospectively. PaO_2/FiO_2, A-aDO_2, PaO_2/P_AO_2 and RI were calculated and compared between the two groups and within each group among the values of different period. Results Under the circumstance that parameters of breathing machine in the death group were obviously or gradually higher than those in the survival group, PaO_2 in the death group [(10.38?1.45)kPa] was lower than that in the survival group [(11.42?0.98)kPa] only at 36 h (P0.05). In the death group, PaO_2/FiO_2 at 24 h and 36 h [(15.86?4.92)kPa and (15.99?5.62)kPa] was lower than that in the survival group [(21.18?6.48)kPa and (27.12?8.33)kPa](P0.05) . Conclusions PaO2is not a sensitive indicator on the prognosisof NRDSinits early stage . PaO2/Fi O2, A-aDO2, PaO2/PAO2and RI are better than PaO2to reflectthe degree of lung injury ,oxygen exchange rate and therapeutic efficacy . A-aDO2and PaO2/PAO2arevery sensitive in assessing the therapeutic effect and the dynamic monitoring may be helpful injudgingthe prognosis .

BACKGROUND: Brain ischemia-reperfusion (IR) injury is closely connected with the activity of Kinesin. Previous research believes that reduced activity of Kinesin, a mierotubule based motor protein, is an early mark for nerve cell death induced by brain ischemia. Erigeron breviscapus can prevent brain IR-induced proteinase C activation, reduce calcium overload, and reduce ischemic infarctional volume, thus attenuating brain IR injury. However, it still remains less reported at present whether the neuroprotective role of erigeron breviscapus is related to Kinesin activity.OBJECTIVE: To observe the effect of erigeron breviscapus on the activity of Kinesin, a microtubule based motor protein, in hippocampal pyramidal cells during brain IR.DESIGN: Randomized controlled study.SETTING: Anesthesia Department, Affiliated Hospital of Jining Medical College; Anesthesiology Key Laboratory, Affiliated Hospital of Xuzhou Medical College.MATERIALS: This experiment was carried out in the Anesthesiology Key Laboratory, the Affiliated Hospital of Xuzhou Medical College, between February and August 1999. Totally 35 male gerbils were included.METHODS: Gerbils were randomized into sham-operation group (n=5), ischemia-reperfusion control group (n=15) and erigeron breviscapus group (n=15), the latter two of which were further divided into three subgroups according to reperfusion time, namely reperfusion group Ⅰ (reperfusion of 6 hours), reperfusion group Ⅱ (reperfusion of 48 hours) and reperfusion group Ⅲ (reperfusion of 96 hours) with 5 in each subgroup. Gerbils in IR group and erigeron breviscapus group were subjected to IR model preparation before experiment by brain arterial occlusion for 10 minutes, while gerbils in sham-operation group had only bilateral common carotid artery isolated without occlusion. Gerbils in erigeron breviscapus group were pretreated 15 minutes before ischemic inducement with intraperitoneal injection of breviscapine (its effective component is erigeron breviscapus) at a dosage of 45 mg/kg, which was replaced with the same volume of isometric normal saline in sham-operation group and IR group. IHC staining was used to detect hippocampus microtubule based motor protein-Kinesin activity with the assistance of computer imaging analysis technology. MAIN OUTCOME MEASURES: Activity and changes of Kinesin of animals in each group.RESULTS: Totally 35 animals were enrolled in this experiment and all entered the result analysis with no one lost during the experiment. In hippocampal CA1 region, Kinesin activity in IR group was found to descend to 58%, 38% and 12% respectively of that in sham-operation group at IR 6 hours, 48 and 96 hours (P < 0.01). In erigeron breviscapus group at IR 6 hours, 48 hours and 96 hours it was 81%, 61% and 21% of that in shamoperation group, and was obviously higher than that in IR control group (P < 0.05). However, the changes of Kinesin activity were not obviously different in hippocampal CA2, CA3 and CA4 regions.CONCLUSION: Erigeron breviscapus can exert brain-protecting function by reducing hippocampal CA1 Kinesin activity during brain IR injury.

Objective:To explore genetic counseling and prenatal diagnosis strategies for women who have androgen insensitivity syndrome (AIS) family history or pregnancy history of AIS proband.Methods:Three families of complete AIS (CAIS) were retrospectively reported and summarized. The subsequent pregnancies and processes of prenatal diagnosis were followed up.Results:Among three CAIS families, one family had androgen receptors (AR) gene mutation diagnosis; the other two families were diagnosed clinically without gene diagnosis. All three mothers of CAIS probands were in pregnant again when they sought counseling, with gestational weeks between 7－13 weeks. They underwent chorionic villi sampling or amniocentesis in their second trimester (at 12, 16, 17 weeks respectively). Chromosome gender of all three fetuses were 46,XY, which was inconsistent with the ultrasonographic phenotype of external genitalia. All patients chose selective abortion in their second trimester. The external genitalia of all aborted fetuses were female phenotype, which supported the diagnosis of CAIS.Conclusion:Genetic counseling and prenatal diagnosis should be provided to high-risk patients with family history of AIS or proband pregnancy history, so as to achieve the goal of good childbearing and sound childrearing.

BACKGROUND:intervertebral disc degeneration can reduce nucleus pulposus cells,and peroxiredoxin II involved in the regulation of resist oxidation damage,cell division,differentiation,signal transduction and apoptosis.Peroxiredoxin Ⅱ has promotive effect on intervertebral disc degeneration,whereas the mechanism remains poorly understood.OBJECTIVE:To observe the effects of perexiredoxin Ⅱ on human intevertebral disc cells activity and type Ⅱ collagen synthesis in vitro.METHODS:Human degenerated human lumbar disc cells were cultured in vitro,and assigned into the control and peroxidase Ⅱ groups.Peroxidase Ⅱ with doses of 10,100 and 1 000 ng/L were added into the peroxidase Ⅱ groups.The cells were identified by immunohistochemical staining,and the cell proliferation was detected using cck-8 kit.Cell supematant was collected at days 3 and 7 after operation,and the expression of type Ⅱ collagen was measured by double-antibody sandwich enzyme-linked immunosorbent assay.RESULTS AND CONCLUSION:In vitro cultured human degenerative lumbar intervertebral disc nucleus pulposus cells by adding peroxidase increased with the dose-Ⅱ,the disc nucleus pulposus cells of the volume and type Ⅱ collagen synthesis gradually reduced(P ＜ 0.01).Tips peroxidase Ⅱ on the intervertebral disc nucleus pulposus cells,the number and type Ⅱ collagen synthesis significantly inhibited in a dose-dependent manner.Thus speculated that peroxidase Ⅱ on the nucleus pulposus cells in vitro may lead to disc degeneration as a precipitating factor.

Objective To explore the application of reading education in cultivating nursing students' humanities in vocational college.Methods Nursing students were selected at random and divided into two groups,35 students in the experimental group and 50 in the control group.The students in the experimental group were given the 2-year related instruction through reading activities in the light of the principle enhance general humanities foundation in the first grade and strengthen humanistic features in the second grade.Nursing skill assessment and questionnaire oriented to humanities were used to test the educational effect.Results The result of nursing skill assessment in the experimental group was significantly better than that of the control group.The score of humanities' moral,law,culture and aesthetic dimension and the total score of the experimental group were significantly better than those of the control group.Conclusions Well targeted reading is effective in the cultivation of nursing students' humanities.Meanwhile reading education can serve as an important and beneficial way to improve the cultivation mode of vocational college's nursing humanities.