Objective To compare the clinical efficacy of orotracheal intubation with video intubationscope and visual laryngoscope in obese patients. Methods 60 ASA I or II obese patients, BMI >30 kg/m2, aged 22 ~ 60 years, underwent elective surgery requiring orotracheal intubation were randomly divided into two groups: the video intubationscope group (Group V) and the visual laryngoscope group (group K), 30 cases in each. Cormark-Lehane grade (C-L classification), tracheal intubation time, total intubation attempts, success rate of tracheal intubation and complications of tracheal intubation were recorded. Results Good glottic exposure view (C-L classification) was achieved in the two groups (P > 0.05), there were no significant difference in tracheal intubation time, the total success rate and the one-time success rate of tracheal intubation between the V and K groups [(24.4 ± 11.6) s vs (22.3 ± 13.2) s, 100.0% vs 100.0%, 90.0% vs 86.7%] (P > 0.05). There was no significant difference in the complications of tracheal intubation between the two groups (P > 0.05). Conclusion Video intubationscope and visual laryngoscope are suitable for tracheal intubation in obese patients, and has an advantage of good glottis exposure view, rapid intubation, great successful rate and few complications.

Objective To compare the clinical efficacy of the video intubationscope and Macintosh direct laryngoscope in simulated cervical spine immobilization. Methods Sixty patients, ASA Ⅰ or Ⅱ , between 19 and 68 years old, underwent general anesthesia requiring oro-tracheal intubation, were randomly assigned to undergo intubation using video intubationscope (group V) or Macintosh direct laryngoscope (group M), 30 cases in each. Each patient was provided mannal in-line axial stabilization of the head and neck by an experienced assistant. The following data were recorded and analyzed: glottic exposure time, Cormark-Lehane grade (C-L classification), tracheal intubation time, total intubation attempts, manoeuvre needed to aid tracheal intubation, failure for tracheal intubation, one-time success rate of tracheal intubation and total success rate of tracheal intubation, mean arterial pressure (MAP) and heart rate (HR) before induction of anesthesia, before intubation, at glottic exposure, at intubation, 1 and 3 min after intubation, and complications. Results Compared with group M, better glottic exposure view (C-L classification) was achieved in group V (P < 0.05), and the tracheal intubation time was shorter (P <0.05), but the glottic exposure time was longer (P < 0.05). More assistance was need and the intubation failure and complication rate was higher in group M (P < 0.05). Compared with T1, MAP in group M were significantly increased at T2~T5 (P < 0.05), MAP in group V were no significantly changed at T2 (P > 0.05) and were significantly increased at T3~T5 (P < 0.05); compared with group M, MAP at T2~T4 in group V were significantly lower (P < 0.05). Compared with T1, HR in group V were no significantly changed at T2~T5, HR in group M were significantly increased at T2~T4 (P < 0.05), and significantly higher than that in group V at the same time point (P < 0.05). Conclusion Compared with Macintosh direct laryngoscopy in patients with cervical spine immobilization, Video intubationscope could provide better view of glottic exposure, decrease the difficulty of intubation and increase the success rate of intubation, have less complications and influence on patient’s hemodynamics.

Objective To establish a method to simultaneously determine syringing and isofraxidin by HPLC;To investigate the features of percutaneous absorption in vitro of Jiegugao blended and pasted by white vinegar, honey and vaseline; To discuss the mechanism of commonly used ointment matrices in Tujia Minority. Methods Rat abdomen skin in vitro was as transdermal barrier;the modified Franz diffusion pool was used to simulate human skin medication; the content of syringin and isoprofen was determined by HPLC; the percutaneous absorption equation was established and the related parameters, such as cumulative permeation rate and permeation rate, were calculated. Results When using Syncronis C18 (250 mm × 4.6 mm, 5 μm) as chromatographic column, acetonitrile-0.1%phosphoric acid as mobile phase, 1.0 mL/min as perfusion speed and 265 nm as determine wavelength, regression equation of syringingwas A=10 686.454 6C+1565.778 8 (r=1.000 0), regression equation of isofraxidin was A=12 297.305 4C-5913.729 9 (r=0.999 9). Cumulative permeation quantity of syringing in Jiegugao blended and pasted by white vinegar, honey, vaseline and blank were 7.549 2, 4.580 3, 3.890 8 and 5.378 4 μg?cm-2?h-1 respectively and permeation rate were 25.66%, 16.11%, 13.73% and 18.78%. Meanwhile, cumulative permeation quantity of isofraxidin were 2.536 9, 1.941 8, 1.178 2 and 2.293 6 μg?cm-2?h-1 respectively and permeation rate were 47.04%, 35.06%, 22.11%and 41.11%. Conclusion Using white vinegar as the ointment matrix can promote the percutaneous absorption of effective composition in Jiegugao blended. However, it will retard the percutaneous absorption of effective composition in Jiegugao when using honey and vaseline as the ointment matrices, but honey and vaseline can be used as a slow-release matrix.

Objective To investigate the effect of lineal polypeptide injection on immune function of severe sepsis patients in ICU.Methods 40 severe sepsis patients in ICU were randomly divided into two groups after signed the consent form:the treatment group (20 cases)and the control group (20 cases).On the 1st day of antibiotic therapy, the patients in the treatment group were simultaneously treated with lineal polypeptide intravenous injection,while the patients in the control group received the same routine treatment,but without lineal polypeptide injection,all with a 10 days treatment course.Blood bacteria culture and drug sensitivity test were completed after entering the hospital. The scores of Sequential Organ Failure Assessment(SOFA)before treatment and at day 3,7 and 10 of therapy were evaluated.The peripheral blood of patients was taken and send to the clinical laboratory.The WBC,NEU%,PCT, hs -CRP,IL -6,total T lymphocytes (CD +3 )and T lymphocyte subgroup (CD +4 ,CD +8 ,CD +4 /CD +8 )were detected in both the treatment group and the control group.Adverse drug events were also detected in the process of therapy. Results Compared with before treatment[(5.56 ±2.03)points],after 7 days of lineal polypeptide therapy,the SOFA score of the treatment group[(3.48 ±1.83)points]decreased significantly(t =2.793,P <0.05),and after 10 days therapy,the descending degree in the treatment group was more significantly and declined earlier than the control group (t =4.401,P <0.01 ).In the aspect of improving the inflammatory markers,two groups were all improved after therapy,but the degree of improvement in the treatment group was better than the control group.After 7 days therapy,IL -6 level was (37.61 ±7.51)mg/L in the treatment group,while (50.49 ±7.68)mg/L in the control group (t =1.969,P <0.01),and the improvement of NEU% was not found in control group.In the aspect of improving the immune function,the CD +3 ,CD +4 ,CD +4 /CD +8 ratios were increased significantly [before therapy:(41.27 ±6.91)%,(19.65 ±5.29)% and (0.96 ±0.42);after 3 days therapy:(46.57 ±7.11 )%,(24.99 ± 7.70)%,(1.27 ±0.39)],and CD +8 [before therapy:(25.62 ±5.18)%,after 3 days therapy:(23.51 ±3.19)%] was decreased dramatically after 3 days of lineal polypeptide injection treatment,there was significant improvement in time and degree in the treatment group compared with the control group (t =1.390,t =1.407,t =3.974,t =2.081, all P <0.05).No severe adverse drug events were found.Conclusion As an immune modulator,lineal polypeptide injection could effectively improve the immune function of severe sepsis patients in ICU.

Objective To evaluate the effect of single operation video intubationscope assisted by disposable mouthpiece in orotracheal intubation. Methods 100 patients undergoing general anesthesia were randomly divided into two groups with 50 cases in each: mouthpiece group (group M): single operation video intubationscope assisted by disposable mouthpiece in orotracheal intubation was performed; control group (group C): Video intubationscope oral intubation assisted by helper were applied. The BP, MAP, HR and SpO2 in the two groups were recorded during intubation. The success rate of intubation, duration of glottis exposure, duration of intubation and complications were recorded. Results Oral-tracheal intubation with video intubationscope were successfully completed for all 100 pa-tients, SpO2 during intubation in two groups was maintained above 95.0%, there was no significant hemodynamic changes in two groups. There were no significant difference in the one-time success rate of intubation, duration of glottis exposure and duration of intubation between group M and group C [92.0%vs 88.0%, (13.0 ±7.0) vs (14.0 ±8.0), (20.0 ± 10.0) vs (21.0 ± 11.0), > 0.05]. No significant complications were reported. Conclusion Compared with video intubationscope oral intubation assisted by helper, single operation video intubationscope assisted by dis-posable mouthpiece in orotracheal intubation also is feasible and effective without needing assistant, it is a simple and convenient technology worthy of application.

Objective To explore the impact of pre positioned nasopharyngeal airway combined with high head pre inhalation of oxygen on lung oxygenation and blood gas analysis indicators in morbid obese patients undergoing laparoscopic weight loss surgery.Methods 100 morbid obesity patients from January 2020 to April 2022 planned to undergo elective laparoscopic weight loss surgery were selected as the study subjects.All the patients were divided into two groups according to the random number table method:group A with a head height of 25° and a pre installed nasopharyngeal airway;group B with a head height of 25° and no pre installed nasopharyngeal airway,with 50 patients in each group.Two groups were pre oxygenated for 3 min before undergoing intravenous anesthesia to induce tracheal intubation.Observe and record the pH value,partial pressure of oxygen in arterial blood(PaO2),partial pressure of carbon dioxide(PCO2),partial pressure of oxygen in arterial blood/fractional concentration of inspiratory oxygen(PaO2/FiO2)as well as the ratio of arterial pressure to alveolar oxygen partial pressure(a/APO2)of the two groups of patients who breathed air(T0)after entering the room,ventilated with mask positive pressure for 3 min(T1),and intubated with trachea for 3 min(T2).Record plateau pressure(Pplat),peak airway pressure(Ppeak),and dynamic lung compliance(Cdyn)at T1,T2,and 5 min after pneumoperitoneum(T3).Record the time for percutaneous arterial oxygen saturation(SpO2)to decrease to 92.0%under different artificial ventilation after tracheal intubation,the time for SpO2 to recover to 96.0%after resumption of ventilation,and the occurrence of adverse reactions.Results Compared with Group B,at time point T1,Group A showed a decrease in PCO2 and an increase in PaO2,with statistically significant differences(all P<0.05);Compared with T0,at time points T1 and T2,PaO2/FiO2 and PCO2 in the two groups were increased,while a/APO2 decreased(all P<0.05).At T1 time point,Pplat and Ppeak in Group A were lower than those in Group B,while Cdyn was higher than that in Group B,with statistical significance(P<0.05);Compared with T1 time point,at T2 and T3 time point,Pplat and Ppeak in Group A increased,while Cdyn decreased,with statistically significant differences(all P<0.05);Compared with T1,Ppeak increased in B groups at T2 time point(P<0.05),while Pplat and Ppeak increased in T3 time point,and Cdyn decreased in B group,with statistical significance(all P<0.05).Compared with Group B,Group A had a longer time for SpO2 to decrease to 92.0%and a shorter time for SpO2 to recover to 96.0%(P<0.01).Conclusion The combination of pre positioned nasopharyngeal airway and high head pre inhalation of oxygen can effectively improve acute respiratory obstruction during induction of general anesthesia insertion in morbid obesity patients,and extend the duration of no ventilation.