Objective To compare medical students' learning curve between Macintosh laryngoscope and optical laryngoscope in endotracheal intubation and to decide which one is more suitable for novice personnel.Methods Totally 26 interns after being trained by experienced anesthesiologists were enrolled in this study.They performed intubation on 6 patients by using both Macintosh laryngoscope and optical laryngoscope ( each laryngoscope for 3 patients) under the supervision of experienced anesthesiologists.The sequence of laryngoscope was determined by computer-generated random number list.Results Totally 149 patients who were ready to receive surgery under general anesthesia were enrolled in this randomized crossover controlled study.Duration of intubation was significantly shorter in Airtraq group (78 -± 33 ) s than in Macintosh group (114 ± 32) s,P ＜ 0.001.Intubation success rate was significantly higher in Airtraq group than in Macintosh group ( 87.8％ vs.66.7％,P ＜ 0.05 ).Conclusions With the advantages of rapid learning curve,higher intubation success rate and shorter intubation duration,Airtraq laryngoscope is easier to master for novice personnel.

Objective: To explore influence of trimetazidine on cardiac function, levels of inflammatory factors, brain natriuretic peptide (BNP) and homocysteine (Hcy) in patients with congestive heart failure (CHF) and its therapeutic effect.Methods: A total of 120 patients diagnosed as CHF in our department were selected.According to random number table, they were randomly and equally divided into routine treatment group and trimetazidine group (received trimetazidine based on routine treatment group, 20mg/time, twice/d), both groups were treated for six months.Left ventricular relaxation time (LVRT), E peak decrease time (EDT), early diastolic peak velocity/late diastolic peak velocity (E/A), left atrial diameter (LAD), levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, BNP and Hcy were measured and compared between two groups before and after treatment.Results: After six-month treatment, total effective rate of trimetazidine group was significantly higher than that of routine treatment group (93.3% vs.80.0%, P=0.032);compared with routine treatment group after treatment, there were significant reductions in LVRT [(92.1±4.6)ms vs.(74.5±2.7)ms], EDT [(165.3±5.1)ms vs.(139.2±3.9)ms] and LAD [(41.1±2.6)mm vs.(33.1±1.8)mm], and significant rise in E/A [(0.89±0.21) vs.(1.16±0.51)] (P<0.01 all);and significant reductions in serum levels of IL-6 [(16.3±2.8) ng/ml vs.(11.3±1.3) ng/ml], TNF-α [(3.17±0.99) ng/ml vs.(2.01±1.12) ng/ml], BNP [(311.4±27.9)pg/ml vs.(278.2±31.3) pg/ml] and Hcy [(15.6±4.2) pg/ml vs.(11.3±2.7) pg/ml] in trimetazidine group, P<0.01 all.Conclusion: Trimetazidine can significantly improve heart function, reduce inflammatory factor levels and inhibit atrium remodeling in patients with congestive heart failure, and the therapeutic effect is significant.

Objective To investigate the diagnosis and treatment of pseudotumorous pancreatitis. Methods A retrospective clinical analysis was made on 20 cases with pseudotumorous pancreatitis in one stage from 1983.7 to 2004.5. Resulds There were 14 males and 6 females. Jaundice and abdominal pain were the major complaints. 17 cases underwent surgery, including cholangiojejunum Roux-en-Y anastomosis in 11cases, pancreatoduodenectomy in 3 cases, laparotomy and biopay in 3 cases . 3 cases underwent US-guided needle biopsy. All the 15 cases who were followed up had no jaundice at all after operation and abdominal pain relief was achieved to various degree. Conclusion It's difficult to diagnose pseudotumorous pancreatitis before operation. Hepatojejunal Roux-en-Y anastomosis was suitable for the patients with obstructive jaundice. When refractory abdominal pain was encountered or intraoperative pathologic diagnose was diffcult, pancreaticoduodenectomy should be recommended.

Objective:To explore the efficacy of nimodipine in treating cognitive impairment of cerebral small vessel disease (CSVD) and the value of magnetic resonance diffusion tensor imaging (DTI) in CSVD.Methods:A total of 80 patients with CVSD and cognitive dysfunction who admitted to Suzhou Municipal Hospital from February 2018 to February 2019 were selected, and the patients were divided into control group (40 patiengts) and observation group (40 patients) by random number table method. The control group received basic treatment and donepezil, and the observation group added nimodipine on the basis of control group. All patients were followed up for 12 months. Before treatment, 6 months after treatment and 12 months after treatment, the patients’Montreal cognitive assessment scale (MoCA) score, daily living ability scale (ADL) score, and Tinetti balance and gait analysis(TGA) were recorded. The levels of total cholesterol (TC), triacylglycerol (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) before and after treatment were recorded. The changes of DTI data before and after 12 months′ treatment in the two groups were recorded.Results:The MoCA score, ADL score, and TGA score of the two groups were higher than those before treatment and at 6 months and 12 months after treatment, and those 12 months after treatment were higher than those at 6 months after treatment. There were significant differences ( P<0.05). The MoCA and ADL scores of the observation group were higher than those of the control group at 6 and 12 months after treatment at 6 months: (24.61 ± 2.54) scores vs. (22.21 ± 2.83) scores, (71.53 ± 6.25) scores vs. ( 69.51 ± 6.81) scores; 12 months: (26.39 ± 2.16) scores vs. (23.76 ± 2.64) scores, (78.39 ± 5.76) scores vs. (72.39 ± 6.12) scores, P<0.05. At 6 months and 12 months after treatment, the visual space and execution ability, delayed memory, and orientation scores were higher than those before treatment, and in the observation group 12 months after treatment was higher than those 6 months after treatment: (5.97 ± 1.37) scores vs. (5.36 ± 1.29) scores, P<0.05. The observation group′s visual space and executive ability, abstract thinking, delayed memory, and orientation score were higher than those in the control group at the same period ( P<0.05). The levels of TC, TG, LDL-C, Hcy and hs-CRP of the two groups after treatment for 6 and 12 months were lower than those before treatment, and the levels of these index at 12 months after treatment were lower than those at 6 months after treatment ( P<0.05). The levels of Hcy and hs-CRP in the observation group were lower than those in the control group at 12 months after treatment, and Hcy was lower than that in the control group at 6 months after treatment ( P<0.05). After treatment, the fractional anisotropy (FA) values of the center, frontal lobe, and parietal lobe of both sides of the two groups were higher than those before treatment, and the difference in the observation group before and after treatment was higher than that of the control group ( P<0.05). After treatment, the mean diffusivity (MD) values of both frontal lobe and parietal lobe of the two groups were lower than those before treatment, and the difference between the observation group before and after treatment was higher than that of the control group ( P<0.05). Conclusions:Nimodipine has a good effect on the treatment of CVSD, which can effectively improve the patients′ cognitive impairment and other symptoms. DTI can sensitively sense the white matter integrity and cerebral blood flow perfusion of patients, which has a positive significance for the prevention and treatment of CVSD.

Purpose To investigate the clinical and pathological features and differential diagnosis of alveolar soft part sarcoma (ASPS).Methods The clinical data were retrospectively analyzed in 21 cases of ASPS. Histopathological and immunohistochemical changes of the tumors were also observed in the paraffin-embedded tissue samples.Results In 21 cases, 11 were male and 10 females. Ages of the patients ranged from 4 to 56 years old,with mean 25.9 years old.The lesions were mainly located in the deep soft tissues of legs.Microscopically,tumor cells with granular cytoplasm arranged in alveolar or solid structures,and were separated by sinusoidal vessels. There existed crystals in the cytoplasm of tumor cells after PAS staining.Immunohistochemically,10 cases were positive for MyoD1, 4 positive for desmin,9 positive for S-100,11 positive for NSE, and 11 positive for Vim. All of ASPS were negative for AE1/AE3,CK, EMA, SMA, MSA and Syn.Conclusions ASPS is a rare malignant neoplasm in adolescents and young adults. It is prone to early hematogenous metastases and a high recurrence rate after conservative surgical excision. Therefore, the prognosis of ASPS is poor. Careful analysis of the clinicopathological features and immunohistochemisitry will be helpful to reach an accurate diagnosis.

Aged ; Aged, 80 and over ; Candidiasis ; complications ; microbiology ; Coal Mining ; Esophagitis ; complications ; microbiology ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; complications ; microbiology

Purpose To study the clinicopathological features, immunophenotype and differential diagnosis of proximal epithelioid sarcoma (PES).Methods The clinical, radiological and pathological features were reviewed in 6 cases of PES.Results The patients consisted of five males and one female with ages ranging from 32 to 74 years (mean 56 years). Clinically, the tumor mass were progressively-growing solitary nodules with the fuctional disorder and pain. The sites of the tumor involvement were buttock (1 case), thigh (2 cases), iliac spine (1 case), lumbar spine (1 case) and anterior sacrum (1 case). Histologically, the tumors were mainly consisted of epithelioid cells with round or oval nuclei, prominent nucleoli and eosinophilic cytoplasm, some tumor cells appeared rhabdoid features. Immunohistochemically, the tumor cells were positive for vimentin (6/6), CK (5/6), EMA (6/6),β-catenin (6/6), CD99 (5/6), and CD34 (4/6), but negative for S-100 protein, HMB 45, CD 117 and CD 31.Conclusion PES is a distinctive moderate grade malignant tumor with prominent epithelioid and rhabdoid cells appearance.The differential diagnoses include the tumors that have similar cellular appearance with PES, and immunohistochemical staining is useful for diagnosis and differential diagnosis.

AIM: To study the pharmacokinetics of ligustilide in the volatile oil from Angelica Sinensis(Oliv.) Diels in the rabbit. METHODS: HPLC method for ligustilide determination in the blood was developed.The HPLC system consisted of C_(18) column using MeOH-H_2O(65∶35,v/v) as mobile phase at a flow rate of 1.0 mL/min and UV detection at 236 nm. RESULTS: Linear calibration curves were obtained over the concentration range of 0.40 ?g?mL~(-1)～10.00 ?g?mL~(-1) for ligustilide.The minimum limit detection was 0.40 ?g?mL~(-1).The recovery of ligusitilide in blood was 90.90% with RSD 2.74%. CONCLUSION: After oral administration of volatile oil,intracorporal process of ligustilide in rabbit accords with 2-compartment model with 1 st order absorption,(2.6638) h and 108.88 h are obtained as t_(1/2?) and t_(1/2?) respectively.

OBJECTIVE To learn about the factors affecting the quality of the air in operating-rooms and discuss the methods of improving their air quality.METHODS The dynamic and static air bacteriology between laminar air flow operating-room and normal operating-room of a fertiary care level hospital of grade Ⅰ in Changchun were observed.RESULTS The passing rate of samples for air static bacteriology between two types of operating rooms at the begining of selective operations(T0) was without difference.At the begining of emergency operations,there was a disparity.The total number of bacteria in normal operating-room increased with the operating-time,but in the laminar flow operating-room,the total number of bacteria increased in fluctuations during the(T2) time(60 ming since operation begain),and descended dramatically during the(T3) time(90 min since operation).CONCLUSIONS The emergency and operation-time are the main factors affecting the air quality in operating-room and the cleaning air-condition could improve the air quality.

4 h,and for class Ⅰ and class Ⅱ operation.