Objective To assess the efficacy of laryngeal mask airway (LMA) i-gel used in patients undergoing laparoscopic gynecological surgery. Methods Sixty ASA Ⅰ or Ⅱ patients, aged 21-64 yr, weighing 4590 kg, undergoing elective laparoscopic gynecological surgery, were randomized into 2 groups ( n = 30 each):LMA i-gel group (group Ⅰ) and LMA Supreme group (group S) . Mallampatti test was performed before operation in both groups. Anesthesia was induced with target-controlled infusion of propofol (target plasma concentration 2.5-4.0 μg/ml) and remifentanil (target plasma concentration 3-6 ng/ml) . After the patients lost consciousness, rocuronium 0.6 mg/kg was given to facilitate the LMA insertion. LMA i-gel and LMA Supreme were inserted in I and S groups respectively. A gastric tube was inserted through the drain tube of the LMA. In group S the air was injected into the cuff to make intracuff pressure reach 60 cm H2O after successful LMA insertion. The LMA placement time, the number of attempts of LMA insertion, the number of attempts of gastric tube placement, the airway sealing pressure, the parameters of hemodynamics and ventilation, and complications (sore throat, odynopliagia,hoarseness) were recorded. The fiberoptic laryngoscopy scores were assessed after successful LMA placement. The anesthesia time and recovery time were also recorded. Results There was no significant difference in the anesthesia time, recovery time, LMA placement time, fiberoptic bronchoscopy scores and the parameters of hemodynamics and ventilation between the two group. The success rates of LMA and gastric tube placement were 100% in both groups. The airway sealing pressure was significantly higher, while the incidence of sore throat and odynopliagia was significantly lower in group I than in group S. Conclusion LMA i-gel provides adequate ventilation during operation with fewer complications and can be used effectively for gynecological laparoscopic surgery.

Objective To investigated the association between bone morphogenetic proteins-2 (BMP-2)gene mutation and coal-burning skeletal fluorosis of children in Zhijin Guizhou.Methods In 2010,121 cases of children with skeletal fluorosis were diagnosed based on the standard X-ray Diagnosis of Skeletal Fluorosis (WS192-1999) in coal-burning skeletal fluorosis areas in Zhijin Guizhou,and 50 cases of them were selected as skeletal fluorosis group.Thirty healthy children free of skeletal fluorosis,rickets and other bone related diseases excluded by X-ray were selected as a control group in the same area.Using polymcrase chain reaction combined with DNA sequencing technology,all three exons of BMP-2 gene were conducted sequence screening in skeletal fluorosis and the control groups to detect gene mutations.Results ①The T insertion mutation on exon 1 between 401-402 bp:the T insertion mutantion genotype frequencies of skeletal fluorosis group and the control group were 27.7％ (13/47)and 7.1％ (2/28),and the difference was statistically significant (x2 =4.600,P ＜ 0.05),adjusted OR value of 4.62(1.94-10.90).②)The 894 bp T→G mutation on exon 2:the TG genotype frequencies of skeletal fluorosis group and the control group were 14.0％ (7/50) and 16.7％(5/30),and the difference were not statistically significant (x2=0.103,P＞ 0.05).③The 1 046 bp A→G mutation on exon 2:the AA,AG,GG genotype frequencies of skeletal fluorosis group and the control group was 30.0％ (15/50),24.0％ (12/50),46.0％ (23/50) and 50.0％ (15/30),20.0％(6/30),30.0％ (9/30),and the differences were not statistically significant (x2 =3.099,P ＞ 0.05).Conclusion Exon 1at 401-402 bp,T insertion mutation and skeletal fluorosis are closely related.The relationship between A→Gmutation in exon 2 at 1 046 bp and skeletal fluorosis is not significant.

Separation of active ingredients from Chinese materia medica (CMM) by molecularly imprinted polymers has such advantages as high speed, low cost, being reusable, low pollution, and so on. Because of this reason, the synthesis of molecularly imprinted polymers and its application in separation have drawn more and more attention of researchers in the field of CMM all over the world. Obviously, the core of this research is to explore the relationship between the polymer-structure and separation efficiency. Based on the types of active ingredients of CMM (flavone, alkaloids, phenylpropanoids, terpenoids, etc.), the design principle of molecularly imprinted polymer, its preparation methods and latest application in separation of active ingredients from CMM were introduced. Therefore, this paper can provide a reference for designing new materials with higher selectivity in separation of active ingredients from CMM.

Objective To compare the efficacy of laryngeal mask airway-Advance (ALMA) and laryngeal mask airway-Supreme (S-LMA) in patients undergoing laparoscopic cholecystectomy.Methods Two hundred and forty ASA Ⅰ or Ⅱ patients,aged 18-64 yr,weighing 50-70 kg,undergoing laparoscopic cholecystectomy,were randomly divided into2 groups (n=120 each):group S-LMA (group S) and group A-LMA (group A).LMA was inserted after induction of general anesthesia with propofol 2.0-2.5 mg/kg,sufentanil 0.2 μg/kg and rocuronium 0.6 mg/kg.After LMA was placed,the rim was immediately inflated and positive pressure was applied to the reservoir bag of anesthesia machine circuit to check for leaks.The plateau pressure at which leaks occurred was recorded.BP,HR,SpO2,PErCO2 and Ppeak were monitored during operation.Fiberoptic bronchoscopy was performed and the placement was scored (0 =unable to see the vocal cords and the ventilation of the lungs was inadequate,4=vocal cords were clearly seen and ventilation was adequate).The rate of successful placement,placement time,the incidence of leaks during operation,duration of anesthesia and surgery,extubation time,emergence time,blood stain on the LMA after being removed,backflow after extubation and postoperatve complacations including sore throat,hoarseness and dysphagia were recorded.The efficacy for airway management and the difficulty of placement were scored.Results There was no significant difference in the rate of successful placement,difficulty of placement scores,blood stain on the LMA after being removed,incidence of backflow,sore throat,hoarseness and dysphogia,anesthesia time,duration of surgery,extubation time and emergence time between the two groups.The placement time was shorter in group S than in group A,but the airway sealing pressure,FOB scores and efficacy for airway management scores were significantly higher and the incidence of leaks during operation was significantly lower in group A than in group S.Conclusion Both A-LMA and S-LMA can provide adequate ventilation during laparoscopic cholecystectomy.The efficacy of A-LMA is better.

Objective To explore the prevalence satate of children in burning coal endemic fluorosis in Zhijin county of Guizhou province, provide the scientific basis for the prevention of skeletal fluorosis.Methods One thousand six hundred and sixteen children in school under 16 years old that were sampled in cluster sampling were examined with dental fluorosis,X-ray in the type of burning coal pollution fluorosis areas of Zhijin county Guizhou province.Results Total prevalence rate of dental fluorosis was 96.42%,prevalence rate of skeletal fluorosis was 7.49%, constrictive skeletal fluorosis was main type in Zhijin county Guizhou province.Conclusion Prevalence states of dental fluorosis and skeletal fluorosis are still serious, more effectual preventive and control measure shall be used.

Objective To investigate the value of fluorescin-aided confocal laser endomicroscopy (CLE) for diagnosis of helicobacter pylori (Hp) infection. Methods From June 2009 to November 2009, patients undergone gastric endoscope examination with upper gastrointestinal symptoms (upper abdominal discomfort, abdominal distension, satiation, acid reflux and eructation) or screened for gastric cancer were enrolled. The gastric mucosa CLE image data of twenty diagnosed Hp positive patients and 10 Hp negative patients was analyzed retrospectively. By comparing with histological image of targeted biopsy tissue, the CLE diagnostic criteria for Hp infection were established. In the prospective study, CLE diagnose result was compared with Hp tested result. The consistency of CLE diagnostic criteria in different observers was also analyzed. The CLE image data with histopathology result were compared accordingly. Results Total 72 patients were enrolled in the prospective study,of 34 Hp positive patients, 31 patients were correctly diagnosed by CLE. The accuracy, sensitivity and specificity of CLE diagnosis were 88.9%, 91.2 and 86.8% respectively. CLE image displaying fluorescin leakage and cell shedding was the highest specificity for Hp infection diagnosis, (97.4 %);fluorescin leakage plus gastric pits distortion and cell edema was the highest sensitivity (88. 2%). The consistency of CLE diagnostic criteria in different observers was high (Kappa value 0. 72, 0.87). The CLE image of Hp infection was highly correlated with inflammation activity (P＜0. 001). Conclusion CLE can accurately distinguish normal mucosa from Hp infected mucosa at the cellular level. The diagnostic value for Hp infection was reliable.

OBJECTIVETo establish a rapid quantitative analysis method for the content of chlorogenic acid and solid content in the extraction liquid concentration process during the production of Reduning injection by using the near-infrared (NIR) spectroscopy, in order to reflect the concentration state in a real-time manner and really realize the quality control of concentrating process of the extraction and concentration process.

METHODThe samples during the Jinqing extraction liquid concentration process were collected. After the removal of abnormal samples, the spectra pretreatment and the wave band selection, the quantitative calibration model between NIR spectra and chlorogenic acid HPLC analytical value and solid content was established by using PLS algorithm, and unknown samples were predicted.

RESULTThe correlation coefficients between the chlorogenic acid content and the solid content were respectively 0.992 1 and 0.994 0, and the correlation coefficients of the verification model were respectively 0.994 4 and 0.998 4, with the root mean square error of calibration (RMSEC) of 0.814 6 and 2.656 1 and the root mean square error of prediction (RMSEP) of 0.704 6 and 1.876 7 respectively, and the relative standard errors of predictions (RSEP) were 6.01% and 2.93% respectively.

CONCLUSIONThe method is simple, rapid, nondestructive, accurate and reliable, thus could be adopted for the fast monitoring of the chlorogenic acid content and the solid content during the concentration process of Reduning injection extraction liquid.

Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Quality Control ; Spectroscopy, Near-Infrared ; methods

OBJECTIVETo investigate the diagnosis, surgical procedure and clinical outcome of cervical intraspinal benign neoplasm.

METHODSTwenty-two cases confirmed pathologically were reviewed included 16 males and 6 females with an average age of 43.8 years old ranging from 18 to 56 years. Symptoms mainly included neck pain, numbness and weakness of the extremities, urinary and fecal incontinence, pyramid signs, etc. All underwent X-ray, CT and MRI, 11 cases were diagnosed as neurilemomas, 4 neurofibromas, 3 spinal meningiomas, 2 intraspinal cysts and 2 lipomas. The tumors were removed completely in 18 cases, above 60% in 3 cases and 25% with biopsy in 1 case. Cervical stability in 11 cases was restored after removal of tumors.

RESULTSAll were followed-up for from 6 to 84 months(means 12.5 months). Symptoms improved in 20 cases and stable in 1 case and worsened in 1 case postoperatively according to JOA scoring system. Two patients recurred and were treated with second surgery. JOA scoring was (6.52 +/- 1.10) before operation, (11.42 +/- 0.79) after operation, there was statically significance (t = 21.38, P < 0.001). The average recover ratio of total was (46.7 +/- 2.46)%, cervical stability was (62.37 +/- 3.58)%, the other methods was (41.21 +/- 4.63)%. The results of JOA were excellent in 18 cases, good in 2, fair in 1 and poor in 1.

CONCLUSIONThe surgical exairesis for cervical intraspinal benign neoplasm has low post-operative recurrence. The main reason of recurrence is not removed the tumor completely. MRI is regarded the effective method which is helpful in differential diagnosis and surgery guidance.

Adolescent ; Adult ; Cervical Vertebrae ; pathology ; physiopathology ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Spinal Neoplasms ; pathology ; physiopathology ; surgery ; therapy ; Treatment Outcome ; Young Adult

Objective Mutated inbred animal model is introduced to the practical course of genetic diagnosis in the hope that medical students are able to apply what they have learned to clinical cases, based on a deep understanding of principle and technology on gene mutation detection. Methods We integrated DNA extraction, polymerase chain reaction, agarose gel electrophoresis, and gel imaging analysis into a comprehensive experiment and arranged 4-year-programme undergraduates majoring in preclinical medical sciences to conduct it with the purpose of investigating the internal relations between phenotype and genotype in a hairless Uncv mouse model. Subsequently, the questionnaire aimed at evaluating learning effect on the part of students was handed out and their feedbacks were analyzed. Results More than 90% of respondents are satisfied with the general learning effect. Especially, 98. 7% of students support the enhancing effect of the new teaching mode on their research skills and 96% consider the practical course helpful to their problem-solving ability. Conclusions The introduction of mutated inbred animal model to the practical system of molecular diagnostics proves beneficial to boost students' learning effect and scientific research quality. Our practice also provokes thoughts on the further utilization of animal models in teaching system of medical sciences.

OBJECTIVETo study the effects of the extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus.

METHODSFrom March 2007 to March 2010, 7 patients with stage II to III giant cell tumor of bone in the proximal humerus were treated. Among the patients, 3 patients were male and 4 patients were female with a mean age of 34.6 years (ranged, 18 to 49 years). The mean course of disease was 19 months (ranged, 6 to 35 months). All the patients were confirmed to suffer stage II to III giant cell tumor of bone in the proximal humerus by pathology and X-ray examinations. Clinical manifestations of the patients included persistence aggravated pain of the shoulder, swelling in the proximate arm with obviously tenderness, activity limited of the joint. All the patients were treated with extensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation. CMS and OSIS score system were used to evaluate shoulder function and shoulder stability.

RESULTSAll the patients were followed up, and the duration ranged from 14 to 35 months, with an average of 17 months. There were no serious complications or recurrence in all cases. One year after the surgery CMS and OSIS score system were 70.7 scores (ranged,63 to 82 scores) and 25.1 scores (ranged, 18 to 29 scores) respectively. According to evaluation for shoulder function, 2 patients got an excellent result and 5 good. According to evaluation of shoulder stability, 1 patient got an excellent result and 6 good.

CONCLUSIONExtensive resection of the tumor-loading segment and artificial humerus head replacement combined with perioperative rehabilitation for the treatment of stage II to III giant cell tumor of bone in the proximal humerus would not only preserve the upper extremity but also preserve the function of upper extremity.

Adolescent ; Adult ; Bone Neoplasms ; pathology ; rehabilitation ; surgery ; Female ; Giant Cell Tumor of Bone ; pathology ; rehabilitation ; surgery ; Humans ; Humerus ; surgery ; Limb Salvage ; Male ; Middle Aged ; Neoplasm Staging