Objective To evaluate the effect of fentanyl combined with midazolam in painless bronchoscopy.Methods76 patients underwent painless bronchoscopy in our hospital from October 2015 to October 2016 were randomly devided into the observation group and the control group, 38 cases in each group.The control group received conventional lidocaine local anesthesia, based on the control group, the observation group were given intravenous anesthesia using fentanyl and midazolam.Hemodynamic parameters (blood oxygen saturation (SpO2), heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SBP)) were compared in the two groups before anesthesia (t1), 3 minutes after anesthesia (t2), 5 min after anesthesia (t3), wake up (t4), besides, incidence of adverse reactions were compared as well.ResultsAt t2, t3 time point, SpO2 was higher in the observation group than that in the control group, HR, DBP and SBP were lower than the control group, the difference was statistically significant (P<0.05);the incidence of side effects in the observation group was 5.26% (2/38), which was lower than that in the control group (26.31%, 10/38), the difference was statistically significant (P<0.05).ConclusionFentanyl combined with midazolam in painless bronchoscopy can effectively maintain the patient's hemodynamic stability and reduce the incidence of adverse reactions.

Objective To analyze the infection status and variation tendency of chlamydia trachomatis (CT) ,Neisseria gonorrhoe-ae(NG) and ureaplasma urealyticum(UU) in female genital tract in northeast Sichuan province during 2005 -2012 to provide the laboratory basis for their diagnosis and treatment Methods The real-time fluorescent quantitative PCR (RT-PCR) was applied to detect the CT DNA ,NG DNA and UU DNA in 1 386 samples from female genital tract and the detection results were performed the statistical analysis .Results The total positive rate of these 3 kinds of pathogens was 62 .8% (871/1 386) .Among the simple in-fection ,UU had the highest positive rate(48 .0% ,665/1 386);the positive rates of CT and NG were only 2 .2% .In the mixed infec-tion ,the positive rate of CT + UU was highest(6 .5% ,90/1 386) ,while which of UU + NG ,CT + NG and CT+ NG+ UU was 2 .5% (35/1 386) ,0 .4% (5/1 386) and 1 .1% (15/1 386) respectively .In different age groups ,the positive rate in the age <20 years old group was 49 .3% ,while which in the age >20 years old groups were all more than 60% .The positive rate of the CT ,NG and UU pathogens in females was in continuous high level during 2005 -2012 ,and which totally showed an increasing tendency . Conclusion CT and UU are the main pathogens in female genital tract infection in this region ,and the positive rate of genital tract infection in females aged more than 20 years is higher ,the infection rate of these 3 kinds of pathogens demonstrates the increasing trend year by year ,so more attention should be paid to the detection of CT and UU in this group for guiding the clinicians to con-duct the diagnosis and treatment .

Objective To explore the differences in antimicrobial resistance of bacteria isolated from different samples ,and to guide antibiotic chemotherapy in clinic .Methods The sputum ,blood ,pus and urine specimens were collected from 2009 to 2013 in our hospital for bacterial identification and drug sensitivity tests by using automatic system .The drug resistance rate of Staphylo‐coccus aureus ,Escherichia coli ,Klebsiella pneumoniae isolated from different samples were compared .Results All isolates of E .co‐li ,Klebsiella pneumoniae were sensitive to imipenem ,ertapenem ,piperacillin/tazobactam and amikacin .All isolates of S .aureus were sensitive to vancomycin ,linezolid ,nitrofurantoin ,quinupristin/dalfopristin .The ESBLs positive rate of E .coli(71 .5% )and the MR‐SA detection rate(79 .9% ) of Staphylococcus aureus from sputum samples were significantly higher than that from other samples (P<0 .05) .The ESBLs positive rate(44 .4% ) of Klebsiella pneumoniae isolates from urine was significantly higher than that from other samples(P<0 .05) .Conclusion The same bacteria isolated from different samples have different antimicrobial resistance rates ,so the selection of antibiotics should based on drug sensitivity tests results for the treatment of the same pathogen infection confirmed by bacterial cultures from different samples .

Objective: To investigate the therapeutic effect of free superficial circumflex iliac artery perforator (SCIP)flap for reconstruction of soft tissue defects secondary to resection of retromolar and lateral buccal squamous cell carcinoma. Methods: From January 2014 to January 2017, eight patients with retromolar and lateral buccal squamous cell carcinoma received radical resection and reconstructed with SCIP flap immediately. CTA and color Doppler sonography were routinely performed before the surgery. According to the size of the defect in the recipient area, the flap vascularized by the perforator vessel was carefully prepared and transferred to the buccal-pharynx-palate composite defect. The recipient area and donor area were sutured tightly after arteriovenous anastomosis under microscope. The survival and functional recovery of the flap were observed after operation. Results: The flap sizes ranged from 5 cm× 6 cm to 7 cm×9 cm.The mean diameter of the superficial circumflex iliac arteries was 0.65 mm. And the mean diameter of the veins was 1.2 mm. The mean arterial pedicle length was 7.0 cm, and the venous pedicle length was 8.0 cm. Eight flaps were all survived. The shape of the buccal-parapharyngeal-palate was good and the mouth opening was normal after operation. Conclusions Superficial circumflex iliac artery perforator flap was a good choice for repairing the defect of parapharyngeal squamous cell carcinoma in the posterior molar region.