Objectives:To analyze the safety and clinical effect of airway diagnosis in multifactor suspicious difficult airway patients with complex mouth restriction after entering the operating room.Methods:From March 2018 to May 2023, a total of 21 patients with suspicious difficult airway with complex mouth restriction were collected from the Northwest Women′s and Children′s Hospital and the Third Affiliated Hospital of Air Force Military Medical University, who were evaluated according to LEMON airway evaluation rule. Ventilation capacity score, airway airway score with soft vision mirror and comprehensive airway score of difficult airway were performed after admission to the operating room. Patients diagnosed with non-difficult airway were divided into group N and patients diagnosed with difficult airway were divided into group D. The number and proportion of patients in the two groups were counted, and the process of airway diagnosis, the way of airway establishment, the results, the frequency of hypoventilation during airway establishment, the number of intubation, and the time of airway establishment were analyzed.Results:A total of 15 patients in group N, accounting for 71.4%, underwent rapid intravenous induction nasal intubation after diagnosis of non-difficult airway, and the intubation was successful all the time. No hypoventilation occurred in all patients during intubation. A total of 6 patients in the group D, accounting for 28.6%, were assisted by pure oxygen mask ventilation after diagnosis of difficult airway, and underwent awake nasotracheal intubation after recovery. 4 patients were successfully intubated once, 2 patients were successfully intubated twice, and 1 patient experienced one hypopnea during the evaluation of ventilation capacity. The airway establishment time of the group N was (9.3±0.8)min, and that of the group D was (20.0±2.0)min, the difference was statistically significant ( P<0.05). The airway establishment time of all patients was (12.0±5.0)min, and the awake intubation time was (12.0±0.7.0)min. The proportion of patients satisfied with anesthesia in the group N was higher than that in the group D, and the difference was statistically significant ( P<0.05). No agitation during sevoflurane induction or recovery was observed in both groups. Conclusions:The diagnosis procedure of difficult airway can be safely applied to patients with multi-factor suspicious difficult airway with complex mouth restriction. Most of these patients do not have truly difficult airways; The application of difficult airway diagnosis procedures in these patients can significantly reduce unnecessary awake endotracheal intubation; Compared with the direct choice of awake intubation, following the difficult airway diagnosis procedure does not increase airway establishment time in such patients.

Objective To evaluate the validity of the Patient Health Questionnaire(PHQ-9)and the Generalized Anxiety Disorder Scale(GAD-7)in measuring depression and anxiety among employees.Methods A stratified random sample of 1117 employees from various departments of an enterprise was included in the study.The item analysis was performed using the Grade Response Model in IRT to assess the dimensionality,discrimination,difficulty coefficient and average information of each item.The model fit and differential item functioning were also assessed.Results The study population consisted of 661(59.2%)employees under the age of 45 and 456(40.8%)employees aged 45 and above;802(71.8%)were male and 315(28.2%)were female.The Cronbach's α coefficients for the PHQ-9 and GAD-7 were 0.923 and 0.951,and the split-half reliability coefficients were 0.863 and 0.940.The ratio of the first characteristic root to the second characteristic root of both the PHQ-9 and GAD-7 scales was＞3,in line with the hypothesis of unidimensionality.The discrimination of the PHQ-9 items ranged from 2.362 to 3.618,the difficulty coefficient from-0.949 to 2.639,and the average information from 0.772 to 1.935.The discrimination of the GAD-7 items ranged from 3.631 to 5.580,the difficulty coefficient from-0.469 to 2.044,and the average information from 1.880 to 3.547.Differential item functioning indicated that age and gender did not influence the screening of the two scales.Conclusion The PHQ-9 and GAD-7 scales can be used as psychometric tools to assess depression and generalized anxiety disorder in corporate employees.

Lipid Droplets/metabolism* ; Bacteria ; Lipid Metabolism

Cardiovascular disease is currently the leading cause of death all over the world, and its prevalence and mortality are still rising. Changing risk health behaviors is an important prevention and treatment strategy for cardiovascular diseases, which can effectively delay the course of disease and improve prognosis of patients. However, the existing chronic disease management model does not fully exploit and utilize intervenable factors to maximize the effect of intervention. Based on 19 behavioral intervention theoretical frameworks, the behaviour change wheel (BCW) provides clear guidance for behavioral analysis and intervention design, which is worthy of in-depth study and application. This article reviews the framework content, implementation steps and application status of BCW in cardiovascular disease management at home and abroad, in order to provide theoretical support and practical guidance for domestic application of BCW theory to conduct behavior intervention.

We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.
Animals ; Chromoblastomycosis ; Humans ; Laser Therapy ; Lasers, Solid-State ; Male ; Middle Aged ; Rats ; Rats, Wistar ; Terbinafine ; Treatment Outcome

Acute kidney injury (AKI) is a frequent syndrome in hospitalized patients .Recently, a number of studies have been reported that the close relationship exists between genetic polymorphism and AKI .The current research on genetic polymorphism related with AKI is reviewed in this article .

Objective To observe the variation of nicotinamide adenine dinucleotide phosphate (NADPH) oxidase and microglia in the comorbidity of neuropathic pain and depression and discuss the related mechanism.Methods The spared nerve injury model was used.Forty-four male adult Sprague Dawley rats were randomly divided into the following four groups (n=11 each): sham+vehicle group (group SV), sham+APO group (group SA), SNI+vehicle group (group SNV), SNI+APO group (group SNA).In groups SA and SNA, rats were intraperitoneally injected with apocynin (APO) 15 mg/kg 24 hours and 1 hour before SNI and continued once daily until the 14th day.The rats in the other two groups received the equal volume of vehicle.The mechanical withdrawal threshold (MWT) was tested 1 day before SNI and 7 days and 14 days after SNI, and the open field test, the forced swimming test and the sucrose preference test were performed 14 days after SNI.The prefrontal cortex were collected 2 hour after the behavior tests.The expression of gp91phox was detected by Western blot and the expression of Iba1 and gp91phox were detected by double-immunofluorescance staining.Results The reduced MWT, the increased immobility time, the decreased sucrose consumption and the increased content of gp91phox were observed in group SNV compared with groups SV, SA and SNA (P<0.05).The expression of Iba1 and gp91phox were increased in group SNV.The total travel distance in the open field test and the total liquid consumption in the sucrose preference test had no significant difference among the four groups.Conclusion Neuropathic pain may induce depressive behaviors and activate NADPH oxidase in the prefrontal cortex.Moreover, the inhibition of NADPH oxidase by APO can alleviate neuropathic pain and depression, which is potentially related to the activation of microglia.

Objective To observe changes of hippocampal levels of pro-inflammatory cytokines in rats with neuropathic pain-induced depression, and to explore the relationship between hippocampal levels of pro-inflammatory cytokines and severity of depression.Methods Twenty-eight adult male rats were randomly divided into two groups: group sham (n=14) and spared nerve injury (group SNI) (n=14).Mechanical withdrawal thresholds (MWT) were measured 1 day before and 7, 14 and 21 days after operation.Sucrose preference test and forced swim test were tested 1-3 days before and 21-23 days after operation.After test, hippocampus was collected.The hippocampal levels of interleukin (IL)-1β, IL-6 and tumor necrosis factor-α (TNF-α) were measured by ELISA.Correlational relationships between hippocampal levels of pro-inflammatory cytokines and sucrose preference were evaluated.Results Compared with group sham, MWT was decreased 7, 14, 21 days after operation (P<0.001).Group SNI displayed decreased sucrose preference 21 days after operation (P<0.01) and increased immobility time in FST 23 days after operation (P<0.05).The levels of IL-6 and TNF-α were increased in hippocampus (P<0.05 or P<0.01).No significant difference was observed in IL-1β.The hippocampal levels of IL-1β (r2=0.60,P<0.01), IL-6 (r2=0.55,P<0.01) and TNF-α(r2=0.60,P<0.01) were negatively correlated with sucrose preference.Conclusion The hippocampal levels of pro-inflammatory cytokines IL-6 and TNF-α are increased in rats with depression induced by neuropathic pain, and the levels of hippocampal pro-inflammatory cytokines are negatively correlated with the severity of depression.

Objective To evaluate the application value of precise hepatectomy in primary liver cancer (liver cancer). Methods Clinical data of 60 patients with liver cancer undergoing hepatectomy in Zhongshan People's Hospital between January 2011 and December 2014 were retrospectively analyzed. According to the surgical procedures, all patients were divided into the precise hepatectomy group (precise group) and traditional hepatectomy group (traditional group). In the precise group, 30 patients were included, 18 males and 12 females, aged between 25 and 60 years with a median age of 45 years. In the traditional group, 30 patients were included, 20 males and 10 females, aged between 23 and 62 years with a median age of 46 years. The informed consents of all patients were obtained and the local ethical committee approval was received. In the precise group, selective hepatic blood inlfow occlusion was performed. The liver transection plane was determined according to the ischemic boundary and main branch of hepatic vein. The central venous pressure was controlled below 5 cmH2O (1 cmH2O=0.098 kPa). The liver tissues were separated by ultrasonic scalpel. The liver section planes were left without suture. In the traditional group, Pringle maneuver was performed to occlude the blood lfow of porta hepatis. The liver tissues were rapidly separated by vascular clamping. The liver section planes were sutured after surgery. The operation time, intraoperative hemorrhage volume, changes of liver function indexes at postoperative 7 d, postoperative length of hospital stay and postoperative complications were observed between two groups. Data of two groups were compared using t test and the ratio was compared using Chi-square test. Results Hepatectomy was successfully completed in all patients. The incisional margin was detected as negative after tumor resection. No patients died during perioperative period. In the precise group, the mean operation time was (302±47) min, signiifcantly longer compared with (209±30) min in the traditional group (t=4.016, P<0.05). In the precise group, intraoperative hemorrhage volume was (354±71) ml, significantly less than (598±109) ml in the traditional group (t=-2.376, P<0.05). In the precise group, the alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TB) at postoperative 7 d were (80±36) U/L, (61±18) U/L and (29±6)μmol/L, signiifcantly lower than (252±55) U/L, (233±62) U/L and (49±8)μmol/L in the traditional group (t=-2.173,-1.640 ,-2.240;P<0.05). In the precise group, postoperative length of hospital stay was (13±3) d, significantly shorter compared with (22±5) d in the traditional group (t=-2.045, P<0.05). The incidence of postoperative complications in the precise group was 7%(2/30), signiifcantly lower than 27%(8/30) in the traditional group (χ2=4.320, P<0.05). Conclusion Compared with traditional hepatectomy, precise hepatectomy has the advantages of less intraoperative hemorrhage, faster postoperative recovery of liver function, lower incidence of complications, faster postoperative recovery and shorter length of hospital stay.