GlideScope视频喉镜和Macintosh直接喉镜在颈椎损伤患者气管插管中的应用比较

目的:比较GlideScope视频喉镜(加拿大Saturn生物技术有限公司)和普通直接喉镜在颈椎损伤患者气管插管中的难易,及两种工具插管对血液动力学的影响。方法:拟在经口气管插管全身麻醉下行择期手术的患者40例,ASAI级,年龄18～60岁,随机分为G组和M组(n=20)。常规麻醉诱导后,手法制动头颈部,G组采用GlideScope视频喉镜,M组用Macintosh直接喉镜行气管插管。分析比较两组声门暴露情况(Cormark-Lehane分级)以及暴露时间,试插次数,失败例数,有无助手辅助,插管前后心率与收缩压乘积(RPP)变化。结果:与M组比较,G组声门暴露情况较好,但暴露时间显著延长(P<0.05)。M组需要助手辅助及插管失败的比例均高于G组。两组RPP的变化在各个时点无显著差别。结论:在为颈椎损伤患者气管插管中,GlideScope视频喉镜能够更好的显露声门,降低插管难度,提高插管的成功率。     

急救中光棒法与直接喉镜法气管插管引发心血管反应的比较

目的:比较光棒法与直接喉镜法气管插管对心血管系统的影响,探讨光棒在临床急救领域的适用性。方法:选取我院急诊科室进行抢救的80名患者,随机分为两组,分别采用光棒法和直接喉镜法进行气管插管。记录插管所需时间、一次插管成功次数,以及插管前、插管时、插管后1分钟、插管后3分钟患者的收缩压、舒张压、平均动脉压、心率和血氧饱和度的变化情况。数据分析使用使用检验、t检验秩和检验、重复测量方差分析。结果:两组间性别、年龄、身高、体重、ASA、Mallampati评分差异无统计学意义,具备可比性。光棒组平均插管时间少于喉镜组(光棒:31.23 9.94秒,喉镜:48.15 8.67秒),一次插管成功率(97.5%)也高于喉镜组(80.0%)。经重复测量方差分析结果显示,光棒组各时点的收缩压(F=38.312,P=0.000)、舒张压(F=219.692,P=0.000)、平均动脉压(F=54.739,P=0.000)、心率(F=195.161,P=0.000)的整体趋势要低于与喉镜组。血氧饱和度(F=0.020,P=0.889)在两组间差异无统计学意义。结论:在气管插管过程中,光棒法比直接喉镜法引发的心血管系统变化更小,而且插管所需时间更短、一次成功率更高,是一种值得在急诊科室推广的气管插管技术。     

可视软性喉镜与光棒在颈椎损伤手术患者全身麻醉气管插管中的应用效果比较

目的:比较可视软性喉镜与光棒用于颈椎损伤手术患者全身麻醉气管插管的有效性与安全性。方法:选择2017年1月至2019年2月本院60例高位颈椎骨折需行气管插管全身麻醉的患者,随机分为可视软性喉镜组(U组)和光棒组(G组)各30例。术前所有患者颈托固定,U组使用UE可视软性喉镜行气管插管,G组使用光棒行气管插管,确认气管插管成功后接呼吸机机械通气。比较两组气管插管时间、一次性插管成功率、拔管后口咽部并发症、插管前后的皮层体感诱发电位(CSEP)及运动诱发电位(MMEP)的变化。记录两组患者麻醉前、麻醉诱导后、气管插管后即刻、气管插管后1 min、气管插管后3 min的平均动脉压(MAP)和心率(HR)。结果:U组气管插管时间较G组插管时间长(P0.05);U组和G组气管插管一次性成功率分别为95%和100%;插管后即刻G组患者MAP升高较U明显(P0.05);与U组比较,G组插管后即刻及插管后1 min、3 min的HR升高较明显(P0.05);U组患者口咽部并发症较G组少;两组患者插管后SSEP及MMEP与插管前相比无阳性改变。结论:可视软性喉镜较光棒需要更长的气管插管时间,两者的气管插管一次性成功率均较高,但可视软性喉镜插管期间循环波动较小、术后口咽部并发症较轻,值得临床推广应用。     

可视喉镜气管插管对心跳骤停抢救患者血流动力学及心肺复苏质量的影响

摘要 目的：探讨可视喉镜气管插管对心跳骤停抢救患者血流动力学及心肺复苏质量的影响。方法：选取联勤保障部队第九四〇医院于2020年4月~2022年5月期间收治的98例心跳骤停抢救患者为研究对象,根据插管方式将患者分为B组（可视喉镜气管插管,n=50）、A组（传统直接喉镜气管插管,n=48）。对比两组插管次数、声门暴露时间、插管时间、气道与牙齿损伤、心肺复苏质量及血流动力学指标变化情况,观察两组不良反应发生情况。结果：B组的插管次数少于A组,声门暴露时间、插管时间短于A组,气道与牙齿损伤比例少于A组（P<0.05）。B组的插管成功率、心肺复苏（CPR）成功率、存活率均高于A组（P<0.05）。B组插管后15 min的收缩压（SBP）、舒张压（DBP）、平均动脉压（MAP）及心率（HR）均低于A组同期（P<0.05）。B组的不良反应发生率低于A组（P<0.05）。结论：相比于传统直接喉镜气管插管用于心跳骤停抢救患者,可视喉镜气管插管可维持血流动力学稳定,提高插管成功率和心肺复苏质量,安全性较好。     

可视气管导管在全麻手术患者气道插管中的应用及安全性评价

目的:探讨可视气管导管在全麻手术患者气道插管中的应用及安全性。方法:选取2014年10月-2016年12月在广东省第二人民医院麻醉科行全麻手术的患者220例,其中使用可视气管导管进行插管的110例记为观察组,使用普通气管导管进行插管的110例记为对照组。对比两组患者的插管次数、插管时间和并发症发生率,对比两组患者麻醉诱导前(T_0)、麻醉诱导后(T_1)、气道插管后(T_2)、气道插管后5 min(T_3)心率(HR)、收缩压(SBP)、舒张压(DBP)及血氧饱和度(SpO_2)的变化情况。结果:观察组的插管时间和插管次数较对照组降低(P0.05);T1时间点两组患者的HR、SBP、DBP均低于T_0、T_2、T_3时间点,差异有统计学意义(P0.05);T_0、T_1、T_2、T_3两组患者HR、SBP、DBP、SpO_2比较无统计学差异(P0.05);观察组的喉痛发生率为0.91%,显著低于对照组的7.27%,差异有统计学意义(P0.05)。结论:全麻手术患者气道插管时使用可视气管导管插管效果满意,可有效的减少插管时间和插管次数,安全性较高,值得临床推广应用。     

Hyper IgE in New Zealand black mice due to a dominant-negative CD23 mutation

Immunoglobulin E (IgE) plays a critical role in both resistance to parasitic infection and allergy to environmental antigens. The IgE response is in turn regulated by the B-cell co-receptor CD23, and CD23-deficient mice show exaggerated IgE responses and airway hyper-responsiveness. In this report, we show that New Zealand black (NZB) mice express a variant CD23 allele, with mutations in both the C-lectin-binding domain and stalk region, which fails to bind IgE at high affinity and has reduced expression on the cell surface. Expression of the variant CD23 chain interferes with trimerisation of the receptor and has a dominant-negative effect leading to reduced IgE binding in crosses between NZB and other strains. Genetic mapping shows that the variant CD23 leads to an exaggerated primary IgE response, which is independent of other strain-specific effects. These results suggest that NZB mice or mice carrying the variant allele will be useful models for studying both allergy and quantitative traits associated with atopy. The exaggerated IgE response provides an explanation for the natural resistance of NZB mice to parasitic infection by Leishmania.     

Tracheal venous blood and lymph collection: a model to study airway injury in sheep

Airway injury is a frequent result of the inhalation or aspiration of toxic material. Although upper airway damage can be identified endoscopically, pathophysiological changes are difficult to evaluate. This paper describes an animal model in which changes in tracheal blood and lymph flow rates, wet-to-dry weight ratios, and lymph-to-plasma protein ratios can be evaluated after injury. In this model, 12 cm of the cervical trachea were isolated using a double-cuffed endotracheal tube and injured with cotton smoke at near room temperature. Injury to the trachea was evaluated in twenty-five anesthetized sheep 4 (n = 3), 8 (n = 3), 24 (n = 3), 48 (n = 3), 96 (n = 3), and 192 (n = 2) h after smoke exposure and compared with sham control animals (n = 8). A significant increase in tracheal venous blood flow from 1.3 +/- 0.4 (SD) ml.min-1.cm-1 for the noninjured trachea to 2.8 +/- 1.2 was noted 24 h after injury (P less than 0.01). Lymph flow significantly increased from 1.3 +/- 0.4 microliters.min-1.cm-1 for the noninjured trachea to 9.8 +/- 3.3 24 h after injury while wet-to-dry weight ratios were elevated from 3.0 +/- 0.2 for noninjured trachea to 4.6 +/- 0.9 from 4 to 24 h after injury (P less than 0.01) and decreased to 3.7 +/- 0.5 by 96 h. Cast material consisting of airway exudate, cellular debris, and intact ciliated epithelial cells was both expectorated and found in the trachea when the animals were killed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Molecular and Phenotypic Characterization of a New Mouse Insertional Mutation That Causes a Defect in the Distal Vertebrae of the Spine

We have identified and characterized the phenotype of a new insertional mutation in one line of transgenic mice. Mice carrying this mutation, which we have designated TgN(Imusd)370Rpw, display undulations of the vertebrae giving rise to a novel kinky-tail phenotype. Molecular characterization of the insertion site indicates that the transgene integration has occurred without any substantial alterations in the structure of the host sequences. Using probes that flank the insertion site, we have mapped the mutation to chromosome 5 near the semidominant mutation, thick tail (Tht). Thick tail does not complement the TgN(Imusd)370Rpw mutation; compound mutants containing one copy of each mutation display a more severe phenotype than either mutation individually.     

Seedling mortality and damage due to non‐trophic animal interactions in a northern New Zealand forest

Abstract The importance of non‐trophic animal damage (biting and uprooting without consumption) and mortality of canopy tree seedlings were investigated in a warm temperate forest, in northern New Zealand. Two hundred seedlings 10‐30 cm in height were monitored at 4‐6‐week intervals for 2 years. Non‐trophic animal damage accounted for more seedling mortality in the first year (37.5% of all mortalities) than any other cause. Of the seedlings damaged in non‐trophic animal interactions 73% were bitten off close to the ground and left uneaten and the remainder were uprooted. In the second year all non‐trophic animal damage and mortality ceased following the control of rabbits (Oryctolagus cuniculus), suggesting that rabbits were the major cause of this damage. Total annual mortality rates (6‐8%) were low. However, measured seedling growth rates indicated an average time for seedlings to grow from 10 to 30 cm of 37 years. Therefore, in the absence of rabbit control, mortality due to non‐trophic animal interactions (3% per year) can have an important cumulative effect. Non‐trophic animal damage found in the present study before rabbits were culled (5% per year) was similar to that reported for two tropical forests, but much less than that reported for some other tropical and temperate forests.     

Bacterial growth and losses due to bacterivory in a mesotrophic lake

Bacterial secondary production and rates of bacterivory weredetermined from samples collected from mesotrophic Lake Arlington.Bacterial production and losses were determined by comparingthe growth of natural bacterial assemblages in the presenceof predators (unfiltered samples) to growth in the absence ofpredators (water filtered through 1.0 (im porosity filters).Growth rates of heterotrophic nanoflagellates (HNF) were estimatedfrom growth in the absence of predators (water filtered through5.0 µm porojity filters). Bacterial growth rates rangedbetween 0.002 and 0.069 h^–1 and averaged 0.026 h^–1.HNF grew at rates ranging between 0.003 and 0.107 h^–1and averaged 0.028 h^– Grazing rates ranged between 0.002and 0.043 h^–1, and averaged 0.018 h. The annual averagerate of bacterial biomass synthesis was 3.2 –g Cl^–h^–1 and {small tilde}69% of this production was grazed.Temporal changes in growth and grazing rates suggest a tightlycoupled predator-prey linkage in this lake. ¹Present address: Hydrobiological Institute, Czech Academy ofSciences, Na sddkach 7, 370 05 teski Budjovice, Czech Republic     

Estimation of Type-Specific Neutralizing Antibody to Herpes Simplex Virus Type 2 in Uterine Cervical Cancer Patients by a New Absorption Method

A simple method of estimating type-specific neutralizing antibody to type 2 herpes simplex virus (HSV-2) was devised with the use of the microneutralization system. Serially diluted serum was mixed in the well with a constant amount of type 1 virus (HSV-1), and after 3 days' incubation at 37 C, the plate was irradiated with ultraviolet light. The absorbing HSV-1 consisted of culture fluid plus an extract of infected Vero cells not especially concentrated. The well then received indicator HSV-1 or HSV-2, and after being left at 37 C for 1 hr a suspension of dispersed Vero cells was dropped into the wells, following our standard neutralization procedure. Preliminary tests with rabbit antisera showed that even a low level of HSV-2 antibody was detected by this method, unless an exceptionally high titer of HSV-1 antibody originally coexisted with the HSV-2 antibody. Sera from acutely infected persons testified to the specificity of the antibody so detected. It was revealed by means of the new technique that the rate of HSV-2 antibody was significantly higher in uterine cervical cancer patients than in control women. There was no correlation between the clinical stage of cervical cancer and the presence of HSV-2 antibody.     

Risk of disability and mortality due to overweight in a Finnish population.

OBJECTIVE--To investigate the effect of overweight on premature mortality and work disability in young and middle aged Finns. DESIGN--Prospective cohort study based on data collected in the multiphasic health examinations by the Social Insurance Institution of Finland from 1966 to 1972 and follow up until 1982. SETTING--34 Communities throughout Finland. SUBJECTS--12,053 Women and 19,076 men who were employed and aged 25-64 at baseline. MAIN OUTCOME MEASURES--Mortality and work disability pensions from all and specified causes. RESULTS--Body mass index was a weak predictor of death but a strong predictor of early work disability, which increased linearly with body mass index. After adjustment for age, geographical region, occupation, and smoking the relative risks of work disability for women and men with a body mass index greater than or equal to 30 kg/m2 were, respectively, 2.0 (95% confidence interval 1.8 to 2.3) and 1.5 (1.3 to 1.7) when compared with those of subjects with body mass index less than 22.5 kg/m2. The increased risks were due to an excess of cardiovascular and musculoskeletal diseases but not of mental diseases. One fourth of all disability pensions from cardiovascular and musculoskeletal causes in women and half as many in men could be attributed to overweight (body mass index greater than 25 kg/m2) alone. CONCLUSIONS--Though modest overweight has little impact on mortality it predicts severe functional impairment. A considerable proportion of work disability pensions could probably be prevented by efficient weight control.     

Induced electric and magnetic fields due to wave propagation in a tubular bone

Electric and magnetic fields in tubular bones induced due to the propagation of travelling axisymmetric torsional waves, are determined in the paper by accounting for the piezoelectricity, inhomogeneity and anisotropy of osseous tissues. Using the derived expressions and experimentally determined values of the involved physical constants, numerical values of the displacement and stress fields, and also the induced fields are computed for points at different locations of the bone specimen.     

Hyperglycemia impairs osteoblast cell migration and chemotaxis due to a decrease in mitochondrial biogenesis

Molecular and Cellular Biochemistry - Diabetes is associated with an increase in skeletal fragility and risk of fracture. However, the underlying mechanism for the same is not well understood....