Supreme™ laryngeal mask airway use in general Anesthesia for category 2 and 3 Cesarean delivery: a prospective cohort study

Background

The Supreme? laryngeal mask airway (SLMA) is a single-use LMA with double lumen design that allows separation of the respiratory and the alimentary tract, hence potentially reducing the gastric volume and risk of aspiration. The purpose of this prospective cohort study is to evaluate the the role of the SLMA as an airway technique for women undergoing category 2 and 3 Cesarean delivery under general anesthesia.

Methods

We recruited 584 parturients who underwent category 2 or 3 Cesarean delivery under general anesthesia, in which 193 parturients underwent category 2 and 391 parturients underwent category 3 Cesarean delivery. The primary outcome was insertion success rate at 1st attempt in SLMA insertion. The secondary outcomes included anaesthetic, obstetric outcomes and maternal side effects associated with airway device.

Results

The 1st attempt insertion success rate was 98.3%, while the overall insertion success rate was 100%. The mean (Standard deviation) time to effective ventilation was 15.6 (4.4) seconds. Orogastric tube insertion was successful at the 1st attempt in all parturients. There was no clinical evidence of aspiration or regurgitation. No episodes of hypoxemia, laryngospasm or bronchospasm were observed intra-operatively. The incidence of complications was low and with good maternal satisfaction reported.

Conclusions

The SLMA could be an alternative effective airway in category 2 and 3 parturients emergency Cesarean Delivery under general anesthesia in a carefully-selected obstetric population.

Trial registration

Clinical Trials Registration: Clinicaltrials.gov Registration NCT02026882. Registered on December 31, 2013.

     

Mapping one of the 2 genes controlling lemon ray flower color in sunflower (Helianthus annuus L.)

In an F2 population of 120 plants derived from a cross between 2 breeding lines with yellow ray flowers, we observed 111 plants with yellow-colored and 9 plants with lemon-colored ray flowers. The segregation pattern fits a 15:1 (chi2(15:1) = 0.32, P > 0.5) ratio, suggesting that the lemon ray flower color is conditioned by 2 independent recessive genes that had been contributed individually by each of the parents. We sampled 111 plants from the 3 F(2:3) families displaying a 3 to 1 segregating ratio for genotyping with molecular markers. One of the genes, Yf(1), was mapped onto linkage group 11 of the public sunflower map. A targeted region amplified polymorphism marker (B26P17Trap13-68) had a genetic distance of 1.5 cM to Yf(1), and one simple sequence repeat marker (ORS733) and one expressed sequence tag (EST)-based marker (HT167) previously mapped to linkage group 11 were linked to Yf(1) with distances of 9.9 and 2.3 cM, respectively.     

长效重组药物研究进展

生物重组药物半衰期的长短显著影响药物在使用时的剂量以及治疗的效果,所以延长其在体内的生物半衰期,防止药物在体内迅速降解成为现在药物研究的重要方向之一.针对目前较为广泛使用的几种重组药物长效化方法.如定点突变、化学修饰、基因融合、药物剂型和给药方式的改变等,结合目前已经上市的和正在研发中的长效重组药物进行了综述.     

塔里木河下游不同退化区地表植被和土壤种子库特征

对塔里木河下游不同退化程度的4个典型断面进行了植被和土壤种子库的取样调查,采用种子萌发试验研究了不同退化区植被和土壤种子库的特征,结果表明:(1)塔里木河下游地表植被表现为严重的逆行演替,具体体现为胡杨林都为过熟林,几乎没有胸径在10cm以下的幼林;植被盖度、密度和多样性指数均维持在一个较低的水平上;随退化程度不断加重,地表植被中草本植物的相对密度、相对盖度和相对频度逐渐降低,而灌木和乔木的相对密度、相对盖度和相对频度逐渐增加;(2)研究区土壤种子库的基本特征是:土壤种子库种类贫乏、密度低、多样性指数和相似性系数不高;(3) 随退化程度的加重,土壤种子库物种数不断减少、密度明显下降、优势种组成趋于单一、表层种子库比例升高、1年生草本植物占优势逐渐向多年生草本植物和灌木植物转变及土壤种子库物种组成与地上植被物种组成上差异显著.     

健康宣教在小儿狭窄性腱鞘炎围手术期应用价值

目的：对手术疗法治疗狭窄性腱鞘炎的小儿患者采取系统的整体健康宣教,使得患儿疗程缩短,治愈率高,复发率降至最低,功能康复效果良好,提高护理质量。方法：在保守治疗无效的情况下,手术疗法切除部分狭窄腱鞘,围手术期实施系统的全面的功能康复训练及宣教。结果：54例患儿完全治愈,随访3~26个月,无复发及并发症,愈后功能良好。结论：细致、周密的做好围手术期对家长及患儿的双重健康宣教工作,使得护患关系融洽,患者自护能力大大加强,治疗及护理效果满意。     

Self-organizing circuit assembly through spatiotemporally coordinated neuronal migration within geometric constraints

Background

Neurons are dynamically coupled with each other through neurite-mediated adhesion during development. Understanding the collective behavior of neurons in circuits is important for understanding neural development. While a number of genetic and activity-dependent factors regulating neuronal migration have been discovered on single cell level, systematic study of collective neuronal migration has been lacking. Various biological systems are shown to be self-organized, and it is not known if neural circuit assembly is self-organized. Besides, many of the molecular factors take effect through spatial patterns, and coupled biological systems exhibit emergent property in response to geometric constraints. How geometric constraints of the patterns regulate neuronal migration and circuit assembly of neurons within the patterns remains unexplored.

Methodology/Principal Findings

We established a two-dimensional model for studying collective neuronal migration of a circuit, with hippocampal neurons from embryonic rats on Matrigel-coated self-assembled monolayers (SAMs). When the neural circuit is subject to geometric constraints of a critical scale, we found that the collective behavior of neuronal migration is spatiotemporally coordinated. Neuronal somata that are evenly distributed upon adhesion tend to aggregate at the geometric center of the circuit, forming mono-clusters. Clustering formation is geometry-dependent, within a critical scale from 200 µm to approximately 500 µm. Finally, somata clustering is neuron-type specific, and glutamatergic and GABAergic neurons tend to aggregate homo-philically.

Conclusions/Significance

We demonstrate self-organization of neural circuits in response to geometric constraints through spatiotemporally coordinated neuronal migration, possibly via mechanical coupling. We found that such collective neuronal migration leads to somata clustering, and mono-cluster appears when the geometric constraints fall within a critical scale. The discovery of geometry-dependent collective neuronal migration and the formation of somata clustering in vitro shed light on neural development in vivo.     

Metabolome profiling reveals metabolic cooperation between Bacillus megaterium and Ketogulonicigenium vulgare during induced swarm motility

The metabolic cooperation in the ecosystem of Bacillus megaterium and Ketogulonicigenium vulgare was investigated by cultivating them spatially on a soft agar plate. We found that B. megaterium swarmed in a direction along the trace of K. vulgare on the agar plate. Metabolomics based on gas chromatography coupled with time-of-flight mass spectrometry (GC-TOF-MS) was employed to analyze the interaction mechanism between the two microorganisms. We found that the microorganisms interact by exchanging a number of metabolites. Both intracellular metabolism and cell-cell communication via metabolic cooperation were essential in determining the population dynamics of the ecosystem. The contents of amino acids and other nutritional compounds in K. vulgare were rather low in comparison to those in B. megaterium, but the levels of these compounds in the medium surrounding K. vulgare were fairly high, even higher than in fresh medium. Erythrose, erythritol, guanine, and inositol accumulated around B. megaterium were consumed by K. vulgare upon its migration. The oxidization products of K. vulgare, including 2-keto-gulonic acids (2KGA), were sharply increased. Upon coculturing of B. megaterium and K. vulgare, 2,6-dipicolinic acid (the biomarker of sporulation of B. megaterium), was remarkably increased compared with those in the monocultures. Therefore, the interactions between B. megaterium and K. vulgare were a synergistic combination of mutualism and antagonism. This paper is the first to systematically identify a symbiotic interaction mechanism via metabolites in the ecosystem established by two isolated colonies of B. megaterium and K. vulgare.     

Influences of the petroleum-recovering activity on the arsenic level in groundwater of Kuitun,Xinjiang, China

Increasing demands of groundwater in petroleum-recovering regions could elevate the level and mobility of arsenic in groundwater as a result of the enhanced dissolution of arsenic-bearing iron or manganese oxide due to the accelerated sulfate reduction by microorganisms in a reductive environment. To substantiate this possibility, groundwater samples were collected from 220 water wells in the nearby petroleum wells in Kuitun. Dissolved arsenic, iron, manganese, and sulfate levels and pH in groundwater samples were analyzed. The dissolved arsenic levels in groundwater varied from <2.3 to 789.4 μg·L^?1, in which approximately 96.4% of the measured values exceeded the allowed limits of the World Health Organization. An inverse relation existed between dissolved arsenic and sulfate levels. Most of the high arsenic-level samples (>300 μg·L^?1) were found in wells at close proximity to petroleum wells where a high iron or manganese level was also detected. The oil-exploring activity in the study region seemed to have enhanced the microbial reduction of sulfate in underground environment and hence the level of arsenic in groundwater. The microbial sulfate reduction coupled with the reduction of arsenic-bearing iron oxides in the groundwater environment may explain the spatial heterogeneity of the arsenic level in groundwater.