ABSTRACT
BACKGROUND@#Unpredictable difficult laryngoscopy (DL) remains a challenge for anesthesiologists, especially when difficult ventilation occurs during standard laryngoscopy. Accurate airway assessment should always be performed, but the common airway assessment methods only perform superficial screening. Thus, the deep laryngopharyngeal anatomy may not be evaluated. Ultrasound-based airway assessment has been recently proposed as a useful, simple, and non-invasive bedside tool as an adjunct to clinical methods, which may facilitate identification of DL. The present study aimed to determine the correlation between ultrasound-measured indicators and DL.@*METHODS@#Patients undergoing elective surgery under general anesthesia with tracheal intubation were enrolled. Ultrasonic airway assessments were performed before anesthesia induction. Ultrasound diagnostic indicators included the thickness and width of the base of the tongue, the angle between the epiglottis and glottis, the length of the thyrohyoid membrane, and the thickness of the lateral pharyngeal wall. A score of ≥3 in the Modified Cormack-Lehane Scoring System was used as a standard of DL and was also applied to divide patients into DL and non-DL groups. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of various diagnostic indicators.@*RESULTS@#A total of 499 patients were enrolled into non-DL and DL groups comprising 452 (452/499, 90.6%) and 47 (47/499, 9.4%) patients, respectively. One ultrasonic diagnoses indicator correlated with DL, namely, the angle between the epiglottis and glottis. When the angle between the epiglottis and glottis was 50°, the area under the ROC curve was maximum (0.902), and the best sensitivity (81%) and specificity (89%) were achieved.@*CONCLUSIONS@#Airway ultrasounds should be considered to identify DL. The ultrasonic angle measured between the epiglottis and glottis is highly associated with DL, which may occur when the angle is less than 50°.@*CLINICAL TRIAL REGISTRATION@#ChiCTR-DDT-13004102, http://www.chictr.org.cn/showproj.aspx?proj=5465.
ABSTRACT
Background@#Unpredictable difficult laryngoscopy (DL) remains a challenge for anesthesiologists, especially when difficult ventilation occurs during standard laryngoscopy. Accurate airway assessment should always be performed, but the common airway assessment methods only perform superficial screening. Thus, the deep laryngopharyngeal anatomy may not be evaluated. Ultrasound-based airway assessment has been recently proposed as a useful, simple, and non-invasive bedside tool as an adjunct to clinical methods, which may facilitate identification of DL. The present study aimed to determine the correlation between ultrasound-measured indicators and DL.@*Methods@#Patients undergoing elective surgery under general anesthesia with tracheal intubation were enrolled. Ultrasonic airway assessments were performed before anesthesia induction. Ultrasound diagnostic indicators included the thickness and width of the base of the tongue, the angle between the epiglottis and glottis, the length of the thyrohyoid membrane, and the thickness of the lateral pharyngeal wall. A score of ≥3 in the Modified Cormack-Lehane Scoring System was used as a standard of DL and was also applied to divide patients into DL and non-DL groups. The area under the receiver operating characteristic (ROC) curve was used to evaluate the diagnostic ability of various diagnostic indicators.@*Results@#A total of 499 patients were enrolled into non-DL and DL groups comprising 452 (452/499, 90.6%) and 47 (47/499, 9.4%) patients, respectively. One ultrasonic diagnoses indicator correlated with DL, namely, the angle between the epiglottis and glottis. When the angle between the epiglottis and glottis was 50°, the area under the ROC curve was maximum (0.902), and the best sensitivity (81%) and specificity (89%) were achieved.@*Conclusions@#Airway ultrasounds should be considered to identify DL. The ultrasonic angle measured between the epiglottis and glottis is highly associated with DL, which may occur when the angle is less than 50°.@*Clinical trial registration@#ChiCTR-DDT-13004102, http://www.chictr.org.cn/showproj.aspx?proj=5465
ABSTRACT
<p><b>Background:</b>Patients with potential difficult mask ventilation (DV) and difficult intubation (DI) are often managed with awake intubation, which can be stressful for patients and anesthesiologists. This prospective randomized study evaluated a new approach, fast difficult airway evaluation (FDAE). We hypothesized that the FDAE approach would reduce the need for awake intubation.</p><p><b>Methods:</b>After obtaining informed consent, 302 patients with potential DV/DI undergoing elective surgeries were randomly assigned to the FDAE group (Group E) and the control group (Group C). In Group E, patients were gradually sedated, and adequacy of manual mask ventilation during spontaneous breathing was assessed at various sedation levels. Awake intubation was applied in those with inadequate mask ventilation. In Group C, DI was evaluated under local anesthesia. However, the care team could intubate under general anesthesia if the vocal cords were visible. The primary outcome was the rate of awake intubations in both groups and the induction efficiency assessed by the induction time. The secondary outcome was the incidence of serious complications.</p><p><b>Results</b>The rate of awake intubation was significantly lower in Group E than that in Group C (5.81% vs. 36.05%, χ = 42.3, P < 0.001). The induction time was much shorter in Group E than in Group C (11.85 ± 4.82 min vs. 18.71 ± 7.85 min, t = 5.39, P < 0.001). There was no significant difference in the incidence of intubation related complications between the two groups. Patients in Group E had a much lower incidence of recall (9.68% vs. 44.90%, χ = 47.68, P < 0.001) of the induction process and higher satisfaction levels than patients in Group C (t = 15.36, P < 0.001).</p><p><b>Conclusions</b>The FDAE significantly reduces the need for awake intubation and improves the efficiency of the intubation process without comprising safety in patients with potential difficult mask ventilation and DI.</p><p><b>Trial Registration:</b>No. ChiCTR-TRC-11001418; http://www.gctr.org/cn/proj/show.aspx?proj=1562.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Airway Management , Intubation, Intratracheal , Methods , Laryngeal Masks , Methyl Ethers , Prospective Studies , Sevoflurane , WakefulnessABSTRACT
Objective To establish a method for simultaneous detection of norovirus (NV),rotavirus (RV), astrovirus (AV) and hepatitis A virus (HAV) by multiplex reverse transcriptionpolymerase chain reaction (RT-PCR). Methods Specific primers of the four viruses were designed based on the high conserved sequences, the reaction system and conditions optimized and the specificity and sensitivity confirmed. The method was then applied to detect the four viruses in clinical samples. Results The steady detection limits were 100 pg/ml for hepatitis A virus, 50 pg/ml for rotavirus, norovirus and astrovirus respectively. When the developed method was used to detect clinical fecal samples, 62(48.44%)were iden tified as rotavirus, 8 (6.25%) as norovirus, 11 (8.59%) as astrovirus and 4 (3.12%) as hepatitis A virus in a total of 128 samples. Conclusion Data from our study showed that multiplex RTPCR system could be used to simultaneously detect the four viruses in routine monitoring and risk assessment in disease outbreaks with high specificity and sensitivity.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the detective efficacy of Chromogenic Coliform and Escherichia Coli Agar (CCEA).</p><p><b>METHODS</b>A new chromogenic medium CCEA prepared by Huankai laboratory was used to compare with a classical medium of violet red bile agar (VRBA), and other two Chromogenic media Agar I and Agar II by detecting separately 11 reference strains, thirteen sterile samples with Coliform or E.coli and other four samples, and the accordant rates of detection were observed.</p><p><b>RESULTS</b>CCEA had the good selectivity. To seven kinds of quality strains in the resultant analysis, CCEA with VRBA and Agar I had not shown salience difference (P > 0.05), and CCEA with Agar II had significant difference (P < 0.05). CCEA showed more advantages than the Agar II. To thirteen sterile samples with Coliform or E.coli in resultant analysis, CCEA with Agar I and Agar II had shown no significant difference (P > 0.05), while CCEA with VRBA had significant difference (P < 0.05). CCEA might be more advantageous than the VRBA. In analysis of the four actual samples of Coliform, CCEA with VRBA, Agar I and Agar II showed no significant difference (P > 0.05). The accordant rates were 90%, 71.88%, 86.25% and 81.25% respectively, showing CCEA > Agar I > Agar II > VRBA. To two actual samples of E.coli in the resultant analysis, the CCEA with Agar I and Agar II had not shown significant difference (P > 0.05). The accordant rates were 100% respectively.</p><p><b>CONCLUSIONS</b>The CCEA might be more advantageous than the VRBA, having the same efficacy as with Agar I and Agar II.</p>
Subject(s)
Bacteriological Techniques , Culture Media , Enterobacteriaceae , Escherichia coliABSTRACT
Objective To study the protective role of AngiotensinⅡreceptor inhibitor in ventilator-induced lung injury of rats.Method Forty healthy male SD rats were equally divided into four group (A,B,C,D group,n=10).Group A served as control group,group B had low tidal volume (V_T=10 ml/kg) with breathing rate (P)=80/min;group C had high tidal volume (V_T=40 ml/kg) group with breathing rate 80/min;group D had high tidal volume (V_T=40 ml/kg) group with breathing rate 80/min,all rats in group D were pretreated with Losartan.The duration of ventilation in 'all groups was two hours.Rats were sacrificed after experiment finished. The lung lavage liquid and lung tissue were collected and preserved with well established methods.Lung pathological change was observed by microscope;lung cell apoptosis was assessed with TUNEL;the expression of ANGⅡwas assayed with RT-PCR.The measured variables also included total protein,WBC,W/D,MPO. Results In comparison with B group,all variables in group C were significantly increased (P
ABSTRACT
Foodbome viruses are defined to be viruses that can lead to human diseases through food. In accordance with the different origin, foodborne viruses can be divided into two kinds: intestinal viruses and zoonotic viruses. The former include those viruses that can be transmitted to person via fecal-orally route. The latter include those zoonotic viruses that chiefly transmitted to person through livestock and poultry products. This paper expounds foodborne viruses categories, biology nature, epidemiology character, and study circumstance, and clarifies the molecular biological methods and problems on the base of the polymerase chain reactions, and presents the development direction and application perspective of the foodbome viruses study.
ABSTRACT
The brown slime inside pipeline of the polluted mineral waters well was analyzed. It was confirmed that the brown slime was a biofilm formed mainly by growth of bacteria contaminant, using microscope analysis. After treated with HCl, the brown crystals and mycelioid matter presented in slimes disappeared. It was verified these were metal deposits. The samples produced Prussia blue deposits by dropping K 4Fe(CN) 6 and HCl, which proved that the metal deposits were iron compound. Also it was believed the biofilm was produced by growth of iron bacteria, mixed with deposits of iron compound. The iron bacteria have been isolated from the slimes and cultured in the laboratory. The colony on agar plate also produced Prussia blue deposits after treated with K 4Fe(CN) 6 and HCl. The cells form of pure culture was the same as that in the samples by electronmicroscope analysis. Therefore, It indicated that the bacteria on biofilm inside pipeline were iron bacteria mainly.
ABSTRACT
Based on the counting results from nutrition agar in our study, and compared with another two kinds of coliform bacteria detective plates for dinner and drinking sets which were provided by two manufactures and inspected by China National Health Bureau , we accomplished the detectability test of the Huankai coliform bacteria plates. In our study, 3kinds of cell density were adopted: 10cells/mL, 50cells/mL and 100cells/mL . The results shew that the detectability of Huankai plates basically conformed with that of nutrition agar , and was no evident difference from that of another two kinds of plates. The conclusions were that Huankai plates can completely be used in the inspection and test for conform bacteria.
ABSTRACT
In this assay, the reaction kinetics, optimum temperature, pH and various influential factors of ATP microbial rapid detection reagent by bioluminescence were studied. The results showed that it's enough for detection system to have 40 ~ 50?g/mL D-Luciferin. The light production decreased fastest in the first minute of reaction, then began to decay slowly. The optimal reaction temperature was 24℃~25℃and the optimal pH was pH 7.2 -7.4 in the reaction system. In addition, when stored at 4℃for 45h, the dissolved reagent solution could keep its 86% activity. When preserved at 25℃, the enzyme activity decreased less for 1h, and degraded gradually as time went by and only left 53. 5% of its activity after 6. 5h. While stored at 33℃, the enzyme activity decreased quickly with the time and only left 59. 1% after 1. 5h. The result indicated that storage temperature was a very important influential factor to the activity of reagent Meanwhile, different chemical substance such as acid, alkali, salt and surfactants inhibited the ATP bioluminescent reaction. When the concentration of NaCl reached 1. 5g/L, it could inhibit 52. 5% light production. Triton X-100, acid, and alkali also had some effects on the reaction, while CTAB, SDS and TCA would inhibit the bioluminescent reaction seriously.