Evaluation of Impact of Major Causes of Death on Life Expectancy Changes in China, 1990-2005

Objective To evaluate the impact of major causes of death on changes of life expectancy in China. Methods Life expectancy was calculated by standard life table techniques using mortality data from the national censuses in 1990 and 2000 and the 1% National Population Sampling Surveys in 1995 and 2005, Mortality data about the major causes of death from VR-MOH were used as reference values to estimate their death proportions of the specific age groups by sex and regions, as well as all-cause mortality and age-specific mortality rates of major causes of death. Decomposition method was used to quantitatively evaluate the impact. Results Three key findings were identified in our study. First, China＇s health challenge was shifted from diseases related to living conditions to those related to behavior and lifestyle, with rural areas relatively lagged behind urban areas, Second, the impacts of cardiovascular diseases and neoplasm on the middle aged and elderly population were stressed. Third, compared to the urban population, the rural population tended to have increasing mortality of neoplasm and cardiovascular diseases, especially in adults at the age of 15-39 years. Conclusion Further efforts should be made to reduce the incidence of neoplasm and cardiovascular diseases, especially in rural areas, by promoting healthy behavior and lifestyle and providing appropriate therapies for all patients in need.     

Clinical assessment of awake endotracheal intubation using the lightwand technique alone in patients with difficult airways

Background There is few study to determine whether the use of the lightwand technique alone could achieve effective, safe and successful awake endotracheal intubation （ETI）, therefore we designed a prospective clinical study to systematically evaluate the feasibility, safety and efficacy of awake ETI using the lightwand alone in patients with difficult airways.
Methods Seventy adult patients with difficult airways were enrolled in this study. After the desired sedation with fentanyl and midazolam, airway topical anesthesia was performed with 9 ml of 2% lidocaine, which were in order sprayed in three aliquots at 5 minutes intervals into the supraglottic （two doses） and laryngotracheal areas （one dose） using a combined unit of the lightwand and MADgic atomizer. After airway topical anesthesia, awake ETI was performed using a Lightwand. Subjective assessments by patients and operators using the visual analogue scores （VAS）, and objective assessments by an independent investigator using patients＇ tolerance and reaction scores, coughing severity, intubating conditions and cardiovascular variables were taken as the observed parameters.
Results Of 210 airway sprays, 197 （93.8%） were successfully completed on the first attempt. The total time for airway spray was （14.6±1.5） minutes. During airway topical anesthesia, the average patients＇ tolerance scores were 1.7-2.3. After airway topical anesthesia, the mean VAS for discomfort levels that the patients reported was 6.5. Also airway topical anesthesia procedure was rated as acceptable and no discomfort by 94.3% of patients. The lightwand-guided awake ETI was successfully completed on first attempt within 29 seconds in all patients. During awake ETI, patients＇ reaction and coughing scores were 1.9 and 1.6, respectively. All patients exhibited excellent or acceptable intubating conditions. Cardiovascular monitoring revealed that changes of systolic blood pressure and heart rate at each stage of airway manipulations were less than 20% of baseline values. The postoperative follow-up showed that 95.7% of patients had no recall or slight memories of all airway instrumentation. The incidence of postoperative mild airway complications was 38.6%.
Conclusion Alone use of the lightwand technique can achieve effective, safe and successful awake ETI in patients with difficult airways.     

症状性成人脊髓栓系综合症

Tethered spinal cord syndrome （TCS） is a condition of overstretching or compression of the caudal part of the spinal cord caused by various spinal lesions, such as a tight filum terminale or an intraspinal lipoma.l-9 Though it is a well-recognized cause of neurological deterioration in childhood, its symptomatic onset in adulthood is uncommon. Eleven cases of TCS are presented here. In addition, their related clinical features, surgical procedures and outcomes are investigated.     

关于期刊级别问题答作者、读者问

本刊陆续收到一些作者、读者来电询问赣人发[2005]10号文件有关“江西省卫生专业高级资格条件”之规定中关于“国家级、省级、市级正式出版的期刊”期刊级别问题,现将国家新闻出版总署1996年7月14日就有关“划分期刊级别问题”答复摘录如下：     

四氮唑蓝（NBT）法检测SOD条件的探讨

对NBT光照还原法检测SOD的条件及影响因素进行了研究。实验表明,水性条件下各种助溶剂的引入会改变甲月替最大吸收．使560nm波长不再适合NBT法对SOD的分光检测,从而找到了该法即使加入过量的SOD,也无法获得100％的对O2^·-抑制率的原因;对茶叶泡剂直接用NBT法检测SOD的可行性研究表明。茶液复杂的组成在NBT光照还原法体系中的反应表现,不仅有茶多酚对核黄素光照产生的O2^·-离子的抗氧化抑制作用。还掺和有其他明显的促氧化反应。因此不能直接进行SOD检测。     

丙烯腈生物降解实验条件研究

目的:筛选获得高效降解丙烯腈菌株并研究其最佳降解条件。方法:采集长期受高浓度丙烯腈工业废水污染的表层土样,经富集、驯化诱导、分离获得降解丙烯腈菌株,考察影响其降解丙烯腈诸多因素,测定相应情况下丙烯腈降解率或细胞生物量。结果:按5%接种菌量,在装液量25mL/250mL、摇床转速150r/min、30℃、pH7.0及葡萄糖初始浓度20g/L的实验条件下,振荡培养48h,该菌株丙烯腈降解率达到99.4%,且菌株生长良好,降解后水中丙烯腈含量低于国家排放标准。结论:该菌株能高效降解丙烯腈,有望推为工业应用。     

成人术前禁食禁饮的新观念

对于成人择期手术,午夜后就开始禁食、禁饮是一种传统的习惯,起源于1946年。当时,产妇全麻过程中有较高的误吸发生率,因此在当时的麻醉和手术条件下,对于择期手术的病人,午夜后就开始禁食、禁饮并成为一种常规。然而,近20年里的临床实践证明了禁食时间与误吸率无相关性,并且这种长时间的禁食制度给病人带来的心理和生理上的潜在危害日益受到关注,传统的术前禁食受到了质疑。1990年加拿大学会在新的麻醉指南中已删去建议术前禁饮食的部分,     

鼻饲老年患者发生吸入性肺炎38例病例分析

1临床资料 1．1病例选择回顾性分析我科从2006年6月至2010年7月鼻饲老年患者吸入性肺炎38例,均符合吸入性肺炎的诊断条件。其中男性30例,女性8例。年龄70-82岁,平均（75±4）岁。鼻饲时间1个月至2年不等。     

吸入气体摄取率对第二气体效应的影响

目的探讨吸入气体摄取率对第二气体效应的影响,得出第二气体效应存在的条件。方法利用热力学的宏观理论和数学的定量分析方法,分两个层面讨论第二气体效应:第二气体效应存在的条件;不存在的条件。结果当第一气体的摄取率大于氧的摄取率时,存在第二气体效应;当第一气体、第二气体及氧的摄取率三者分别相等时,不存在第二气体效应;当第二气体的摄取率、第一气体和氧的平均摄取率二者相等时,不存在第二气体效应。结论第二气体效应的存在不是必然的,是有条件的,可从吸入气体摄取率的角度对现有相关研究成果予以讨论。     

黑曲霉菌对獐牙菜苦苷的生物转化工艺优化

目的以獐牙菜苦苷为底物,用黑曲霉菌对獐牙菜苦苷进行生物转化,并对转化条件进行优化。方法以獐牙菜新素生成率和獐牙菜苦苷转化率为指标,考察不同培养时间、不同碳源、不同氮源、不同种类金属离子、磷酸盐、生长因子(酵母膏)、接种量、底物加入量、不同初始pH值、不同温度条件,优化獐牙菜苦苷在黑曲霉培养液中的转化条件。结果优化后的培养条件为:葡萄糖10 g/L,蛋白胨5 g/L,酵母膏5 g/L,KH2PO4 5 g/L,MgSO4 1 g/L,CaCl2 1 g/L,初始pH 6.0,接种量0.5%,底物加入量1 mg/mL,28℃,培养5 d。结论黑曲霉转化獐牙菜苦苷生成獐牙菜新素的生成率稳定在8%左右。