Risk factors for difficult mask ventilation and difficult intubation among patients undergoing pharyngeal and laryngeal surgery.

Background: The prediction of difficult mask ventilation (DMV) and difficult intubation (DI) are key questions in anesthesia fields. DMV or DI related to pharyngeal and laryngeal diseases are a special kind of difficult airways. However, there is a lack of risk factors for prediction. Methods: This study retrospectively collected data from patients who were admitted to the Eye & ENT Hospital of Fudan University from May 2014 to May 2018 and underwent laryngopharyngeal surgery under general anesthesia. Results: A total of 126 patients were included. Twenty patients suffered from DMV. Preoperative laryngeal obstruction classification (OR = 7.46, 95% CI: 2.56-21.76, P < 0.001) and airway patency after sevoflurane inhalation (OR = 10.96, 95% CI: 2.70-44.43, p = 0.001) were independently associated with DMV. Seventy-six patients could be intubated at the first attempt. Preoperative laryngeal obstruction grade (OR = 0.28, 95% CI: 0.13-0.62, P = 0.002), neoplasm size (OR = 0.43, 95% CI: 0.22-0.82, P = 0.011), and airway patency after sevoflurane inhalation (OR = 0.14, 95% CI: 0.05-0.36, P < 0.001) were independently associated with first-attempt successful intubation. Conclusion: Among patients with pharyngeal and laryngeal diseases, the degree of laryngeal obstruction before the operation and the degree of airway obstruction after inhaling sevoflurane are the risk factors of DMV. The degree of laryngeal obstruction before the operation, airway obstruction after inhaling sevoflurane, and the neoplasm size are the risk factors of DI.

Heat-shock protein 70 (HSP70) polymorphisms affect the risk of coke-oven emission-induced neurobehavioral damage.

OBJECTIVES: Epidemiology studies indicated that coke-oven workers with long-term exposure to polycyclic aromatic hydrocarbons (PAHs) often have some neurobehavioral abnormalities especially impairment for cognitive function, while the underlying mechanisms are not fully understood. Numerous studies have indicated the antioxidant and anti-apoptosis roles of heat shock protein 70 (Hsp70). The genetic polymorphisms in HSP70 genes are associated with multiple diseases including neurotoxicity. However, it is unclear whether HSP70 polymorphisms are related to the neurotoxicity of PAH. We, therefore, investigate the possible association between HSP70 polymorphisms and neurobehavioral abnormalities. METHODS: 188 coke-oven workers and 137 control workers were recruited in this study. Emotional and cognitive function was assessed using the WHO/NCTB. HSP70 polymorphisms (HSP70-1 G190C, HSP70-2 G1267 A and HSP70-hom T2437C) were checked by PCR-RFLP. RESULTS: The results indicated that HSP70-1 CC genotypes in coke-oven workers were associated with poor neurobehavioral performance such as the attention /response speed and visual perception/memory, while the HSP70-2 AA genotypes were associated with lower short-term auditory memory. CONCLUSIONS: HSP70-1 CC and HSP70-2 AA genotypes in coke-oven workers may increase the risk for neurobehavioral damage, especially attention, learning and memory.

Opposite effects on tumor growth depending on dose of Achyranthes bidentata polysaccharides in C57BL/6 mice.

We report here the investigation on the effects of Achyranthes bidentata polysaccharides (ABPS) against Lewis lung cancer (LLC) in C57BL/6 mice. Depending on its doses administered in vivo, ABPS was shown to have inhibitory as well as stimulative effects on tumor growth in LLC-bearing C57BL/6 mice. ABPS at low dose could significantly inhibit LLC growth, while high dose treatment of ABPS stimulated, rather than inhibited, LLC growth in C57BL/6 mice. Tumor cell cycle analysis revealed that more tumor cells arrested at G2/M phase after daily low dose intraperitoneal injection of ABPS for consecutive 15 days. The spleen weight increased markedly in LLC-bearing C57BL/6 mice treated with high dose of ABPS. However, the spleen cytotoxicity activity was significantly despaired in mice of high dose treatment of ABPS. Furthermore, we demonstrated that the expressions of IL-6 mRNA and TNF-alpha mRNA were markedly up-regulated in spleens from mice treated with a high dose of ABPS by RT-PCR reactions, suggesting that the low dose of ABPS inhibits tumor growth via its effect on tumor cell cycle distribution, rather than activation of NK activity as previously suggested. We postulate that the stimulation of tumor growth by high dose of ABPS is associated with dysfunction of NK cell and up-regulation of IL-6 mRNA and TNF-alpha mRNA expression in murine spleen.