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This study demonstrates the characteristics of brain MRI abnormalities in Chinese NMO patients, which are helpful to the revision of diagnostic criteria for NMO.

SummaryThe TruView EVO2 laryngoscope was compared with the traditional Macintosh laryngoscope in 200 patients who required tracheal intubation for elective surgery. Mallampati score determined prior to laryngoscopy was significantly related to the view of the glottis during laryngoscopy for both laryngoscopes. The view of the larynx was better with the TruView EVO2 laryngoscope than with the Macintosh laryngoscope in patients with a Cormack and Lehane grade greater than 1 (p < 0.01). The mean time to intubate was significantly shorter with the Macintosh laryngoscope (34 s) than with the TruView laryngoscope (51 s) (p < 0.01). Many cases of difficult intubation are unanticipated and are frequently not recognised during pre-operative assessment [1]. Many different designs of laryngoscopes have been developed in an effort to reduce the incidence of this problem [2][3][4].The TruView EVO2 laryngoscope (Truphatek International Ltd, Netanya, Israel) is a recently introduced device with a unique blade that provides an optical view 'around the corner'. The blade is a modified laryngoscope blade incorporating an unmagnified optic side port with anterior fraction of 35% in the line of sight allowing indirect tracheal intubation [5].The aim of this study was to compare the TruView EVO2 laryngoscope with the direct Macintosh laryngoscope. We wished to determine whether the TruView EVO2 laryngoscope provided an improved view at laryngoscopy compared to that provided by the Macintosh laryngoscope and to also to assess the time taken for intubation with these two devices. MethodsApproval for the study was obtained from the hospital research ethics committee and written informed consent was obtained from each patient participating. Patients were considered appropriate for recruitment if they were undergoing elective surgery for which tracheal intubation was planned. Exclusion criteria included the presence of raised intracranial pressure, cervical spine injury, risk factors for pulmonary aspiration of gastric contents and the presence of any pathology of the head and neck. Preoperatively, patients' demographics and characteristics were reported. The Mallampati score and thyromental distance in mouth opening were also recorded.In the operating room, standard monitoring was employed on all patients and, after pre-oxygenation, anaesthesia was induced with midazolam 0.02-0.04 lg.kg )1 , fentanyl 2-4 lg.kg, and propofol 1-2 mg.kg )1 . Neuromuscular blockade was achieved using rocuronium in a dose of 0.6 mg.kg )1 and an adequacy of neuromuscular block confirmed using a peripheral nerve stimulator. Patients were placed in the 'sniffing' position with their head on a pillow. If ventilation via face mask was considered inadequate by the anaesthesiologist, the patient was withdrawn from the study. Anaesthesia was maintained with either propofol or sevoflurane in oxygen during the study and analgesics agents administered according to preference. A standard Macintosh laryngoscope and TruView EVO2 laryngoscope were used throughout the study...

It is well accepted that recurrent laryngeal nerve paralysis is a severe complication of esophagectomy or lymphadenectomy performed adjacent to the recurrent laryngeal nerves. Herein, determination of the effectiveness of implementing continuous recurrent laryngeal nerve monitoring to reduce the incidence of recurrent laryngeal nerve paralysis after esophagectomy was sought. A total of 115 patients diagnosed with esophageal cancer were enrolled in the thoracic section of the Tangdu Hospital of the Fourth Military Medical University from April 2008 to April 2009. Clinical parameters of patients, the morbidity, and the mortality following esophageal resection were recorded and compared. After the surgery, a 2-year follow up was completed. It was found that recurrent laryngeal nerve paralysis and postoperative pneumonia were more frequently diagnosed in the patients that did not receive continuous recurrent laryngeal nerve monitoring (6/61 vs. 0/54). Furthermore, positive mediastinal lymph nodes (P = 0.015), total mediastinal lymph nodes (P < 0.001), positive total lymph nodes (P = 0.027), and total lymph nodes (P < 0.001) were more often surgically removed in the patients with continuous recurrent laryngeal nerve monitoring. These patients also had a higher 2-year survival rate (P = 0.038) after surgery. It was concluded that continuous intraoperative recurrent laryngeal nerve monitoring is technically safe and effectively identifies the recurrent laryngeal nerves. This may be a helpful method for decreasing the incidence of recurrent laryngeal nerve paralysis and postoperative pneumonia, and for improving the efficiency of lymphadenectomy.

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Studies show that the Th17/IL-17A axis plays an important role in the pathogenesis of kidney diseases. Previously, we also showed that IL-17A may play a role in the pathogenesis of primary nephrotic syndrome; however, the underlying mechanism(s) is unclear. The aim of this study was to explore the molecular mechanism of IL-17A-inducing podocyte injury in vitro. In this study, the NLRP3 inflammasome activation and the morphology of podocytes were detected by Western blot and immunofluorescence. The results showed that podocytes persistently expressed IL-17A receptor and that NLRP3 inflammasome in these cells was activated upon exposure to IL-17A. Also, activity of caspase-1 and secretion of IL-1β increased in the presence of IL-17A. In addition, IL-17A disrupted podocyte morphology by decreasing expression of podocin and increasing expression of desmin. Blockade of intracellular ROS or inhibition of caspase-1 prevented activation of the NLRP3 inflammasome, thereby restoring podocyte morphology. Taken together, the results suggest that IL-17A induces podocyte injury by activating the NLRP3 inflammasome and IL-1β secretion and contributes to disruption of the kidney's filtration system.