Aims and objectives: To investigate whether positioning the body in a lateral decubitus position will facilitate nasogastric tube insertion in unconscious patients.Background: Inserting a nasogastric tube into unconscious patients can be challenging because these patients cannot cooperate with the operator. The piriform sinus and arytenoid cartilage are the most commonly reported impaction sites. However, we found that the first impaction site was the backward displaced tongue when inserting a nasogastric tube in unconscious patients who often exhibited glossoptosis. Performing an intubation in the lateral decubitus position could make this procedure easy.Design: This prospective, double-blind, parallel, randomised controlled trial was conducted in Hengshui City, Hebei Province, China.Methods: A total of 110 cases of unconscious patients were enrolled. The patients were randomly assigned to a conventional group (group C) or a lateral decubitus position group (group L). In group C, the nasogastric tube was inserted while the patients were in a supine position using the conventional technique, and in group L, the tube was inserted in a lateral decubitus position or further tilting the body to a prone decubitus position 20-30°. We discussed reasonable intubation methods in unconscious patients by comparing the success rate on first insertion, the overall success rate, the intubation time and the complication rates between the two groups.Results: Group L had a higher success rate on first insertion and overall success rate than group C (p < .05). The intubation time in group L was shorter than that in group C (p < .001), and the complication rate in group L was lower than that in group C (p < .05). The differences were statistically significant. Conclusions:The backward displaced tongue blocks the pharyngeal passage. Nasogastric tube insertions in the lateral decubitus position are recommended in unconscious patients because of the higher success rate, reduced intubation time and lower complication rate.Relevance to clinical practice: This study provides an effective method for nasogastric tube insertions in unconscious patients.

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Abnormal expression of let-7b has been observed in many tumors, including glioma. However, the clinical significance of let-7b in glioma remained unclear. The aim of the study was to explore the correlation of let-7b expression with clinicopathological factors and prognosis in human glioma. Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to detect the relative expression of let-7b in glioma tissues. The association of let-7b expression with clinicopatholoigcal features of glioma patients was estimated using chi-square test. Overall survival curves were plotted using Kaplan–Meier method with log rank test. The prognosis analysis was performed using Cox regression model, and the results were shown as hazard ration (HR) with 95% confidence interval (CI). The relative expression of let-7b was significantly lower in glioma tissues than that in normal brain tissues ( P < .001). Furthermore, let-7b level was closely correlated with World Health Organization (WHO) grade ( P = .027) and Karnofsky performance score (KPS) ( P = .018). Survival analysis indicated that glioma patients with low let-7b expression had significantly shorter overall survival time than those with high expression (log rank test, P < .001). Let-7b might be an independent prognostic biomarker for glioma ( P < .001, HR = 2.415; 95% CI: 1.531–3.808). Let-7b may be a promising prognostic factor in glioma.