Objective To investigate the different doses of dexmedetomidine on reducing the effects of restlessness after anesthesia.Methods Forty-eight patients who occurred restlessness after general anesthesia were collected and randomly divided into A,B,C group (16 cases in each group).Dexmedetomidine were given at dose of 0.3 μg/kg,0.5 μg/kg,1.0 μg/kg for treatment as A,B,C group.Blood pressure,heart rate,Riker sedation-restlessness (SAS) score and other changes of patients were recorded at different time points after treatment.Results SAS scores were significantly lower in B,C groups than that in A group (P ＜ 0.05) at immediately after administration and 5 min and 10 min after administration.Systolic pressure and heart rate were significantly lower in C group than in B,A group (P ＜ 0.05) at immediately after administration and 5 min after administration.Only the heart rate in B group at immediately after administration was lower than that in A group.Time in the recovery room in B group was (37.5 ± 6.4) min,significantly lower than A group and C group ((43.2 ± 8.9) min,(47.5 ± 9.8) min ; F =14.362 ; P ＜ 0.001).Conclusion Dexmedetomidine is a more ideal sedation drug and 0.5 μg/kg dexmedetomidine can reduce restlessness and cardiovascular reactions in patients with restlessness after general anesthesia,which is the best recommending therapeutic dose.

Objective:To evaluate the effects of dibutyl phthalate on rat sperm production and quality. Methods:Totally 150 male rats were randomly divided into the low dose group (50 mg·kg-1), the middle dose group (200 mg·kg-1), the high dose group (1 000 mg·kg-1 ) , the blank control group and the solvent control group ( peanut oil as the control) with 30 ones in each. After continu-ous administration for every 30 days, 10 rats from each group were anatomized, the weight of testes and epididymides were determined, and one side of epididymis was used to carry out the sperm analysis including counting, survival rate and morphology. Results:After intragastric administration for 90 days, the sperm count and survival rate, the weight of testis and epididymis and organ coefficient in the middle dose group and high dose group were decreased significantly(P<0. 05 or 0. 01). Conclusion:The long-term administration of dibutyl phthalate at high dose exhibits notable toxicity on rat reproductive function.

Objective To report 56 cases of congenital heart disease with congenital single coronary artery and to evaluate the imaging diagnostic techniques. Methods All 56 patients with congenital single coronary artery underwent angiocardiography. Contrast enhancement magnetic resonance angiography (CE MRA) was performed in 4 cases. 48 cases were confirmed by operation. Results In these 56 cases, single left coronary artery was found in 44 cases and single right coronary artery was found in 12. Conclusion Congenital heart disease with congenital single coronary artery is not rare and correct diagnosis is very important for surgery.

Objective To explore the value of phase-contrast magnetic resonance imaging (PC-MR) in diagnosis of secundum atrial septal defect (ASD) in pediatric patients. Methods Totally 42 patients (aged from 9 months to 15 years) with secundum ASD proved with tansthoric echocardiographic (TTE) were evaluated with PC-MRI. Images of the flow through ASD were obtained with PC-MRI. The distances of ASD rim to superior vena cava (SVC), inferior vena cava (IVC), atrioventricular valves (AVV) and right upper pulmonary vein (RUPV), as well as the entrances of the vena cava and right upper pulmonary vein (RUPV) were assessed. Results The sizes of ASD and distances of ASD rim to the adjacent structures (SVC, RVC, AVV and RUPV) at PC-MRI were well consistent with those of TTE in 42 patients (P<0.001). PC-MRI results in 26 patients correlated well with surgical results (P<0.001). With different velocity encoding, compared with surgical results, measurements of ASD's sizes were more accurate when setting velocity from 50 to 70 cm/s than 90 cm/s. Conclusion The shape of ASD can be virtually depicted with PC-MRI. PC-MRI can accurately assess the defect size, number, rim distances to adjacent structures, therefore providing a new method for depiction of congenital heart anomaly.

Objective To investigate the clinical value of serum glycyl-proline dipeptidyl aminopeptidase(GPDA)combined with carcino-embryonic antigen (CEA),carbohydrate antigen724 (CA724),carbohydrate antigen242 (CA242) in the early diagnosis of gastric cancer.Methods Collected in Changan hospital in patients with gastric cancer and atrophic gastritis patients and healthy subjects 60 cases,by TBA-120FR biochemical analyzer glycyl-proline dipeptidyl aminopeptidase (GPDA),chemiluminescence analyzer to detect the levels of serum CEA,CA724 and CA242,analysis of single detection and joint detection and the differences between the positive rate and sensitivity.Results The detection of GPDA in gastric cancer group was significantly lower than that in atrophic gastritis group and healthy control group,the difference was statistically significant (F=69.532,P=0.000).The results of CEA,CA724 and CA242 in gastric cancer group were higher than those in atrophic gastritis group and healthy control group,the difference was statistically significant (CEA:F=59.926,P=0.001;CA724:F=51.056,P =0.001;CA242:F =72.613,P =0.000).Serum GPDA,CEA,CA724 and CA242 single detection positive rate were 70 ％,45 ％,61.7 ％ and 50 ％.Tumor markers CEA,CA724,CA242 positive rate of three joint detection was 75％.Serum GPDA and tumor markers of CEA,the positive rate of CA724 and CA242 combined detection of four was 86.7％.The positive rate of three and higher than that of single detection,the difference was statistically significant (F=49.635,P=0.003).Serum GPDA,CEA,CA724 and CA242 single detection sensitivity was 70.2 ％,50.2 ％,67.3 ％ and 53.2％.Tumor markers CEA,CA724,CA242 three joint detection sensitivity was 85.6％.Serum GPDA and tumor markers CEA,CA724 and CA242 four joint detection sensitivity was 90.3％.The sensitivity was higher than the three items and the individual tests,and the difference was statistically significant (F=52.016,P =0.001).Conclusion GPDA joint CEA,CA724 and CA242 tumor markers detection can improve the positive rate and sensitivity in early diagnosis of gastric cancer,but it will not reduce the diagnostic specificity,the clinical diagnosis of early gastric cancer has important significance and value.

Objective To report 115 cases of congenital aortic arch anomalies, and to evaluate the imaging diagnostic techniques. Methods One hundred and fifteen patients with congenital aortic arch anomalies underwent angiocardiography and(or)contrast enhancement magnetic resonance angiography (CE MRA). Results In this 115 cases, double aortic arch was seen in 5 cases, right aortic arch with aberrant left subclavian artery in 45 with isolated left subclavian artery in 11, left aortic arch with aberrant right subclavian artery in 33, right aortic arch with left descending aorta in 7, left aortic arch with right descending aorta in 4, cervical aorta in 4, and others in 6. Conclusion CE MRA is a reliable noninvasive imaging diagnostic method.

Objective To evaluate a combination of interventional treatment and surgical exploration for acute lower limb ischemic disease.Methods We reviewed 42 cases admitted from July 2007 to January 2010,all patients complained pain,paralysis,pulselessness,pallor and paresthesia.After Fogarty thrombectomy angiography was taken in DSA room.Patients with angiostenosis greater than 50％ were then managed by interventional treatment(CDT,PTA,Stenting).Results Lives were saved in all patients,40 lower limbs were saved,and 2 patients received below knee amputation.The amputation rate was 4.76％.Dorsal or(and)posterior tibial artery of foot was felt in 33 patients,symptoms significantly improved.The other 7 patients still had painful and paralysis on the diseased limb.Conclusions The interventional treatment and surgical operation in acute lower limb ischemic disease is safe and result is satisfactory,which can improve the long-term patency and salvage rate of the lower limb.

Objective To evaluate balloon angioplasty and stenting of the hepatic veins for the treatment of Budd-Chiari syndrome with long segmental inferior vena cava (IVC).Methods The hepatic veins were evaluated by colour Doppler,CT or MR.Epidiaphragmatic inferior vena cavography was performed to locate the stenused opening of the hepatic veins,in case of membrane occlusion of the hepatic veins,a puncture was attempted with Rups100 needle and then balloon dilation of the hepatic veins and stents implantation was carried out.Results In 40 cases of long segmental inferior vena cava ( IVC ) occlusive Budd-Chiari syndrome,membranous obstruction of the hepatic veins was found in 5 cases and short-segmental occlusion in 24 cases.28 cases were successfully treated with balloon dilation and stents implantation,including percutaneous transluminal angioplasty(PTA) of hepatic vein in 5 cases,and stent implantation in 23 cases,puncture procedure was failed in 1 case.Postoperative follow-up was made in 26 cases from 6 to 62 months ( mean,24.0 ± 1.3 months ).Symptoms recurred in 6 cases.Hepatic vein restenosis or occlusion were observed using color Doppler ultrasound in 6 cases.Conclusions Most lesions in hepatic veins were membranous obstruction or short-segmental occlusion among patients with long-segmental occlusion of IVC.Balloon angioplasty and stenting of hepatic veins for long segmental IVC occlusive Budd-Chiari syndrome through jugular vein can relieve hepatic venous obstruction and relieve portal hypertension.

ObjectiveTo study the anatomical abnormalities of basal ganglia and research their influence on depression status in patients with post stroke depression (PSD)by diffusion tensor imaging (DTI) of MRI.MethodsPatients with basal ganglia infarction were recruited,and divided into groups of PSD and non depression control group by Hamilton Depression Rating Scale (HAMD) assessment. All the patients were evaluated with National Institute of Health Stroke Scale ( NIHSS). And the patients were checked by DTI sequence.Fractional anisotropy (FA),average diffusion coefficient (ADC) values and the number of nerve fiber were measured in bilateral caudatum,pallidum,putamen and thalamus.ResultsThe score of NIHSS (6.29 ± 3.45 ) was significantly higher in PSD group than that in non-depression group (3.95 ± 1.90 ;t =2.219,P =0.036). No significant difference was found between the two groups for the DTI data of the basal ganglia nuclei ( t =0.056-1.618,all P ＞ 0.05 ). Compared with contralateral construction (0.40 ± 0.02 ),the FA value decreased in the left putamen ( 0.37 ± 0.03 ) in the PSD group ( t =2.243,P =0.045 ).By Spearman correlations analysis,the HAMD score was positively correlated with NIHSS score ( r =0.464,P =0.017 ),and negatively correlated with the FA values of left pallidum (r=-0.563,P=0.005),right pallidum (r=-0.416,P=0.035) and left putamen (r =-0.428,P =0.029).Conclusions The occurrence of PSD was associated with neurological functional deficit following basal ganglia infarction.The depression level was correlated with the increasing of NIHSS score,the reductions in bilateral pallidum and left putamen FA values.This research contributes to evaluation of the PSD status in patients with basal ganglia infarction.

Objective To observe the cerebral protective effect of mild hypothermia by semiconductor cooling device on the liver surface in rabbits after cardiac arrest (CA). Methods Eighteen healthy male New Zealand white rabbits were randomly and equally divided into CA control group, ice saline group and semiconductor group. CA was induced by rapid intravenous injection of potassium chloride. Five minutes after onset of CA, CPR was initiated. Compared to the control group, which was not treated by hypothermia intervention after CPR, the ice saline group was treated by 4 ℃ ice saline infusion and the semiconductor group was treated by the semiconductor refrigeration piece device cooling on the liver surface for hypothermia intervention after CPR. We recorded the changes of temperature (tympanic temperature and anus temperature), heart rate (HR), mean arterial pressure (MAP) of rabbits in each group, neurological deficit scores (NDS) at 24, 48, 72 hours after the return of spontaneous circulation (ROSC) and the changes of serum neuron specific enolase (NSE) by enzyme linked immunosorbent assay (ELISA). Pathological changes of the hippocampus tissue, liver tissue and skin tissue were obtained by HE staining. Results There was no significant difference in ROSC time in each group. Two rabbits died at 55 hours and 67 hours after ROSC respectively in the control group. The remaining rabbits survived to 72 hours after challenge. There was no significant difference in the overall survival time in groups. Two hypothermia intervention groups had significantly lower level of serum NSE at 24 hours after ROSC and lower DNS scores at 24, 48, 72 hours after ROSC than control group. And the level of serum NSE after 24 hours of ROSC in the semiconductor group were significantly lower than the ice saline group (μg/L: 6.916±1.161 vs. 8.615±1.430, P < 0.05). DNS scores at 24, 48, 72 hours after ROSC in the semiconductor group were all significantly lower than the ice saline group (scores: 1.33±0.52 vs. 2.00±0.01, 1.01±0.41 vs. 2.00±0.01, 0.92±0.40 vs. 2.10±0.52 respectively, all P < 0.05). Two hypothermia intervention groups had more minor damage of neuronal cell in hippocampus than the control group. And the semiconductor group had more minor damage than the ice saline group. There were no obvious hepatic and subcutaneous tissue injury through which the semiconductor induced hypothermia was performed at corresponding liver surface skin. Conclusion The hypothermia by semiconductor cooling device on the liver surface is a new safe way of protecting brain tissue after CA, which has better cerebral protective effect than ice saline infusion.