Objective To observe the feasibility and safety of dexmedetomidine used in motor evoked potentials(MEP)monitoring in patients undergoing neurosurgery.Methods Thirty ASA Ⅰ orⅡ patients,male 1 5 cases,female 1 5 cases,aged 20-60 years,weighing 40-80 kg undergoing neuro-surgery receiving MEP monitoring were randomly divided into 2 groups (n =1 5 each):control group (group C)and dexmedetomidine group (group D).In group D,dexmedetomidine 0.5 μg/kg was in-fused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.5 μg·kg-1 · h-1 toward the end of operation.Group C received the equal volume of normal saline.HR,MAP and BIS were recorded at admission to the operating room (T0 ),skin incision (T1 ),when the muscle re-laxants were stopped (T2 )and 50 minutes later (T3 ).The current intensity and the time when first MEP was induced after muscle relaxant was stopped,the amplitudes and latencies of MEP on thenar muscle at T3 ,the total consumption of anesthetics,and development of adverse effects were also re-corded.Results Compared with T0 ,HR in group C at T1 ,T3 and MAP in group C at T1-T3 was in-creased,HR in group D was decreased at T2-T3 (P <0.05).Compared with group C,HR and MAP were decreased at T1-T3 in group D(P <0.05).The amount of propofol consumed and the current in-tensity inducing MEP were lower in group D than in group C (P <0.05).The amplitude of MEP at T3 was higher in group D than in group C (P <0.05).Compared with group C,the incidences of hy-pertension and tachycardia were decreased in group D,and the incidence of bradycardia was increased (P <0.05).Conclusion Dexmedetomidine used in MEP monitoring in patients undergoing neurosur-gery can meet the operation requirements,maintain hemodynamic stability,reduce the incidences of adverse reactions,and improve monitoring quality of MEP.It is a safe and feasible anesthesia method.

Objective To investigate the effects of different doses of dexmedetomidine used in SEP and MEP monitoring in patients undergoing neurosurgery. Methods Eighty patients undergoing neurosurgery receiving SEP and MEP monitoring were randomly divided into 4 groups(n = 20 each):group C,group D1,group D2 and group D3. In groups D1 ,D2 and D3 ,dexmedetomidine 0.5 μg/kg was infused over 10 minutes before anesthesia induction,and then was infused at a rate of 0.1,0.3 and 0.5μg/(kg·h)respectively toward the end of operation. Group C received the equal volume of normal saline. HR ,MAP and BIS were recorded at admission to the operating room(T1),skin incision(T2),when the muscle relaxants were stopped(T3)and 50 minutes later(T4). The current intensity and the time when first MEP was induced after muscle relaxant was stopped ,the amplitudes and latencies of SEP(N20-P25,N20)and MEP on thenar muscle at T4,the total consumption of propofol,and development of adverse affects were also recorded. Results Compared with groups C and D1,HR and MAP were decreased at T2-T4 in groups D2 and D3(P<0.05). The amount of propofol consumed were lower in groups D2 and D3 than in groups C and D1(P < 0.05). The current intensity inducing MEP was lower and the amplitude of MEP at T4 was higher in group D2 than in groups C,D1 and D3,and the situation was same in group D3 than in group C (P<0.05). No significant change was found in the other parameters in groups C ,D1 ,D2 and D3(P>0.05). Conclusion Dexmedetomidine infused at 0.3 μg/(kg · h) after infusion of a loading dose of 0.5 μg/kg could improve monitoring quality of MEP through reducing the amount of propofol consumed ,have less inhibition on MEP than other groups,have no obvious effects on SEP,andmaintain hemodynamic stability.

Objective In order to investigate the interactions between the activities of daily living of children with post poliomyelitis and depression of their parents.Method 40 cases whose children were with post poliomyelitis were tested by SDSCR.Children's activity of daily living were tested with Barthel's index.Result 65％ of parents whose children with post polimyelitis were depression.Their symptoms of depression were mainly moderate level.There are marked difference comparing with the domestic normal analyzing model.The activities of daily living of the post poliomyelitis's children was worse,the older their parent's age was the higher the incidence of depression occurred was.Conclusion We should pay attention to their parents emotion changes when we carry out the community rehabilitation of post poliomyelitis's children,and strive them for positive coperating our rehabilitation training.

Objective To explore the expression characteristics of vascular endothelial growth factor (VEGF) receptor (VEGFR).Methods The 123I-VEGF165 and 123I-VEGF121 were marked to human umbilical vein endothelial cell (HUVEC),several human tumor cell lines (HMC-1,A431,KU812,U937,HEP-1,HEP-G2,HEP-3B and Raji),a variety of human tumors and adjacent non-neoplastic tissues as well as peripheral blood cells.Then,the specific binding site maximal binding capacity (Bmax),dissociation constant (Kd) and concentration of 50％ required specific binding (IC5o) were analyzed.The affinity,quantity and specificity of different cells combined with 123I-VEGF165 and 123I-VEGF121 were judged.Results Two kinds of analogous 123I-VEGF165 binding sites on the surface of HUVEC were found.While,there was only one kind of 123I-VEGF121binding site.123I-VEGF121 was found on the special cell lines (HUVEC,HEP-1 and HMC-1) and special early tumors (early melanoma,ductal breast cancer,ovarian cancer and meningioma).Compared with peripheral blood cells and adjacent non-neoplastic tissues,the number of VEGFR of tumor cells was bigger.Among the 123I-VEGF165 marked VEGFR,the Bmax value of early melanoma,ductal breast cancer,hepatocellular carcinoma,papillary thyroid carcinoma,ovarian carcinoma,renal cell carcinoma were 45 ± 13,13 ± 3,25 ±8,5 ±2,42 ± 12,20 ±6,respectively.While among the 123I-VEGF121 marked VEGFR,the Bmax value of early melanoma,ductal breast cancer,ovarian carcinoma were 30 ± 8,8 ± 3,20 ± 6.123I-VEGF165 and 123I-VEGF121 had specific binding capacity with a variety of human tumor cells and tissues.Compared with 123I-VEGF121,there were more different kinds of tumor cells could be bound to 123I-VEGF165 with higher capacity.Conclusion 123I-VEGF165 may be a potential target of tumor imaging in vivo,and it is expected to be used to diagnose and treat tumors.

Objective Resveratrol can improve nonalcoholic fatty liver disease , but its action mechanisms remain unclear . This study aimed to investigate the protective effect of resveratrol against the free fatty acid ( FFA)-induced apoptosis of human hepatic L02 cells and its possible mechanisms . Methods Human hepatic L02 cells were incubated with FFA and resveratrol for 24 hours.The prepared cells were divided into a blank control , an FFA ( 2 mmol/L) , and a resveratrol group ( 50 μmol/L resveratrol +2 mmol L/FFA).After treatment, we measured the triglyceride (TG), glutathi-one (GSH), and malonaldchyde (MDA) contents and caspase3 ac-tivity in the hepatocytes , determined the apoptosis of the cells by flow cytometry , and detected the protein expression of silent information regulator 1 (SIRT1) by Western blot as well as the mRNA expressions of catalase (CAT), Mn superoxide dismucase (MnSOD), Bcl-2, and Bax by qRT-PCR. Results The TG content and caspase 3 activity in the hepatocytes were significantly increased in the FFA ([3518.±64.2] μmol/L and [5.97 ±0.78] U/g) and the resveratrol group ([201.1 ±60.1] μmol/L and [3.60 ±0.73] U/g) as compared with those of the blank control ([40.2 ±7.4] μmol/L and [2.56 ±0.49] U/g) (both P<0.05), but the caspase3 ac-tivity was markedly decreased in the resveratrol group in comparison with that of the FFA group (P<0.05).Both early and late apop-tosis rates of the hepatocytes were remarkably higher in the FFA ([6.75 ±0.81]%and [8.52 ±0.54]%) and the resveratrol group ([4.94 ±0.44]%and [6.52 ±0.61]%) than those in the blank control ([3.38 ±0.33]% and [2.72 ±0.19]%) ( both P<0.05), with statistically significant differences between the former two groups (P<0.05).The resveratrol group showed significant differences in the GSH content ([100.2 ±8.8] nmol/g), the MDA level ([2.36 ±0.82] mg/g), and the relative expression of SIRT1 (0.84 ±0.04) from the FFA group ([73.8 ±13.1] nmol/g, [3.77 ±0.92] mg/g, and 0.61 ±0.07) and the control ([113.7 ±13.8] nmol/g, [1.85 ±0.41] mg/g, and 0.90 ±0.02) (all P<0.05).The resveratrol group also exhibited statistically significant differences in the relative expressions of the MnSOD , CAT, and Bax genes from the FFA and control groups (P<0.05). Conclusion Resveratrol attenuates FFA-induced apoptosis of human hepatic L 02 cells by activating SIRT1 and reducing the oxidative stress of hepatocytes .

Objective To investigate the procedure,imaging features and clinical significance of CT virtual gastroscopy(CTVG) in the diagnosis of gastric carcinoma using bi-tilted CT scanning.Methods Thirty patients and ten normal volunteers had bitilted CT scan using helical CT(GE lightspeed 16 CT).The patients and yolunteers were given bubble-making powder by mouth and placed in a supine position on the CT table.CTVG and MPR images were obtained using the virtual dissection and reform of GE.Results The appearances of the inner lesion and normal wall of the stomach on CTVG were similar to those on fiberoptic gastroscopy.The CTVG and MPR features of gastric cancer were focal or diffuse mural thickening,soft tissue mass,stenosis of stomach,cancerous ulcer,infiltration to adjacent tissues,and lymph node and distant metastases.In comparison with fiberoptic gastroscopy(as the gold standard),CTVG showed a diagnostic accuracy of 92.5 %,a sensitivity of 93.3 %,a specificity of 90.0 %,a positive prediction value of 96.7 %,and a negative prediction value of 81.8 %.Conclusions CTVG is a safe,reliable,non-invasive method for demonstrating the structure of normal and abnormal stomach,and is a good complementory method to conventional fiberoptic gastroscopy.

Objective To study the value of DSA for hepatic vascular anatomy,and to evaluate the efficacy of portal vein occlusion in rabbits with hepatic VX2 tumor.Methods Twenty New Zealand white rabbits were randomly divided into two groups with 10 in each group,including test group A and positive control group B of ham operation.For the test group A,portal branch ligation(PBL)was performed for the left external branch after 3 weeks of the tumor implantation to the left external lobe.Two weeks later,the DSA of hepatic artery and portal vein were performed in all of the rabbits.Results The total displaying effectiveness of the branches of hepatic artery by DSA was better than that by vascular perfusion.There was hypovascular blood supply to hepatic artery implantation of the tumor in the test group A,comparing with that of the group B.Conclusion DSA can clearly display spacial details of the hepatic vascular anatomy in rabbits,and play an important role in post-procedual evaluation of the portal vein occlusion in rabbits.

Objective To evaluate the clinical efficacy and safety of retroperitoneal laparoscopy and open surgical treatment of simple renal cyst by Meta analysis.Methods Computer retrieval of MED-LINE,Cochrane Library,EMBASE,CNKI,Wanfang and VIP databases,according to the inclusion and exclusion criteria collected and screened out a randomized controlled studies on the treatment of simple renal cysts,published from January 1,2000 to August 31,2015.Two independent authors screened out randomized clinical trials (RCTs),extracted data,assessed quality of data,and then carried out Meta analysis by Revman 5.0 software with related data.Results Twenty one studies met the inclusion criteria with a total of 2 296 patients,including 1 162 patients of retroperitoneal laparoscopy and 1 134 cases of open operation group.Compared to the open operation group,retroperitoneal laparoscopy showed shorter operation time,less bleeding,shorter hospitalization time,and earlier postoperative drainage tube extraction time.No significant difference was found in the recurrence rate of the cyst for two groups.Conclusions The clinical efficacy,safety,and complication of retroperitoneal laparoscopy in the treatment of simple renal cyst is better than the open operation.

Objective To observe the thyroid hormone (TH) changes in patients with acute cerebral infarction in acute phase and convalescence,and to explore its clinical value.Methods Fifty cases of acute cerebral infarction patients from March 2015 to May 2016 in Heilongjiang Provincial Hospital were selected as observation group,at the same time 30 cases of healthy check-up people as control group.Serum levels of triiodothyronine (T3),thyroxine (T4),free triiodothyronine (FT3),free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured in 50 cases of acute cerebral infarction patients on the 2nd day (acute phase) and the 14th day (recovery) after onset of the disease,by using chemiluminescence method,and 30 cases of people underwent healthy physical check-up were treated the same way.Neurological injury and recovery of patients with cerebral infarction were evaluated using NIHSS.According to the recovery level of FT3,patients with cerebral infarction were divided into low FT3 group (FT3 ＜ 3.10 pmol/L) and normal FT3 group (FT3 ≥ 3.10 pmol/L).Prognosis of the patients was judged according to the NIHSS scores 90 days after discharged from the hospital,and NIHSS score improving acuity of 2 was judged as good prognosis.Results The T3 and FT3 levels in patients with acute cerebral infarction were significantly lower than those of people underwent healthy physical examination,the differences were statistically significant [(0.68 ± 0.22) vs(1.82 ± 0.31) nmol/L,(2.08 ± 0.31) vs (4.19 ± 0.75) pmol/L,all P ＜ 0.05].The T4,FT4 and TSH levels in patients with acute cerebral infarction were increased significantly,the differences were statistically significant [(142.56 ± 20.78) vs (109.89 ± 12.37) nmol/L,(12.88 ± 1.15) vs (9.77 ± 0.96) pmol/L,(5.15 ± 1.16) vs (2.95 ± 1.31) mU/L,all P ＜ 0.05].Compared with the acute phase,convalescence of cerebral infarction patients' serum T3 and FT3 levels [(1.75 ± 0.19) nmol/L,(3.97 ± 0.61) pmol/L] increased significantly,the differences were statistically significant (all P ＜ 0.05),and T4,FT4 and TSH [(115.64 ± 14.38) nmol/L,(10.05 ± 1.02) pmol/L,(3.16 ± 0.98) mU/L] obviously decreased,the differences were statistically significant (all P ＜ 0.05).Compared with control group,convalescence of cerebral infarction patients' serum T3,T4,FT3,FT4 and TSH were not statistically different (all P ＞ 0.05).There was a negative correlation between FT3 levels and NIHSS scores on admission (r =-0.586,P ＜ 0.05).Ninety days after discharge,7 cases (38.89％) of the patients had a good prognosis in low FT3 group,and normal FT3 group had 22 cases (68.75％) of patients with good prognosis,and the difference was statistically significant (x2 =7.186,P ＜ 0.05).Conclusions The thyroid hormone has a protective stress reaction in patients with acute cerebral infarction.The thyroid hormone level has changed significantly in the acute phase,and returned to normal level with improvement of the patients.As a biochemical indicator thyroid hormone detection can be used to estimate the prognosis of patients with acute cerebral infarction.

OBJECTIVETo evaluate the clinical effects of single posterior debridement, bone grafting, internal fixation and local chemotherapy in treating thoracolumbar spinal tuberculosis.

METHODSFrom February 2009 to September 2012,11 patients with thoracolumbar spinal tuberculosis were treated by single posterior debridement, bone grafting, internal fixation and local chemotherapy. There were 7 males and 4 females, aged from 27 to 65 years old with an average of 53.7 years. The courses of disease was from 3 months to 2 years with the mean of 9 months. According to ASIA standard of spinal cord injury, 3 cases were grade C and 8 cases D. After treatment, clinical effects were evaluated by ASIA grade, visual analogue score (VAS) and Oswestry Disability Index (ODI); kyphosis Cobb angle change was observed by X-rays.

RESULTSEleven patients were followed up from 12 to 29 months with an average of 18 months. ASIA grade of spinal cord injury, 3 patients with grade C improved to grade D in 2 cases and grade E in 1 case 8 patients with grade D improved to grade E in 7 cases and unchanged in 1 case. VAS decreased from preoperative 6.10 ± 1.30 to 1.70 ± 0.80 at 3 d after operation (P < 0.05). ODI improved from preoperative (68.36 ± 10.41)% to (14.55 ± 8.99)% (P < 0.05) at 3 d after operation. Kyphotic Cobb angle was corrected from preoperative (22.64 ± 4.84)° to (4.27 ± 1.49)° (P < 0.05) on the 3rd day after operation, and angle loss was mild at final follow-up, there was no significant difference between postoperative at 3 d and final follow-up.

CONCLUSIONSingle posterior debridement, bone grafting, internal fixation and local chemotherapy for the treatment of thoracolumbar spinal tuberculosis can effectively remove the lesion, improve nerve function and correct deformity, has advantage of single incision, little trauma, and low recurrence rate. But it still need long-term and systemic treatment with anti-TB drugs.

Adult ; Aged ; Bone Transplantation ; Debridement ; Female ; Humans ; Internal Fixators ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Thoracic Vertebrae ; surgery ; Tuberculosis, Spinal ; therapy