Objective To investigate the effect of dexmedetomidine on awareness during intraoperative Wake-up tests in patients undergoing spinal surgery under propofol-remifentanil anesthesia .Methods 36 patients ,requiring intraoperative arousal test during posterior spinal surgery were randomly divided into the group D (DEX ,n= 18) and C (NS ,n= 18) .DEX 1 μg/kg followed by 0 .2 μg · kg -1 · h-1 and equal volume NS were infused respectively 10 min before anesthesia induction and maintenance of anesthe-sia in two groups .Hemodynamic parameters were monitored 5 min(T1) before anesthesia induction ,3 min(T2)after anesthesia in-duction ,at the beginning of wake-up test(T3) ,at the end of the test(T4) and 5 min(T5) after deepen anesthesia respectively . Meanwhile the wake-up time ,success rate of arousal ,incidence agitation and the dosage of nitroglycerin during wake-up were also recorded .Results Successive rate of arousal awakening time between two group had no statistically significance (P>0 .05) .less in-cidence of agitation was found in group D compared with group C ,the dosage of nitroglycerin used during wake-up in group D was less than that in group C(P<0 .05) .Conclusion Dexmedetomidine auxiliary propofol remifentanil anesthesia can effectively implement intraoperative wake up ,during the awakening the hemodynamic was more smoothly ,and it has lower incidence of adverse events .

Objective:To evaluate the clinical application of 64-slice spiral computer tomography pulmonary angiography (CTPA)in diagnosis of pulmonary embolism(PE).Methods:Sixty-two patients suspected of PE were examined by 64-slice spiral CTPA.The image findings combined with their clinical data were retrospectively analyzed.Results:Twenty-four of the 62 patients were confirmed to have PE by clinical data,laboratory examination and follow-up examination.64-slice spiral CTPA discovered 152 involved branches in the 24 PE patients,including 4 branches in left and right pulmonary trunk,52 in lobar pulmonary arteries,82 in segmental pulmonary arteries,and 14 in subsegmental arteries.Four types of PE were detected in our group,including eccentric filling defect in 58 branches,central filling defect in 49 branches,total occlusion of the pulmonary arteries in 21 branches,and mural embolism of host artery in 24 branches.The diagnosis accuracy of 64-slice spiral CTPA in the present group of patients was 100%,with no missed diagnosis and misdiagnosis.Besides,64-slice spiral CTPA could reflect the location,morphology,involvement and degrees of PE.Conclusion:64-slice spiral CTPA is a rapid,accurate and non-invasive diagnostic approach for PE.It is the first choice in clinical screening of PE and may serve as a gold standard for diagnosis of pulmonary embolism.

Humans ; Liver Neoplasms ; diagnosis ; diagnostic imaging ; Magnetic Resonance Imaging ; Tomography, X-Ray Computed ; Ultrasonography

Background Diabetic complication is associated with lipid peroxidation.Aldehyde dehydrogenases (ALDH) catalyze the irreversible oxidation of a variety of biological aldehydes,including lipid-derived aldehydes (LDAs),and thus protect organs and tissues from toxic LDAs.Understanding the activity of ALDH in different ocular tissues in diabetic subjects is very important for prevention and treatment of diabetic ocular complications.Objective This research aimed to investigate the activity and expression of ALDH in different ocular tissues in diabetic rats and to explore the mechanism of ALDH in diabetes-induced eye disease.Methods Twenty-eight healthy SPF male Sprague-Dawley(SD) rats weighted 170-180 g were randomly divided into the normal control group and diabetic group.The diabetic animal model was established by intraperitonial injection of 4％ streptozotocin at 65 mg/kg.Isometric citric acid buffer was injected in the rats of the normal control group.The rats were sacrificed in each group 2 and 4 months after the establishment of the diabetic models,and eyeballs were obtained for the preparation of corneal,lens and retinal homogenates.ALDH activity was detected using a multifunctional microplate reader SpectraMax M5,and ALDH content was measured by ELISA at the wavelength of 450 nm with the SpectraMax M5 ELISA reader.Results The blood glucose level in diabetic rats was significantly elevated at various time points compared with the normal control group(P=0.000),and body weights were evidently lower in the diabetic group than in the normal group (P =0.000).The activities of ALDH (A340) in corneal,lens and retinal tissues in the diabetic group were increased in comparison with the normal control group (F =396.601,P=0.000),and showed an enhancement with the lapsing of time (F =53.139,P =0.000).In addition,the highest level of ALDH was found in the cornea and the lowest level in the lens(F =6973.000,P=0.000).The expression level of ALDH in the corneal,lens and retinal homogenates was significantly higher in the diabetic group compared with the normal control group (F=312.985,P =0.000) and showed a considerable increase over the course (F =19.203,P=0.000).The highest expression level was seen in the cornea and the lowest was in the lens,with a significant difference among these three kinds of tissues (F =3243.000,P =0.000).Conclusions ALDH can protect ocular tissue from the damage of lipid peroxidation.Thess results suggest that ALDH plays a role in preventing diabetes-related ocular complications.

Objective: To evaluate the clinical value of multislice CT (MSCT) in the diagnosis and preoperative TNM staging of gastric carcinoma. Methods: Fifty patients with advanced gastric carcinoma were examined by MSCT, gastrointestinal series (GI), fiberoptic gastroscopy (FG) and transabdominal ultrasonography (US). The results of the 4 methods were compared with postoperative pathological results. Forty patients, who were diagnosed as having advanced gastric carcinoma by both MSCT and US, had their TNM staging evaluated and the results were compared with postoperative pathological TNM evaluation. Results: The detection rates of MSCT, FG, GI and US for advanced gastric carcinoma were 98%, 100%, 88% and 80%, respectively. The detection rate of MSCT was not significantly different with that of FG, but was obviously higher than that of GI (P=0.027) and US (P=0.004). The accuracy of MSCT in preoperative TNM staging was significantly higher than that of US(92.5% vs 72.5%). Conclusion: MSCT, with two-phase thin slice incremental scanning image, multiplaner reformats (MPR) and three-dimension (3D) image, is more advantaged in detecting the gross type, size, location, invasion and metastasis of advanced gastric carcinoma, thus greatly improving the detection rate and preoperative TNM staging of advanced gastric carcinoma.

Objective:To validate the clinical value of CT-guided curve-needle percutaneous ethanol injection (CNPEI) for celiac plexus block analgesia. Methods: Thirty-two patients with end-stage cancer, including 13 complicated with extensive retroperitoneal lymph node enlargement and fusion, were enrolled in this study. All patients complained of refractory upper abdominal pain and had received narcotic analgesics and radiotherapy, but the analgesic effect was not good. CT-guided CNPEI was therefore prescribed. Results: The effective rates of CT-guided CNPEI were 100%, 100%, 96.9%, 90.6%, 87.5%, and 84.4% immediately,and at 2 weeks, 4 weeks, 8 weeks, 12 weeks, and 16 weeks after treatment, respectively. All enlarged lymph nodes had obvious necrosis and became shrunk. Conclusion: Combined application of bilateral anterior and posterior diaphragmatic crura block and trans-lymph node block can produce good analgesic effects, and curve-needle puncture make the above technique simpler.

Objective:To validate the therapeutic value of CT-guided percutaneous ethanol injection (PEI) in the treatment of metastatic adrenal tumors. Methods: Thirty-one foci (diameter ranging from 1.5 cm to 7.2 cm) in 25 patients with metastatic adrenal tumors were treated with CT-guided PEI for more than twice. Plain and enhanced CT scans were performed 1-2 months after PEI to observe the size and necrosis of the tumors. Results: Post-PEI enhanced CT scan showed that 18 of the 20 foci with diameters less than 3 cm completely necrotized; 11 foci with diameters between 3 cm and 7.2 cm necrotized partially, and 2 foci completely necrotized after another 2-3 courses of PEI treatment. Conclusion: CT-guided PEI is a simple and minimally invasive means for treatment of metastatic adrenal tumors, and the therapeutic effect is satisfactory.

Objective:To evaluate the clinical value of Truview~(TM)EVO_2 optic laryngoscope by comparing it with the Macintosh laryngoscope in patients receiving cervical vertebral surgery.Methods:One hundred patients scheduled for elective cervical vertebral surgery were enrolled in this randomized crossover study.After induction,the patients'glottis in group A (n=50)was displayed by Macintosh laryngoscope and the Cormack-Lehane(C/L)grade was recorded,and then optic laryngoscope was employed to display the laryngeal structure.The order of laryngoscopy attempts was reversed in group B(n= 50).Parameters recorded included demographics,airway assessment feat ures(BMI,thyromental distance,mandibular size,mouth opening,mallampati oropharyngeal scale,and neck movement),C/L grade,laryngoscopic force applied,duration of intubation, difficulties of laryngeal view and injury of upper airway.Results:There were no significant difference in demographics,airway assessment features,C/L grade and duration of intubation between the 2 groups,whereas the laryngoscopic force in group A was significantly lower than that in group B(P

Three candidate antisense target sites of mouse Fas gene were screened by PARASS (poly-A anchored RNA accessible sites screening) technology. They were target at Fas gene 297nt-317nt, 618nt- 638nt and 662nt-682nt. Antisense oligos (A1, A2 and A3) and DNAzymes (D1, D2, and D3) for every target site were designed and synthesized. In vitro, the validation of the sites were judged by antisense oligos included RNase H splicing and the DNAzyme degradation. The results indicated that A1, A2 and A3 introduced RNase H degradation. DNAzymes D1, D2 and D3 cleaved Fas mRNA effectively. Neither degradation observed in antisense oligo RNase H group in non-target site (1211-1231nt) and 2 bases mismatched of A3, nor splicing occurred in DNzyme group in non-target site ( 1211-1231nt) and 2 bases mismatched of D3. Site 2 and 3 were at the same positions with those of ISIS Pharmaceuticals. The effective antisense oligos and DNAzymes for Fas gene could be used for the research subsequently.

Objective To evaluate the therapeutic efficacy of percutaneous drainage of solitary retroperitoneal abscess under CT guidance.Methods A retrospective analysis was made for percutaneous drainage of solitary retroperitoneal abscess with CT guidance in 13 patients including 4 at the tail of pancreas, 3 nearby the head of pancreas,3 in perirenal space,2 in posterior renal space and 1 case was by the side of psoas muscle.The maximum diameters of retroperitoneal abscess were between 3.5cm and 8cm.Results Out of 13 patients,8 with one time drainage,3 with twice drainages and 2 with thrice drainages.The mean duration of drainage was 16 days with no recurrence or residual lesions during clinical follow up.Conclusion CT guided percutaneous drainage of solitary retroperitoneal abscess is effective and minimally invasive.(J Intervent Radiol,2007,16:828-830)