Objective To explore the causes of accidental instability of SYSMEX XS-800i blood cell analyzer for WBC testing and their countermeasures.Methods Totally 10 pieces of specimen with high deviation were analyzed retrospectively, and the changes of DIFF-Y values of WBC were observed. Sysmex detergent was used to clean the pipelines including 4DL, 4DS and EPK pipes. Fluid path electromagnetic valve was checked and then repaired or replaced. Results It's proved that the results at the first time were not reliable, and there was significant differences between the results at the first and second times for DIFF-Y value, with P<0.01. The failures were eliminated after the above countermeasures were carried out.Conclusion WBC testing pipelines and electromagnetic valve of fluid path have to be cleaned periodically to eliminate the influence on DIFF-Y value of WBC and false increase of WBC counting.

To observe the effects of urapidil on the cardiovascular responses to tracheal intubation, forty-six patients (ASA Ⅰ - Ⅱ) were randomly divided into group A (n=23) and group B(n=23). Anesthesia was induced with valium 0.2mg/kg, 2.5% thiopental sodium 5mg/kg and tracheal intubation was facilitated with succinylcholine 1.5mg/kg. Urapidil 0.5mg/kg was intravenously given immediately after administration of succinylcholine in group A. After intubation. SP, DP,MAP,HR and RPP increased by 6%,12%, 15%, 24% and 28% in group A and increased by 30%,37%,33%,48% and 95% in group B respectively. Compared correspondingly with those in group B, the values of the parameters mentioned above decreased significantly in 5 minutes after intuhation in group A(P

Objective: To study pharmacokinetics of lidocaine during superior laryngeal nerve block (SLNB) combined with topical anesthesia to endotracheal mucosa by thyrocricocentesis(TCC). Method: Eight patients (ASA Ⅰ-Ⅱ grade)scheduled for general anesthesia and operation were performed bilateral SLNB with 2% lidocaine 2mg/kg and TCC with 5 % lidocaine 2mg/kg within 1 min,The internal jugular venous blood samples were taken at 1,5,10,20,30, 60,120 and 180 minutes after lidocaine administrations to determine lidocaine serum concentrations using a fluoresence polarization immunoassy. Pharmacokinetics were calculated with a procedure (3p87) by computer. Result: The pharmacokinetics could be described as two-compartment model. Absorption rates of lidocaine were fast,values of t_(1/2) Ka and Tpeak were 5.0?2.5 min and 7.5?2.1 min respectively。Maximal concentrations (Cmax) of lidocaine were 3.8?0. 6?g/ml, which were within safety ranges. Conclusion: It may be safe that 2% lidccaine 2mg/kg superior laryngeal nerve block is combined with 5% lidocaine 2mg/kg topical anesthesia to endotracheal mucosa by thyrocricocentesis.

Objective To investigate the clinical effect of the compound flaps of foot with joint transplantation bridging severed segmental damage type finger.Methods Eleven cases with segmental composite tissue damaged fingers,emergency free with plantar metatarsal or metatarsophalangeal,interphalangeal joint of the foot com posite tissue flap transplantation and bridging replanted finger form February,2006 to September,2011 were retrospective reviewed in our study.The therapeutic effect was evaluated according to the assessment standard of Chinese Medical Association of Hand Surgery.Results All patients were followed-up for 6 to 48 months.The composite flap and amputated fingers in the 11 cases were survived after surgery,with satisfactory appearance.Range of motion of interphalangeal joints from 40° to 90°,and metacarpophalangeal joints from 45° to 65°.There was no nonunion or refracture.Two-point discrimination of finger pulp was 5-8 mm.According to the Chinese Medical Society of Hand Surgery Trial upper part of the standard evaluation function assessment,the results were excellent in 3 cases,good in 6 cases,may in 2 case.Conclusion Compound flaps of foot with joint transplantation bridging severed segmental damage type finger could recover the appearance and functions of amputated fingers to satisfy the daily need of patients in a maximum degree.

Objective To identify the differential inflammation factors in nephroblastoma tissue using proteomics technology and analyze its relationship with clinical stage,pathological phenotype,lymph node metastasis,vascular invasion.Methods From Jan 2010 to Dec 2014,nephroblastoma tumor tissues from 40 patients were obtained.Meanwhile,the 35 tissue near proximal kidney and 25 tissues distal kidney were also obtained.The classification of clinical stage included Ⅰ stage in 6 cases,Ⅱ stage in 12 cases,Ⅲ stage in 13 cases and Ⅳ stage in 9 cases.Other characters contained good prognosis type in 37 case,poor prognosis type in 3 cases,lymphatic metastasis in 17 cases,no sign of lymphatic metastasis in 23 cases,vascular invasion in 9 cases and non-vascular invasion in 31 cases.The SELDI-TOF-MS was used for screening differential protein peaks among three groups.Then,SPE and TRICINE-SDS-PAGE were used to separate and purificate the protein,which showed high peaks expression in tumor tissue,respectively.After in-gel digestion,we received the identification of targeted proteins according to sequence information through Nano-LC-MS/MS.Finally we compared differential expression of inflammatory peaks in different groups of clinical stage,pathological type,lymph node metastasis and vascular invasion.Results All the peaks high expression in tumor tissue,m/z12138 and m/z 13462 are identified as MIF and NAP-2.Expression of two protein peaks in tumor tissue(1437.8 + 997.3,1730.4 + 1147.8) is higher than those in proximal tissue (952.6 + 591.2,1031.1 + 1120.8) and in distal tissue(315.4 + 296.5,114.7 + 118.9),which showed the significant difference (P ＜ 0.001).According to the clinic stage classification,the expression of those protein were 678.8 + 189.0,746.2 + 238.7 in stage Ⅰ,664.0 + 202.0,1180.7 + 404.9 in stage Ⅱ,1524.7+407.9,2160.4 + 1252.3 in stage Ⅲ and 2850.2 + 861.2,2498.4 + 1290.5 in stage Ⅳ.Based on the other characters,expression of those protein were the 1271.7 + 809.2,1553.3 + 991.4 in good prognosis type,3487.2 + 166.2,3915.1 +507.3 in poor prognosis type,2207.1 +961.7,2569.5 + 1285.2 in lymph node metastasis,869.2 + 474.6,1110.2 + 433.6 in non-lymph node metastasis,2850.2 + 861.2,2498.4 +1290.5 in vascular invasion and 1027.8 + 521.3,1507.5 + 1019.9 in non-vascular invasion.All the comparison results have significant statistical difference (P ＜ 0.001).Conclusion MIF and NAP-2significantly increase in nephroblastoma tumor tissue.Meanwhile,there was obvious relationship between those protein with clinical stage,pathological type,lymph node metastasis and vascular invasion.

Objective To investigate the influence of cartilage degeneration grades of patellar on the clinical outcomes after total knee arthroplasty (TKA) without patellar resurfacing.Methods 151 patients performed TKA without patellar resurfacing from February 2007 to January 2010 were retrospective studied.There were 65 males and 86 females,with the mean age of 65±5.0 years (range,56-82 years).The mean duration of follow-up was 3.5 years (range,2-5 years).Intraoperatively,the cartilage degeneration was classified according to Outerbridge classification.At the final follow-up,the patients' satisfaction was evaluated,and the incidence of anterior knee pain was assessed using visual analogue scale (VAS).If VAS was more than 3 points,patient was defined suffered anterior knee pain.Compare KSS and patella score of patients with different grades of cartilage degeneration.Results The articular cartilage of the patella was graded according to Outerbridge:grade Ⅰ in 18 patients,grade Ⅱ in 36 patients,grade Ⅲ in 62 patients,and grade Ⅳ in 35 patients.At the final follow-up,the patients' satisfaction rate and the anterior knee pain rate was 96.7％ 046/151) and 4.0％ (6/151),respectively.In the patients with different grades of cartilage degeneration,the patient satisfaction rate (H=5.54,P=0.14),anterior knee pain rate (H=0.56,P=0.91),KSS (knee score:F=1.95,P=0.12； function score:F=2.11,P=0.10) and patella score (F=1.35,P=0.26) were not found to be significantly difference.Conclusion The differentiae grades of cartilage degeneration may not affect the clinical outcomes of TKA.TKA without patella resurfacing appears to be a reasonable option for degenerative osteoarthritis.

Objective To explore the prognostic effect of hyperintense vessel sign (hyperintense vessel sign,HVS) in fluid-attenuated inversion recovery (FLAIR) on endovascular recanalization of acute ischemic stroke.Methods The clinical and imaging data of the patients with acute middle cerebral artery (MCA) occlusion treated by endovascular therapy from January 2013 to october 2015 were analyzed retrospectively.The inclusion criteria:(1)＜8 h after symptom onset;(2) The preoperative MRI included conventional non-enhanced MR,FLAIR,diffusion-weighted imaging (DWI),magnetic resonance angiography (MRA) and DWI-ASPECTS (Alberta Stroke Program Early CT Score) ≥7;(3) acute MCA occlusion verified by conventional angiography and recanalizations (TICI score of 2b and 3) were obtained after endovascular therapy;(4) postoperative similar MR examinations were performed within one week.The patients were divided into group A (HVS score＜5) and B (HVS score≥5).The clinical outcomes and radiological characteristics were compared between two groups.Results There were 15 patients in group A and 33 patients in group B.No significant differences were noted in onset-to-MRI interval (4.8±0.7 h vs 4.6± 0.6 h),MRI-to-recanalization interval (2.1 ±0.5 h vs 2.2±0.5 h) and preoperative DWI-ASPECTS score (7.8± 0.9 score vs 8.2± 1.0 score) between the two groups (all P＞0.05).Significant differences were noted in NIHSS score at admission (14.6±2.6 score vs 10.1±2.2 score),grade of collateral circulation (1.6±0.3 score vs 2.4± 0.4 score),postoperative DWI-ASPECTS score (5.6±0.8 score vs 7.3±0.9 score),postoperative extension of DWI-ASPECTS score (2.2±0.4 score vs 0.9±0.2 score),the incidence of cerebral hemorrhage transformation (26.7％ vs 12.1％) and mRS score at 3 months (3.2±0.5 score vs 2.3±0.4) score between the two groups (all P＜0.05).Conclusion HVS score is clearly associated with collateral circulation and high HVS score indicates better functional outcomes than low HVS score.

Objective To evaluate the safety and efficiency of thrombectomy with clamping embolus technique ( TCET ) by partial retrieving stent comparing with conventional stent retrievers thrombectomy (CSRT) for acute ischemic stroke.Methods Retrospective analysis was performed in 42 consecutive patients treated by stent retrievers thrombectomy between January 2015 and November 2016 for acute intracranial large vessel embolism . Data on recanalization rates , procedure duration , thrombectomy attempts, one-pass rate, postoperative subarachnoid hemorrhage (SAH),and modified Rankin Scale (mRS) score during 90 days follow-up were compared between TCET and CSRT groups .Results Recanalization rate was 90.0%(18/20) in TCET group and 90.9% (20/22) in CSRT group, post-procedural SAH was 10.0%(2/20) in TCET group and 13.6% (3/22) in CSRT group, good outcome (mRS score≤2) was 60.0%(12/20) in TCET group and 59.1% (13/22) in CSRT group, all without significant differences (P>0.05).The number of thrombectomy attempts with TCET was significantly lower than that with CSRT (1.7 ±0.5 vs 2.6 ±0.8, t=2.118, P=0.040), the procedure duration with TCET was significantly shorter than that with CSRT ( (36.8 ±8.6) min vs (55.5 ±10.5) min, t=-3.493, P=0.001) and one-pass thrombectomy rate with TCET was significantly higher than that with CSRT ( 60.0% ( 12/20 ) vs 22.7%(5/22), χ2 =6.041,P=0.014) .Conclusion TCET is safe and feasible for acute ischemic stroke and might improve the efficiency of thrombectomy comparing with CSRT .

0.05). 100% occlusion was achieved in 18 patients with cerebral aneurysms by using embolization. Conclusion 3D DSA may improve the accuracy in diagnosing SAH and in showing clearly the stereo conformation of aneurysm and the relationship of sac and parent artery. It is helpful in the evaluation and guidance of embolization of cerebral aneurysms.

This paper presents a method for estimating three-dimensional (3D) motion of coronary arteries from single-plane X-ray angiogram sequences on two views. Firstly, original images are preprocessed and two-dimensional (2D) vessel skeletons are extracted. 2D motion estimation is performed along the skeletons in two images. Then geometrical transformation matrix between views is obtained based on perspective projection model for X-ray angiography system, and 3D coordinate of spatial points are calculated. The 3D motion estimation and reconstruction algorithm is applied along the two image sequences to accomplish 3D reconstruction of vessel skeletons and motion vectors between consecutive time instants. Its effectiveness has been demonstrated on clinical single-plane coronary artery angiograms and potential errors are discussed.
Algorithms ; Coronary Angiography ; methods ; Coronary Disease ; diagnostic imaging ; Electrocardiography ; Humans ; Imaging, Three-Dimensional ; methods ; Movement ; Radiographic Image Interpretation, Computer-Assisted