Objective To study the effect of chloral hydrate on click sound evoked auditory brainstem re-sponse (ABR) in healthy adult guinea pig .Methods A total of 20 healthy wild type albino male guinea pigs were se-lected for ABR assessment with click sound stimulation conscious and cholral hydrate anesthesia conditions .The ABR threshold was determined according to the wave that presents highest occurrence rate under different stimulus intensity .The latency ,interpeak latency of each wave at 90 dB peSPL stimulation as well as the amplitude of waveⅡ ,Ⅲ ,Ⅳ under different stimulus intensity were recorded .Results The ABR threshold in chloral hydrate anes-thesia was 25 .50 ± 2 .76 dB peSPL and at the waking state was 28 .5 ± 3 .66 dB peSPL from control group (P>0 .05) .The latencies of each wave recorded under chloral hydrate anesthesia state were prolonged compared to those of under waking state ,wave Ⅲ ,Ⅳ and Ⅴ had significance differences (P<0 .05) ,but wave Ⅰ ,Ⅱ had no significant differences (P>0 .05) .The interpeak latency between wave Ⅰ - Ⅴ ,Ⅲ - Ⅳ ,Ⅳ - Ⅴ in chloral hydrate anesthesia were longer compared to those of under waking state with significant differences (P<0 .05) ,while interpeak latency between Ⅰ - Ⅱ ,Ⅱ - Ⅲ had no significant differences (P> 0 .05) .The amplitude and occurrence rate of wave Ⅱwere the highest among all the waves in both experimental group and control group .The amplitude of wave Ⅱ and Ⅲ in chloral hydrate anesthesia was higher than that of the waking state under acoustic stimulation conditions ofhigh intensity(P<0 .05) while the amplitude of wave Ⅳ was lower than the waking state (P<0 .05) .Conclusion The chloral hydrate anesthesia may be able to apparently lengthen the ABR latencies of wave Ⅲ ,Ⅳ ,Ⅴ and affect the amplitude .This effect should be considered during the assessment of ABR under anesthesia state in guinea pig ;The ABR threshold of guinea pig could be determined according to the wave Ⅱ because it 's highest occurrence rate .

OBJECTIVE To investigate the distribution of bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on 123 patients diagnosed infection who stayed in ICU from May 2002 to May 2004.RESULTS Most of bacteria resulted in infection of general ICU were Gram-negative(62.88%) and then Gram-positive(19.65%). Fungal infection accounted for 17.47%.Pseudomonas aeruginosa occupied the highest percentage among Gram-negative bacteria.Most of Gram-positive bacteria were Staphylococcus aureus and all of them were MRS.The infection site in ICU focused on lower respiratory tract(89.09%).The second was urinary tract(11.79%).CONCLUSIONS Most of the bacteria causing infection in general ICU locate in respiratory tract.They are mainly Gram-negative.All of the Gram-positive bacteria are MRS.The risk factors of hospital-acquired infection are related with patient′s age,underlying disease,intensive care time,ventilation time and invasive operation.

OBJECTIVE To investigate the characteristic of Gram-positive bacteria in general ICU then discuss the susceptible factors and the treatment.METHODS A retrospective analysis of clinical information was performed on patients with Gram-positive infection in ICU from May 2002 to May 2004.RESULTS Most of Gram-positive bacteria resulted in infection in general ICU were Staphylococcus aureus and all of them were MRSA.The infective site focused on lower respiratory tract(84.44%).The second was catheter(8.89%).CONCLUSIONS The risk factors of hospital-acquired infection are relative with patient's age,underlying diseases,stay time in ICU,ventilated time and invasive operation.

Objective To study the effects of treating herpes zoster with the combination of Chinese and western medicine.Methods 160 cases of herpes zoster were randomly recruited into a treatment group(n=80),and a control group (n=80).The control group was treated with westem medicine(acyclovir,ethacridine solvents,and vitamin B6 and B12).The treatment group was administrated with Chinese medicines,acupuncture and cupping on the basis of treats in the control group Results The total effective rate was 100%in the treatment group and 72.5%in the control group.There was significant difference between the two groups(χ~2=23.85,P＜0.05).Conclusion The combination of Chinese and western medicine is effective in treating herpes zoster and worthy of generalization.

Objective To study the results of functional hemispherectomy for pediatric intractable epilepsy with hemisphere lesions , and to explore the indications of functional hemispherectomy , as well as the prognosis. Methods Twenty-four children with intractable epilepsy caused by hemisphere lesions were included , who underwent functional hemispherectomy. All patients were followed up for 3 ~ 48 months. Results All 24 cases obtained improvement of abnormal behavior , and no significant exacerbation of neurological deficits was observed. During the follow-up, 18 cases were in EngelⅠ(75%), 5 in Engel Ⅱ(21%), and 1 in Engel Ⅰ(4%) respectively. No long-term complication was observed. Conclusion Comprehensive presurgical evaluation is a prerequisite for the surgical treatment of pediatric intractable epilepsy caused by hemisphere lesions. Functional hemispherectomy can effectively control seizures and obviously improve the prognosis.

Objective: The present study aims to summarize the clinical experience in the surgical treatment of thoracic aortic dissecting aneurysm.Methods: We retrospectively analyzed the clinical data of 115 cases of thoracic aortic dissecting aneurysm treated by surgery from December 1995 to December 2006.Thirty-eight of them were DeBakey type I aortic dissection,18 type Ⅱ,and 59 type Ⅲ.Of the 38 DeBakey type I patients,30 underwent ascending aorta with total aortic arch replacement(2 cases of total thoracic aortic artificial vessel replacement,25 Wheat procedure and 3 aortic valvuloplasty) and the other 8 received ascending aorta with semi-aortic arch replacement.Of the 59 DeBakey type Ⅲ patients,36 underwent descending aortic aneurysm resection with artificial vessel replacement via left posterolateral thoracic incision by left heart bypass or aorta to artery bypass(using Cott tubes),while the other 23 received endovascular stent-graft exclusion in descending aorta via the femoral artery.Results: All the patients were successfully treated except 5 that died during the perioperative period.The survivors were followed up for 3-118 months,among whom 2 died long-term death after the operation and the others were living healthy.Conclusion: Surgical treatment improves the clinical outcome of thoracic aortic dissecting aneurysm.Bilateral perfusion via the carotid artery in aortic arch replacement has a definite cerebral protective effect.Surgical procedures can be simplified by using the modified elephant trunk technique.Endovascular stent-graft exclusion is safe and effective in the treatment of DeBakey type Ⅲ aortic dissection.

Objective:To elucidate the factors influencing the differences in the survival rates of esophageal squamous cell carcinoma (ESCC) patients between the rural and urban regions in China. Methods:A total of 36,723 ESCC patients derived from the clinical data-bases containing 500,000 esophageal and gastric cardia carcinoma cases (1973-2015) of the Henan Key Laboratory for Esophageal Can-cer Research of the First Affiliated Hospital, Zhengzhou University, were analyzed. Of these patients, 33,625 were from the rural re-gions (91.6%), comprising 20,906 male patients with an average age of 58.98 ± 8.71 years and 12,719 females with an average age of 59.59 ± 8.53 years. The remaining 3,098 were from the urban regions and composed of 2,089 male patients with an average age of 60.84±9.10 years and 1,009 females with an average age of 62.46 ± 9.14 years. All the patients underwent radical esophagectomy, de-tailed histopathological diagnosis, and TNM staging. Chi square test, Kaplan-Meier, Log-rank, and Cox proportional hazards regression model were used to analyze the differences between ESCC patients from rural regions and those from urban regions and among the risk factors in prognosis. Results:Kaplan-Meier and Log-rank analysis results showed that the ESCC patients from the rural regions had significantly higher overall survival than the urban patients (χ2=12.971, P=0.000). Further analysis showed that rural patients≥50 years old and diagnosed with stage IIa and IIb (middle stage) ESCC had higher survival rates than urban patients in males and females (male:χ2=16.188, P<0.001;female:χ2=5.019, P=0.025). However, the survival rates of rural and urban patients with stage 0,Ⅰa,Ⅰb (early stage) and Ⅲa, Ⅲc, and Ⅳ (late stage) were similar (P>0.05). The results of Cox proportional hazards regression model analysis showed that age, gender, and TNM stages were independent risk factors for rural and urban ESCC patients. When the rural and urban ESCC patients were both considered, the Cox proportional hazards regression model analysis results showed that male ESCC patients≥50 years old, urban residence, and TNM stages were independent risk factors. Conclusion:Rural ESCC patients have significantly high-er overall survival than urban patients. Male, age of≥50 years old, urban residence, and TNM stages were independent risk factors for ESCC patient survival.

Objective To compare the effectiveness and safety of ketamine and etomidate for rap-id sequential intubation.Methods Randomized controlled trials and cohort studies with ketamine and etomidate for RSI in patients with acute and critical illnesses published by China National Knowledge Infrastructure,Wanfang Data,VIP Network,PubMed,Embase,Cochrane Library and Clinicaltrials.gov from the date of database creation to May 1,2023 were searched by computer.The literatures were screened according to inclusion and exclusion criteria,and the data of literatures were also extracted for quality assessment.Meta-analysis was performed by RevMan 5.3 software.Results A total of 15 literatures with 20 839 patients were included,including 3 RCT studies and 12 cohort studies.Meta-a-nalysis showed that there were no significant differences in the success rate of primary intubation(RR=0.99,95％CI,0.98 to 1.00,P=0.10),incidence of cardiac arrest(RR=1.00,95％CI,0.62 to 1.62,P=0.99),time of mechanical ventilation(MD=0.33,95％CI,-0.34 to 1.01,P=0.33),and mortality rate(RR=1.05,95％CI,0.95 to 1.16,P=0.31)between the ketamine group and the etomidate group,but the incidence of adrenal insufficiency(RR=0.54,95％CI,0.41 to0.70,P＜0.001)and ICU stay(MD=-0.44,95％CI,-0.70 to-0.18,P=0.001)in the etomidate group were significantly lower and shorter than those in the ketamine group,while the inci-dence of hypoxemia was significantly higher in the etomidate group(RR=1.50,95％CI,1.27 to 1.79,P＜0.001).Conclusion During the process of RSI with sufficient preoxygenation,ketamine is a safe and effective alternative drug,and compared with etomidate,it has a lower incidence of adrenal insufficiency and shorter ICU stay.

Objective To compare the effectiveness and safety of ketamine and etomidate for rap-id sequential intubation.Methods Randomized controlled trials and cohort studies with ketamine and etomidate for RSI in patients with acute and critical illnesses published by China National Knowledge Infrastructure,Wanfang Data,VIP Network,PubMed,Embase,Cochrane Library and Clinicaltrials.gov from the date of database creation to May 1,2023 were searched by computer.The literatures were screened according to inclusion and exclusion criteria,and the data of literatures were also extracted for quality assessment.Meta-analysis was performed by RevMan 5.3 software.Results A total of 15 literatures with 20 839 patients were included,including 3 RCT studies and 12 cohort studies.Meta-a-nalysis showed that there were no significant differences in the success rate of primary intubation(RR=0.99,95％CI,0.98 to 1.00,P=0.10),incidence of cardiac arrest(RR=1.00,95％CI,0.62 to 1.62,P=0.99),time of mechanical ventilation(MD=0.33,95％CI,-0.34 to 1.01,P=0.33),and mortality rate(RR=1.05,95％CI,0.95 to 1.16,P=0.31)between the ketamine group and the etomidate group,but the incidence of adrenal insufficiency(RR=0.54,95％CI,0.41 to0.70,P＜0.001)and ICU stay(MD=-0.44,95％CI,-0.70 to-0.18,P=0.001)in the etomidate group were significantly lower and shorter than those in the ketamine group,while the inci-dence of hypoxemia was significantly higher in the etomidate group(RR=1.50,95％CI,1.27 to 1.79,P＜0.001).Conclusion During the process of RSI with sufficient preoxygenation,ketamine is a safe and effective alternative drug,and compared with etomidate,it has a lower incidence of adrenal insufficiency and shorter ICU stay.

Objective:To explore the application value in cerebral blood perfusion status of dynamic susceptibility contrast enhanced perfusion weighted imaging (DSC-PWI) in ischemic cerebrovascular disease (ICVD).Methods:Retrospective analysis of 31 cases ICVD head magnetic resonance imaging (MRI), diffusion weighted imaging (DWI), magnetic resonance angiography (MRA) and DSC-PWI image in clinical diagnosis, and selectively analyze parameters including relative cerebral blood flow (rCBF), relative cerebral blood volume (rCBV), mean transit time (MTT) and time to peak (TTP) for generalize its characteristics.Results:31 cases of ICVD, 16 cases hypoperfusion, rCBF decreased significantly, rCBV decreased, MTT and TTP prolonged, include 7 cases of large vessel disease and 5 cases of small vessel disease. The collateral circulation formed 9 cases, including 3 cases with good compensation, rCBF normal, rCBV normal, MTT and TTP prolonged, 6 cases with bad compensation, rCBF decreased, rCBV normal or increased, MTT and TTP prolonged. The blood reperfusion in 3 cases, rCBF normal or slightly increased, rCBV increased, MTT shortened or normal, and TTP shortened. The excessive perfusion in 3 cases, rCBF significantly increased and rCBV significantly increased, with MTT and TTP shortened.Conclusions:DSC-PWI can reliably reflect the perfusion state and collateral circulation compensation of ICVD, so as to guide the selection of clinical treatment program and significantly improve the prognosis of patients.