Objective　To study the clinical application of MRI in neonatal asphyxia.Methods　There were twenty-two cases of full term infants(≤one year old),they all had asphyxia during delivery.Transverse section on TSE T2-weighted,TSE T1-weighted and FLAIR sequences,and sagittal section on TSE T2-weighted were obtained on MRI.Results　The abnormal signal intensity in white matter on MRI were found in 15 cases.The volume of white matter was decreased in three cases.Subarachnoid spaces of frontal and temporal lobe were enlarged in two cases.Two cases were normal on MRI.Conclusion　We believed that the changes of the white matter of brain in neonatal asphyxia can be showed on MRI,it is of important significance for clinical diagnosis and treatment.

Objective To analyze the etiology and the clinical characteristis of fever in older patients in Wenzhou.Methods Totolly 87 cases admitted to the First Affiliated Hospital of Wenzhou Medical College from January 2001 to April 2004 were retrospectively analyzed;all cases displayed fever as the major clinical manifestation and met the criteria of fever well.Results The etiology of fever which was infectious disease was in 44 of the 87 cases,accounting for 50.6%,collagen-vascular diseases 4.6%,neoplasms 10.3% and miscellaneous diseases 5.7%.In 28.7% of the cases the etiology could not be found.And in the infectious disease the tuberculosis accounted for 13.6%(6/44). Ultrasonography ,X-rays,CT scan,MRI,the marrow puncture and biopsy contributed to the final diagnosis in 21.1%,16.9%,63%,0,16.7% and 57.1% of the cases,respectively.Conclusion Because the symptoms of the older patients'febrile diseases are atypical,the diagnosis is more difficult.Infectious disease still remains a major cause of the fever in the elderly.A thorough history of disease,full physical examination of the patient and routine laboratory studies,especially erythrocyte sedimentation rate,are very important in determining the etiology of febrile disease.Early and reasonable use of non-invasive imaging techniques and the essential invasive methods are helpful to diagnosis.

Objective To investigate early changes of angiopoietin-2(Ang-2)in multiple trauma patients and assess its clinical significance.Methods Forty-five multiple trauma patients aged 2060 years admitted to the hospital within one hour after injury were randomly divided into three groups according to injury severity score(ISS).Blood specimens were obtained immediately upon arrival in the emergency department and plasma samples were assayed for comparing changes of Ang-2,TNF-a and IL-6.Meanwhile,plasma level of Ang-2 was measured and analyzed under different oxygenation index,shock index and base deficit.Results Plasma level of Ang-2 was positively correlated with ISS(P ＜ 0.01)and was concordant with the plasma levels of TNF-a and IL-6(P＜0.01).Furthermore,plasma level of Ang-2 was elevated upon increase of shock index or decrease of oxygenation index(P ＜ 0.01).Plasma level of Ang-2 was elevated with the increase of base deficit(P ＜ 0.01).Conclusions High level of Ang-2 is a marker of endothelial activation and dysfunction early after trauma.Ang-2 is related tightly with the injury severity,inflammation factors,systemic oxygenation and tissue hypoperfusion and may have a tight relation with pathophysiological development and clinical outcome after trauma.

This article analyzes and summaries the problems and difficulties existing in the first-aid medicine's clinical teaching.Combined with his own teaching experience,the author has made some exploration on the teaching time,the way of teaching and inspection form,which has got a good teaching effect.It provids the reference and development for the clinical teaching of first-aid medicine.

Objective To determine the effects and significance of endotoxin preconditioning on iNOS activity,nNOS activity in rat cerebral cortex,hippocampus and cerebella region after global brain ischemia/reperfusion.Methods Global ischemia for 20 min was made by four-vessel occlusion model(4-vo) in 60 Wistar rats,among which 30 were injected of 20 ?g/kg MPL through caudal vein 24 h before model establishment.Another 8 rats undergoing sham operation served as controls.The dynamic change of iNOS activity,nNOS activity and neuron density of the cerebral cortex,hippocampus and cerebella region were observed at 1,4,8 h after reperfusion. Results The activity of iNOS and nNOS decreased significantly after endotoxin preconditioning in the regions mentioned above,as compared with that of rats only undergoing the ischemia/reperfusion.The neuron number in rat hippocampus decreased after ischemia/reperfusion,but no significant difference was found between control and endotoxin preconditioning groups.Conclusion The activity of iNOS and nNOS changed significantly after global brain ischemia/reperfusion.That endotoxin preconditioning decreased iNOS and nNOS activities may be the protective mechanism.

Objective To investigate the effects of sustained inflation (SI) combined with small tidal volume ventilation on lung recruitment and hemodynamics in patients with acute lung injury (ALI). Methods Patients with severe trauma followed by ALI were selected for this study. Patients underwent small tidal volume ventilation (baseline) for 1 h and then SI with 20 cm H 2O?30 s(SI 1), 30 cm H 2O?30 s(SI 2), 40 cm H 2O?30 s(SI 3) and 50 cm H 2O?30 s(SI 4) for 1 h, respectively. Parameters of pulmonary mechanics and hemodynamics were measured at 1 h after baseline, SI and returning baseline, respectively. Results Compared with those of the baseline, no changes of parameters were found after SI 1 and SI 2, but EELV and Cst increased significantly after SI 3 and SI 4. Paw, PAP and PVRI decreased significantly after SI 3 and SI 4. After SI interruption, all the physiological variables returned to baseline. SI had no significant effect on HR, AP and CI. Conclusion Treatment with SI combined with small tidal volume ventilation in patients with ALI can provide lung recruitment and improve lung compliance, but it has no significant side effect on hemodynamics.

Objective To investigate the protective effect of endotoxin pretreatment on hippocampal neurons in rat forebrain following ischemia reperfusion and its possible mechanism. Methods Rat forebrain ischemia reperfusion model was used. The effects of endotoxin pretreatment on the changes of superoxide dismutase (SOD), glutathione peroxidase (GSH PX) and malondialdehyde (MDA) activities and the neuron count in CA1 region were observed. Results Pretreament with endotoxin before cerebral ischemia enhanced the activities of SOD and GSH PX but decreased MDA level and the number of ischemic neurons in CA1 region. Conclusion Endotoxin pretreatment can protect the neurons in rat forebrain against ischemia reperfusion injury. The mechanism may be associated with the enhancement of endogenous antioxidant activity in central nervous system.

30 ml) undergoing minimally invasive evacuation of intracranial hematoma from January 1999 to October 2002 in our department were analyzed retrospectively. The changes of IL 1, IL 6, and IL 8 in hematoma fluid were observed continuously. The content of IL 1 was determined by radioimmunassay and IL 6, IL 8 by ELISA methed. Results IL 1, IL 6, and IL 8 were observed at 6 12 h after hypertensive cerebral hemorrhage, and showed different changes in acute stage. Conclusion Inflammatory cytokines are involved in the pathological process of cerebral hemorrhage.

Experiments were carried out in 14 closed-chest dogs anesthetized with urethane and chloralose. The tracings of FAP, the 1 st derivatives of cardiac impedance variations ( dZ/dt) , PCG and ECG were recorded synchronously on a SJ-42 Polygraph. CO and STI were determined according to Kubicek and Weissler, respectively.5-10 min after injection of 5 mg/kg wt of anisodamine intravenously, MAP and TPR reduced drastically, accompanied by a slight slowing in HR and a moderate decrease in CO; increased PEP/LVET associated with lengthening of Q-Z interval and reduction of Heather's index. There were significant differences (P

Objective To compare the effects of short- term high- intensity interval training (HIT) and moderate continuous training (MCT) on inflammatory mediators for healthy young males. Methods 19 healthy young male volunteers were randomized into HIT group (n=6), MCT group (n=7) and no training control (CON, n=6) group. The groups of HIT and MCT accepted treadmill exercise once per 2 days to 6 times (2 weeks), and the CON group did not accepted treadmill exercise. The levels of high-sensitive C-reactive protein (hs-CRP), interleukin (IL) -1α, IL-6 and tumor necrosis factor α (TNF-α) were detected 3 days before exercise, immediately after the first exercise, 3 days after the course. Results There was no difference among groups in the level of hs-CRP, IL-1α, IL-6 and TNF-α in all the time (P>0.05). The concentration of IL-1α increased in the MCT group after the first exercise (P<0.01), and also the concentration of IL-6 in the CON group after the course (P<0.05). Conclusion It needs further srudy for the significance of HIT and MCT in the levels of inflammatory media.