Objective To explore MR features of periventricular leukomalacia(PVL) in premature infants. Methods The clinical and MR data of 30 cases with premature infant PVL were analyzed retrospectively.Results In 30 cases with PVL,the gestational age was 28~31 weeks in 18 cases,32~35 weeks in 9 cases and 36~38 weeks in 3 cases.Clinical presentations included limbs palsy in 30 cases,cortex blind in 6 cases mental retard in 14 cases and epilepsy in 8 cases.At early and medial phase,the white matter lesions at periventricular appeared as long T1 and T2 signal with blured borderline,the boundary of white-gray was blured.According to the criterion,the mild,moderate and severe cases was 11,18 and 1 respectively.Conclusion PVL is a main factor of cerebral palsy, MRI has a characteristic manifestations of PVL.

Objective To investigate the effect of perioperative fluid therapy on blood glucose in the neonates undergoing gastrointestinal operation. Methods Sixty-four ASA Ⅰ or Ⅱ neonates undergoing gastrointestinal operation were randomly divided into 4 groups ( n = 16 each). Group Ⅰ received water orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅱ received water orally 2 h before operation and iv infusion of 2% glucose (in normal saline) during operation. Group Ⅲ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of acetated Ringer's solution during operation. Group Ⅳ received 10% glucose 5 ml/kg orally 2 h before operation and iv infusion of 2 % glucose (in normal saline) during operation. Blood sam ples were collected from radial artery for determination of blood glucose concentrations at the beginning of fluid therapy (T0), immediately after induction of anesthesia (T1), at the beginning of operation (T2), and at 20,40and 60 min (T3-5) and 2 h after operation ( T6 ). MAP and HR were also recorded simultaneously. The blood lactic acid concentration was determined at T0 . Results There was no significant difference in MAP and HR among the 4 groups. Compared with group Ⅰ , blood glucose concentrations were significantly increased at T4-6 in group Ⅱand Ⅳ, but no significant change was found in blood glucose concentrations at each time point in group Ⅲ. There was no significant difference in blood glucose concentrations between group Ⅱ and Ⅳ. The blood lactic acid concentration was significantly higher in group Ⅲ than in group Ⅰ , and in group Ⅳ than in group Ⅱ . Conclusion Oral 10% glucose 5 ml/kg before operation and iv infusion of 2% glucose (in normal saline) during operation is beneficial for the stabilization of blood glucose levels in neonates undergoing gastrointestinal operation.

Objective To investigate the effect of mild hypothermia on cerebral oxygen metabolism in a rat model of chronic cerebral hypoperfusion and reperfusion. Methods Twelve healthy SD rats weighing 170-210 g were randomly divided into normal body temperature group (group NT, n = 6) and mild hypothermia group (group MH, n = 6). Arterio-venous fistula was established by end-to-end anastomosis between the right common carotid artery and right external jugular vein according to Yassari. Mild hypothermia was induced in group MH before reperfusion and maintained for 3 h. The rectal temperature was reduced to 32 ℃ while in group NT rectal temperature was maintained at about 37 ℃ . Cerebral blood perfusion (CBP) was assessed by using a lasser Doppler perfusion image system before reperfusion (T_1), immediately after reperfusion (T_2) and 24 h after reperfusion (T_3). Venous and arterial blood samples were collected from superior sagittal sinus and femoral artery respectively for blood gas analysis at T_(1-3) . Cerebral arterial venous O_2 saturation difference (Sa-vO_2), cerebral O_2 extraction rate (CERO_2) and cerebral arterial-venous lactic acid concentration difference ( Da-vL) were calculated. Results In NT group left CBP was significantly decreased at T_2 as compared with the baseline value at T_1 , while at T_3 bilateral CBP was decreased. In MH group bilateral CBP was significantly decreased at T_2 but returned to baseline level at T_3. CERO_2 was significantly decreased at T_2 as compared with the baseline value at T_1 in MH group. Da-vL was significantly increased at T_3 in NT group. Compared with group NT, bilateral CBP was significantly decreased, CERO_ and Da-vL were significantly decreased at T_2 ,while no significant change was found in Sa-vO_2 in group MH. Conclusion Mild hypothermia is beneficial for the balance of cerebral oxygen metabolism in the rats with chronic cerebral hypoperfusion and reperfusion.

Objective: To observe two methods of cardioplegia under intrograde and retrograde, using mixed hypothemic blood in 59 patients receiving coronary artery bypass graft (CABG). Method:During perioperation and postoperation 24 hours,hemodynamie parameters were recorded. Myocardial enzyme level,the changes of ECG on 12 leads in postoperation,the frequency of using inotrope,time of staying in ICU and automatical reovery heart beat rate after openning aortic clamp were tested. Result: Cardioplegia by mixed hypothemie blood had better protective effects to the heart function, all patients could left the ICU safely,without significant differences between the two methods of cardioplegia,but in the retrograde group,there was obvious reduce in the change of myocardial enzyme level and less change of ECG in postoperation compared with those in the intrograde group. Conclusion:Both methods of mixed hypothemic blood for cardioplegia in CABG can protect effetively myocardium, but retrograde eardiaoplegia has better effect.

Objective To observe the changes of systemic and pulmonary hemodynamics during veno-venous bypass in liver transplantation Methods During the anhepatic phase, extracorporeal veno-venous bypass (EVVB) was utilized in 20 patients undergoing live transplantation Systemic and pulmonary hemodynamics were monitored through Swan-Ganz catheter during whole procedures Results As compared with the preoperative values , MAP remained unchanged in normal range during perioperative period;CO,CI,LVSW and RVSW decreased significantly during anhepatic phase and increased markedly 15 min after hepatic reperfusion (P

Objective To explore the value of MRI features of the appendixes bone in differentiating vertebral myeloma from metastatic tumor. Methods There were vertebral myelomas and metastatic tumors in 32 cases respectively involved the appendixes bones,the number,positions,forms,size,distribution ranger and T_1 of the lesions,the vertebral pedicles and the diameters of the cross sections of vertebrallaminas were analysed.Results Among the 32 cases of vertebral myeloma,the destruction of appendixe was bilateral in 21 cases andunilateral in 11 cases.Totally 89 lesions were checked out ,of them,the lesions were the form of mass or nodule in 39,patch in 28,mixed form in 12.In compared with its adjacent and normal one,the ratio of evary invaded vertebral pedide , vertebral lamina and spinous process was between 1.048~2.135 . There was significant difference (P0.05).Conclusion The difference of MRI features of the appendixes bone invaded by vertebral myeloma and by metastatic tumor is helpful in distinguishing vertebral myeloma from metastatic tumor.

005) As compared with those before operation ERO_2, VO_2I, DO_2 and DO_2I increased significantly during early neohepatic stages (P

Objective It was estimated that about 70% patients suffered from mild brain function disturbances after cardiac surgery with CPB Methods for early detection of brain injury after CPB in current use like EEG, transcranial Doppler, CT, MRI are expensive and not sensitive It was repored that combined assays of S 100 protein and NSE were conducive to early detection of brain ischemic injury and prediction of the prognosis The purpose of this study was to assess the changes in cerebral blood S 100 protein and NSE levels during and after open heart surgery with mild hypothermic CPB Methods 15 consecutive ASA Ⅱ Ⅲ patients undergoing elective open heart surgery under CPB were studied Aortic cross clamping time was 30 60 min and CPB time was less than 120 min Patients with hypertension and neurologic or endocrine diseases were excluded Anesthesia was induced with midazolam 0 15mg/kg, fentanyl 5?g/kg and vecuronium 0 1mg/kg Fentanyl 30 50 ?g/kg was continuously infused after tracheal intubation and during CPB Vecuronium was given intermittently to maintain muscle relaxation Midazolam was infused at 0 2mg?kg -1 h -1 during CPB Temperature was reduced to 32℃ 35℃ during CPB Aterial blood pH and PCO 2 were maintained within normal range and Hct between 25% 30% during CPB Internal jugular vein was caunulated and the catheter was advanced retrogradely until jugular bulb Jugular venous blood samples were taken for determination of S 100 protein and NSE content before CPB (A),when mild hypothermia (32℃ 35℃ ) was steadily maintained (B), rewarming to 36℃ (C), 30 min (D),4 6h (E) and 24h (F) after termination of CPB Results (1) After institution of CPB, S 100 protein level increased significantly (P

24 h. The operation was performed under continuous epidural block. Right subclavian or internal jugular vein was cannulated for blood sampling. Exclusion criteria included acute bleeding, acute thrombosis, patients who had received any drug which may affect platelet function or coagulation within a month. TEG was performed before operation, 10min after release of cross-clamping of artery and vein of the translated kidney and at the end of operation. The measured TED variables included the reaction time (r) representing the rate of initial fibrin formation; k(coagulation) time and alpha angle reflecting fibrin-platelet interaction and maximal amplitude (MA) indicating qualitative platelet function. Results Before operation in group A r and k values were both significantly smaller than normal values and alpha angle, MA and coagulation index (CI) significantly increased, indicating increased coagulability, while group C exhibited decreased coagulability with r-value larger than normal and MA smaller than normal. 10min after release of cross-clamping of artery and vein of the transplanted kidney in group B and C r-value decreased and MA, CI increased as compared with the preoperative values. There were no significant differences in TEG variables at the end of operation among the three groups. Conclusions TEG shows that hypercoagulability may exist within 6 h after hemodialysis, and there is likelihood of fibrinolysis after 24 h. The venous blood is hypercoagulable after the release of cross-clamping of artery and vein of the transplanted kidney, indicating the risk of potential thrombosis.

Objective To assess the lung inflammatory response to cardiopulmonary bypass (CPB). Methods Twenty ASAⅡ-Ⅲ patients of either sex (9 male, 11 female) aged (43 ? 12)yr, undergoing elective cardiac valve replacement were studied. Patients with liver or kidney dysfunction and lung inflammatory diseases were excluded. Premedication included intramuscular morphine 5mg and atropine 0.1mg. Anesthesia was induced with propofol 1.5-2.0mg? kg-1, fentanyl 5?g?kg-1 and vecuronium 0. 1mg?kg-1 and maintained with isoflurane (