Twenty-two neurosurgical patients were randomly divided into two groups:Group 1 iv drip midazolam and isoflurane inhalation;Group 2 isoflurane inhalation only. The hemodynamic indices and concentration of isoflurane were studied. The results showed that the blood pressure of all the patients were significantly decreased(PMO.01). The concentration of isoflurane in group 1 were .signicantly lowered by 27% than in group 2(P

Objective To evaluate the effects of sevoflurane-remifentanil anesthesia on the balance between cerebral oxygen supply and demand during cerebral revascularization for ischemic moyamoya disease by monitoring regional cerebral O2 saturation (rSO2) with near infrared spectroscopy.Methods Forty patients of both sexes aged 19-59 yr with a body mass index of 19-25 kg/m2 undergoing superficial temporal artery-middle cerebral artery anastomosis were randomly allocated into 2 groups (n =20 each):propofol-remifentanil group (group PR) and sevoflurane-remifentanil group (group SR).Radial artery was cannulated for direct BP monitoring and blood sampling.Near infrared spectroscopy probe was placed on the forehead.Anesthesia was induced with propofol TCI (Cp =5 μg/ml),fentanyl 3 μg/kg and rocuronium 0.6 mg/kg.The patients were mechanically ventilated after tracheal intubation (VT 8-10 ml/kg,RR 10-12 bpm,I∶ E 1∶2,FiO2 =1.0).PETCO2 was maintained at 35-40 mm Hg.Anesthesia was maintained with sevoflurane (end-tidal concentration 1.0％-1.7 ％) or propofol TCI (Cp =3-4 μg/ml) in combination with remifentanil TCI (Cp =3.5 ng/ml) and intermittent iv boluses of rocuronium 0.3 mg/kg.BIS was maintained at 40-60 during operation.rSO2 was recorded before induction of anesthesia (T0),10 min before and 10 min after blood vessel was clamped (T1,T2) and 10 min after anastomosis was completed (T3).Results rSO2 was significantly increased on the operated side at T3 in PR group while in SR group bilateral rSO2 was significantly increased at T1-3 as compared with the baseline values at T0 (P ＜ 0.05 or 0.01).rSO2 on the operated side was significantly higher at T1 in group SR than in PR group (P ＜ 0.05).Conclusion The efficacy of sevoflurane-remifentanil anesthesia is similar to that of propofol-remifentanil anesthesia for revascularization for moyamoya disease in terms of maintence of the balance between cerebral oxygen supply and demand.

To establish the HPLC fingerprints of Eucommia ulmoides at different ages of different varieties with pi-noresinol diglucoside as the reference material to provide the basis for the HPLC fingerprints in the enterprise quality standards of Eu-commia ulmoides from the GAP base of Chenzhou Dacheng Chinese Herbal Medicine Co. Ltd. . Methods: A column of ZORBAX E-clipse XDB-C18 (250 mm × 4. 6 mm, 5μm) was used. The mobile phase consisted of methanol-0. 1% phosphoric acid with gradient e-lusion. The detection wavelength was 277 nm, the column temperature was 25℃,the flow rate was 1. 0 ml·min-1 , and the injection volume was 5 μl. Results:The Eucommia ulmoides HPLC fingerprints including 14 common peaks were established with pinoresinol diglucoside as the reference material. The similarity of the HPLC fingerprints of 10 samples was over 0. 939. Conclusion:The method is accurate and reliable. The HPLC fingerprints can be used as the enterprise quality standards of Eucommia ulmoides for Chenzhou Dacheng Chinese Herbal Medicine Co. Ltd. .

Objective To determine the cerebral protective effect of different concentrations of desflurane anesthesia during craniotomy.Methods Twenty two patients, scheduled for selective craniotomy for resections of supratentorial mass lesions, were anesthetized by inhalation of desflurane. When the concentrations of desflurane were maintained at 0.7,1.0 and 1.3 mean alveolar concentration (MAC) for 30 min during removing the tumor, venous blood samples which were drawn through internal jugular bulb were analyzed. Mean arterial pressure (MAP), heart rate (HR), and jugular bulb pressure (JBP) were recorded during the craniotomy.Results Jugular bulb oxygen saturation (SjO2) was significantly declined at 1.0 and 1.3 MAC compared with that at 0.7 MAC (P<0.05 and P<0.01 respectively). There was no significant changes in SjO2 between 1.0 and 1.3 MAC (P>0.05). MAP declined dose dependently, and decreased more significantly at 1.3 MAC (P<0.01).HR and JBP increased slightly with the raising concentration of desflurane but there were no significant changes at any MAC of desflurane (P>0.05).Conclusion Desflurane anesthesia at 1.0 MAC shows cerebral protection effect during craniotomy with stable hemodynamics and improved cerebral oxygen supply and demand.

Objective To evaluate the values of prenatal surveillances of ultrasonography in twin pregnancies with amniotic fluid discordance. Methods Two hundred and seventy cases of diamniotic twins were included. Both postnatal outcomes and prenatal amniotic fluid discordant variations were analyzed,and the incidences of amniotic fluid discordance were compared between the monochorionic-diamniotic(MCDA)and dichorionic-diamniotic (DCDA) gruop. Results Twenty four cases of twins with amniotic fluid discordance were found in the study. The incidence of amniotic fluid discordance in MCDA group was much higher than that in DCDA group (28.9% vs 5.6%, P ＜0. 001 ) ,and 24 cases of twin-to-twin transfusion syndrome (TTTS) were diagnosed in the former group and none were found in the latter group. Downward tendency of amniotic fluid discordance was shown in non-TTTS cases of MCDA group. Compared with TTTS cases, the postnatal outcomes of non-TTTS cases with amniotic fluid discordance were much better in MCDA group ( P ＜0.001 ). Conclusions TTTS and MCDA twins with amniotic fluid discordance may overlap each other in the early stage. Serial surveillances of ultrasonography are necessary for prenatal differentiating twin pregnancies complicated by amniotic fluid discordance,and providing strong support to clinical treament.

Objective: To express and purify outer membrane protein FomA of Fusobacterium nucleatum (Fn) through gene recombination technique with Escherichia coli (Ec) expression system, and to detect the immunogenicity and the immune effects of the recombinant protein on gingival tissues. Methods: The gene recombination technique and Ec expression system were used to express and purified the FomA protein. Totally 20 C57 mice were immuned with the protein or the phosphate buffer solution (PBS) buffer by subcutaneous injection (each 10 mice), and the specific FomA antibody was detection in mice serum. The immunogenicity of FomA protein was assessed by comparing the differences between groups. Furthermore, the model of mice gum abscess was constructed with Fn or Fn and Porphyromonas gingivalis (Pg) mixed suspension used the above mice. The score of the gingival abscess was recorded and the interleukin (IL)-1β in gum tissue and mice serum was determined by enzyme-linked immunosorbent assay method, and the differences of the indexes between groups were compared to evaluate the effect of the FomA protein immunization. Results: Totally 1.0-1.5 g FomA protein were successfully obtained and the protein purity was over 90%. The FomA specific antibody was detected in the serum of mice by subcutaneous injection of the protein, and the antibody titer reached the highest level in 2 weeks after secondary immunization. The model of submaxillary gingival abscess was successfully constructed. In the Fn model, the score of the FomA protein immune group was (1.82±0.35), and the PBS control group was (2.62±0.71), with statistically significant difference between the two groups (P=0.049). In the Fn+Pg mixture model, the score of gingival abscess in the FomA immune group (2.31±0.55) was lower than that in PBS group (3.63±0.45), and the difference was statistically significant (P=0.003). Both in Fn and Fn+Pg injection group, the concentration of IL-1β in the serum of FomA immune mice and gingival tissues was lower than that of PBS control mice (P<0.001). Conclusions The recombinant FomA protein can be acquired by Ec expression system, and it can produce a certain level antibodies in the mice serum. The way of mice subcutaneously injected with the recombinant FomA protein can reduce the severity of periodontal infections caused by Fn and Pg.

Objective: To compare the prevalence of dental caries and periodontal disease in patients with end-stage renal disease treated with maintenance hemodialysis with that in healthy controls and to investigate the relationship between end-stage renal disease, dental caries and periodontal disease. Methods : A total of 82 maintenance hemodialysis patients who met the inclusion criteria were selected as the case group, and 86 healthy persons who underwent oral examination in the physical examination center were selected as the control group. Dental caries and periodontal conditions were examined in the two groups. The dental caries examination was conducted by determining the number of decayed-missing-filled teeth, which was recorded as recommended by the World Health Organization. The periodontal condition parameters included the plaque index, calculus index, bleeding on probing, periodontal pocket depth and clinical attachment loss. Results: The prevalence of dental caries in the case group and healthy control group was 87.8% and 81.4%, respectively, and there was no statistically significant difference between the two groups (P > 0.05). The periodontal indexes, including the plaque index, calculus index, probe bleeding index, periodontal pocket depth and clinical attachment level, in the case group were significantly higher than those in the control group (P < 0.05), and the prevalence of periodontitis in the case group was significantly higher than that in the control group (97.6% vs 88.4%, P < 0.05). Conclusion The dental caries conditions were comparable between the case group and the control group, but the prevalence and severity of periodontitis were significantly higher in the case group than in the control group.