Objective To explore the clinical characteristics of patients during recovery period in low flow and circulation closed pattern anesthesia by ZEUS with isoflurane.Methods During elective gynecologic surgery,35 ASA Ⅰ or Ⅱ patients were anesthetized with isoflurane under general anesthesia with tracheal intubation.The ventilation was used with the closed circuit breathing mode (Autocontrol) of ZEUS anesthesia machine.The time of inhale drug,exhale drug and eyes-opend,consumption of drug and complication were recorded during the process.The values of NT stage (NTS),NT index (NTI),the final endexpiratory concentration of isoflurane (EXP),MAC and hemodynamic parameters were recorded during the time of isoflurane stopping inhale,recovery of spontaneous respiration,eyes opening.Results The values of NTI (50±7,74±12,86±10,t =-9.382,t =-16.682,P ＜ 0.01),the EXP [(0.9±0.0)％,(0.1±0.1)％,0,z =-7.262,z =-7.835],MAC [(1.2±0.1)％,(0.2±0.2)％,0,z =-7.186,z =-7.728,P ＜ 0.01] and hemodynamic parameters (SBP,DBP,MAP,HR) [(108.1±13.4) mm Hg (1 mm Hg =0.133 kPa),(66.3±12.1) mm Hg,(84.3± 12.5) mm Hg,(69.8±12.5) /min and (124.6±17.9) mm Hg,(75.7±14.5) mm Hg,(96.0±14.6) mm Hg,(82.8±15.0)/min and (128.0±16.3) mm Hg,(77.1±15.0) mm Hg,(99.8±15.3) mm Hg,(85.2±18.5) bpm] (t =-4.365,t =-2.951,t =-3.574,t =-3.921; t =-5.554,t =-3.309,t =-4.642,t =-4.085,P ＜0.01) during the time of recovery of spontaneous respiration and tracheal extubation were statistically significant compared to the time of isoflurane stopping (P＜ 0.01).None of patients experienced intraoperative was awareness.Conclusion Isoflurane can be used for closed circuit breathing mode of ZEUS anesthesia machine,but consciousness recovery need a long time.

Objective To explore the CT manifestation and the diagnostic value of leiomyomatous tmnor of gastrointestinal tract in 8 patients.Methods 8 patients with gastrointestinnal tract leiomyoma tumor were scaned with GE HISPEED CT/I.proceeding to scan with contrast agent when detected and ascertained the nidus.Results There were 4 eases gastric smooth muscle tumors in 8 patients,and 1 case was leiomyosarcoma of stomach,1 case was duodenal muscle tumors,1 case as jejuna muscle tumors and another is leiomyosarcoma of jejunum.Conclusion The location,contour and characteristic of imaging is important standard of leiomyomatous tumor of gastrointestinal tract.

Objective To evaluate the predictive effects of Narcotrend(NT) monitor on laryngeal mask intubation and consciousness recovery in propofol-laryngeal mask total intravenous anesthesia of gynecilogical surgery.Methods Thirty ASA I patients undergoing elective gynecilogical surgery under general anesthesia with laryngeal mask intubation were anesthetized with propofol by target-controlled infusion (TCI).NT monitor was used to monitor the anesthesia depth.The ventilation was used on the closed circuit breathing mode of ZEUS anesthesia machine.The values of NT stage (NTS),NT index (NTI),the effect compartment concentration (Ce) and hemodynamic parameters were recorded during the time of sleeping,laryngeal mask intubation,propofol stopping pumping,recovery of spontaneous respiration and eyes opening.The incidence rate of intraoperative awareness was recorded.Results The NTI (77±23,30±9) (Z =5.561,P =0.001),Ce [(1.1±0.4) μg/ml vs (2.2±0.4) μg/ml] (Z=6.38,P=0.006),MAP [(92±14) mm Hg (1 mm Hg =0.133 kPa)vs (83±14) mm Hg] (t =2.490,P =0.016) and HR [(74±15) bpm vs (65±10) bpm] (t =2.688,P =0.009) of the time of intubation were significantly decreased compared to the time of sleeping.The NTI (37±7 vs 71±14)of the time of recovery of spontaneous respiration was significantly increased compared to the time of propofol stopping pumping (Z =6.34,P =0.005).The NTI (37±7 vs 83±13) (Z =6.668,P =0.003),Ce [(3.1±0.4) μg/ml vs (1.6±0.2) μg/ml] (Z =6.414,P =0.002) and HR[(59±7) bpm vs (64±8) bpm] (t =-2.825,P =0.006) of the time of eyes opening were statistically significant compared to the time of propofol stopping pumping.None of patients experienced intraoperative awareness.Conclusion NT monitor can effectively guide the intubation and extubation of laryngeal mask in total intravenous anesthesia of gynecilogical surgery.

Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively (P=0.006<0.05 ).Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke (AUC=0.810;P=0.032<0.05). Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

Objective To investigate the superiority of direct multi-slice spiral CT venography in inferior vena cava. Methods Twenty-eight patients performed MSCT venography in inferior vena cava, including 2 cases with both indirect and direct venography, 10 cases with indirect venography, 20 cases with direct venography through unilateral or bilateral lower extremity venous injection. The image quality and enhancement degree of the inferior vena cava were compared in double-blind method. Results Of 10 cases with indirect venography of inferior vena cava, 1 case was failed due to mild enhancement in inferior vena cava. Image quality was good in 2 cases, poor in 7 cases, no excellent case. Of 20 cases with direct venography of inferior vena cava, the enhancement degree was scored 1, 2 degree in 16, 4 cases respectively and no case was scored 3 degree, the image quality was excellent, good in 16, 4 cases and no case was bad. The success rate was 100%. Conclusion The image quality of direct MSCT venography in inferior vena cava is better than that of indirect method.

0bjective To translate and revise the Assessment of Interprofessional Team Collaboration Scale (AITCS) into Chinese, then to evaluate the reliability and validity of the Chinese version of AITCS. Methods The Chinese version of AITCS was translated from the original one, back-translated and adjusted for cultural adaptation. The reliability and validity were tested among 288 nurses, 81 physicians, 25 respiratory therapists, 10 physical therapists and 3 nutritionists from a tertiary hospital in Hangzhou using convenience sampling. Results The average of scale-level content validity index was 0.98, unanimity of scale-level content validity index was 0.84 and item-level content validity index was 0.89-1.00. Exploratory factor analysis extracted three common factors,which explained 61.427% of the total variance,and each item had high factor loading quality (>0.4). The correlations coefficients between each dimension score and the total score ranged from 0.801 to 0.898 (P<0.05),and the correlations coefficients between each dimension score ranged from 0.607 to 0.698 (P<0.05). The Cronbach α of AITCS was 0.909, split-half reliability was 0.835 and test-retest reliability was 0.763. Conclusion The Chinese version of the AITCS has been proved to be reliable and valid. It is a valuable tool for evaluating interprofessional team collaboration among the health professional providers in mainland China.

OBJECTIVE To study the improvement effect and mechanism of sanguinarine （SG） on inflammatory pain in rats with lumbar disc herniation （LDH） and its mechanism. METHODS LDH model rats were established and divided into model group， SG low-dose， medium-dose and high-dose groups （1.00， 2.50， 6.25 mg/kg）， high-dose of SG+Anisomycin [mitogen-activated protein kinase （MAPK） activator] group （6.25 mg/kg SG+5 mg/kg Anisomycin）， with 10 rats in each group. Another 10 rats were included as the control group. Each group was given corresponding drugs intraperitoneally， while the control group and model group were given an equal volume of normal saline intraperitoneally， once a day， for 7 consecutive days. The general situation and neurological changes of rats in each group were observed， and the pain threshold [including paw withdrawal mechanical threshold （PWMT） and paw withdrawal thermal latency （PWTL）] of rats was determined； the histopathological changes of dorsal root ganglion （DRG） were observed in rats. The serum levels of inflammatory factors [tumor necrosis factor-α （TNF-α）， interleukin-1β （IL-1β）] and pain factors [neuropeptide Y （NPY）， 5-hydroxytryptamine （5-HT）] in rats were detected.The positive expressions of ionized-calcium binding adaptor molecule-1 （Iba-1） in spinal cord microglia and glial fibrillary acidic protein （GFAP） in astrocytes were observed. The expressions of proteins related to MAPK/extracellular signal-regulated kinase （ERK）/nuclear factor κB （NF-κB） signaling pathway， TNF-α and IL-1β proteins were detected in DRG tissue of rats. RESULTS Compared with the control group， the rats in the model group showed decreased appetite， hindlimb movement disorders， and disordered neuronal cell arrangement， the neurological score， the levels of TNF-α， IL-1β， NPY， the positive expressions of Iba-1 and GFAP， the phosphorylations of p38 MAPK， ERK1/2 and NF-κB p65， the protein expressions of TNF-α and IL-1β were significantly increased （P＜0.05）； PWMT， PWTL and the levels of 5-HT were significantly reduced （P＜0.05）. Compared with the model group， the rats of SG groups showed some relief in their mental appetite and hindlimb motor disorders， the intervertebral disc structure of DRG was restored， and the levels of the above quantitative indicators had significantly reversed （P＜0.05）. Anisomycin reversed the improvement effect of SG on inflammatory pain in LDH rats. CONCLUSIONS SG can improve inflammatory pain by inhibiting the activation of microglia in DRG tissue of LDH rats， reducing the release of inflammatory factors， and increasing pain threshold， and its mechanism of action may be related to the inhibition of MAPK/ERK/NF- κB signaling pathway.