Objective To investigate the effect of ketamine on learning and memory function of adult rats after injection of ketamine at early development stage. Methods Twelve rats born in a week were randomly divided into ketamine anesthesia group(Ket group)and normal saline control group(Ns group).Rats in Ket group were intraperitoneally injected with 50 mg/kg ketamine,and those in Ns group were administrated with same amount of normal saline.After eight weeks,Morris water maze test was adopted to explore the latency in place navigation and spatial probe ability.The sections of hippocampus were obtained,and immunohistochemical staining was employed to detect the expression of Bax and Bcl-2.Results In Morris water maze test,the latency in place navigation of Ket group Was significantly longer than that of Ns group(P<0.05),and the spatial probe ability significantly decreased(P<0.05).It Was revealed by immunohistochemical staining that the expression of Bax in Ket group was significantly higher than that in Ns group,while there was no significant difference in the expression of Bcl-2 between these two groups. Conclusion Application of ketamine in neonatal rats may result in learning and memory impairment in adulthood,and the underlying mechanism may correlate to the apoptosis of neuron in hippocampus region.

Objective To evaluate the clinical results of biofeedback and pelvic electric stimulation therapy for stress urinary incontinence in women. Methods Totally 36 women with stress urinary incontinence were prospcctively studied by treating with biofeedback and pelvic electric stimulation therapy (MeprasolBIO2001). All the patients were follow-up for 3 months. Results About 70% of the patients were completely dry and 22% reported subjective improved,the recurrence rate at 3 months follow-up was 60%. Conclusion Biofeedback and pelvic electric stimulation therapy is a safe method for treating stress urinary incontinence. It is effective and easy to perform as an outpatient treatment. But the therapy should be performed for a longterm.

Objective To study the risk factors of periventricular-intraventricular hemorrhage (PIVH) in extremely low birth weight infants(ELBWI). Methods A retrospective study was performed in 41 ELBWI hospitalized between January 2001 and August 2008. Univariate analysis and Logistic regression analysis were performed to detect the risk factors of PIVH. Results Of 41ELBWI, twenty-three suffered from PIVH with the incidence of 56.1%. Univariate analysis revealed that,in PIVH group,gestational age,mean blood pressure and the minimum values of blood pressure were lower than non-PIVH group[ ( 27.1 ± 1.9 ) weeks vs ( 28. 7 ± 1.6) weeks, t = 2. 834, P ＜ 0. 05 ;(28.9±4.8) mm Hg vs (33.1±4.9) mm Hg, t=-2.747,P＜0. 05; (24.4±4.3) mm Hg vs (31.4 ± 6.6) mm Hg,t= -3. 863, P＜0. 05], while blood pressure fluctuation and the highest values of PaCO2 during the first week of life were higher[(19.0 ± 5.2) mm Hg vs (13.7 ± 4. 8) mm Hg;(60. 2± 19. 4) mm Hg vs (49.5±12.1) mm Hg] (t= 3. 310 and 2. 166, P＜0. 05), the incidence of administration of pulmonary surfactant, neonatal respiratory distress syndrome, shock, hypotension before 4 days of age, hyperglycemia and mechanical ventilation therapy were higher[73. 9 % (17/23) vs 27. 8%(5/18), 60. 9%(14/23) vs 27.8%(5/18),52. 2%(12/23) vs 5.5%(1/18),73. 9%(17/23) vs 33.3%(6/18) ,78. 3%(18/23) vs 44. 5%(8/18),87. 0% (20/23) vs 44. 5% (8/18)]( all P＜0.05).Multivariate Logistic analysis revealed that blood pressure fluctuation (OR = 1. 260, 95% CI: 1. 009-1. 572, P = 0. 041 ) and lowest mean blood pressure(OR = 0. 805,95 % CI: 0. 672-0. 965, P = 0. 019)were risk factors of PIVH. Among twenty-eight ELBWI received mechanical ventilation, only peakinspiratory pressure(OR=- 2. 086,95% CI: 1. 140-3. 819, P= 0. 017) was the risk factor of PIVH by Logistic analysis. Conclusions Low blood pressure and blood pressure fluctuation may be risk factors of PIVH in ELBWI. The high values of peak inspiratory pressure is a risk factor of ELBWI with mechanical ventilation.

Percutaneous vertebroplasty has many advantages such as minimal trauma, simple mode of operation, rapid and correct therapeutic effect, high safety, and wide indications. Therefore it has been generally paid close attention and accepted. Percutaneous vertebroplasty has conspicuous curative effect, especially in vertebral compression fracture. Polymethyl methacrylate is the most used filling materials at present; There is not significant difference between unipedicular and bipedicular vertebroplasty; Using vertebral body venography and appropriate dense bone cement can reduce leakage of bone cement; Bolster for self-replacement can rebound vertebral body height, and balloon kyphoplasty and sky bone expander kyphoplasty can be avoided; In order to reduce refracture of vertebral body, anti-osteoporosis drugs should be used in the treatment of percutaneous vertebroplasty.

BACKGROUND:The anesthesia process is required strict in establishing rabbit models of ileal neobladder. It is required for cleaning operation field, quick postoperative recovery, and the choice of anesthetics and anesthesia does not influence smooth muscle peristalsis. OBJECTIVE:To compare the anesthetic effects between urethane and chloral hydrate in rabbits with ileal neobladder. METHODS:Eighteen rabbits were randomly assigned to urethane and chloral hydrate groups, and were respectively anesthetized with 20% urethane 5 mL/kg and 10% chloral hydrate 2 mL/kg through the ear vein. Double ureter was dissociated at 1 cm outside original bladder, and 15 cm-intestine obtained from 10 cm of ileocecal junction was implanted so as to establish models of ileal neobladder. RESULTS AND CONCLUSION:Heart rates were significantly lower compared with these before anesthesia in al cases (P≤ 0.05), but no differences were detected between two groups (P > 0.05). Compared with the chloral hydrate group, the maintain time and recovery time were longer and the mortality rate was higher in the urethane group. Above data indicated that chloral hydrate is a safe long-acting anesthetic in establishing rabbit models of ileal neobladder.

Objective To explore the efficacy of liver retransplantation for hepatocellular carcinoma (HCC) patients with or without HCC recurrence.Method 131 cases of retransplantation performed between 2003 and 2012 were analyzed retrospectively.Their first and second liver transplantations were both performed in our hospital.Diagnoses of their primary diseases before transplantations were confirmed pathologically after the first transplantation.Patients were divided into two groups in terms of benign causes and HCC.Results Sixty cases were fallen into benign disease group and 65 cases into HCC group.The proportions of main causes of retransplantation were similar between two groups.The graft survival rate of early retransplantation (retransplantation performed within 30 days after the first transplantation) and late retransplantation (retransplantation performed beyond 30 days after the first transplantation) was calculated and compared respectively due a great difference in survival rate between the two phrases.The deaths of HCC patients with HCC recurrence before retransplantation were more than those without HCC recurrence (P＜0.01) and benign disease group.The 5-year cumulated survival rate was close between HCC patients without recurrence before retransplantation (51.0％) and benign disease group (51.8％).Conclusion The retransplantation after HCC recurrence has an unacceptable prognosis.The survival rate was similar between patients without HCC recurrence and patients with benign diseases.HCC patients without recurrence should not be restrained from retransplantation just for the HCC history.

Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.

目的探讨对老年2型糖尿病患者行空气净化前后动脉血氧分压(PaO2)和二氧化碳分压(PaCO2)的变化。方法55例老年2型糖尿病患者分为观察组(29例)和对照组(26例)。观察组患者所处疗养室每日24h进行空气净化。分别于净化前、净化后第2、3、4周抽取动脉血检测PaO2 、PaCO2 、PH值和氧饱和度。 结果空气净化4周后,观察组PaO2、PaCO2 、氧饱和度有明显改善(P<0.01),PH值无显著性变化。结论空气净化能改善老年2型糖尿病患者的PaO2 、PaCO2。

Through several years of exploration in Shanghai Chongming region, the team from Chongming Branch of Xinhua Hospital has established the initial multidisciplinary diagnosis and treatment model of cancer pain, which includes the department of oncology, anesthesiology, pain, rehabilitation, psychology and so forth. By means of medical informationization, they take cancer pain management as the starting point and have initially real-ized a new model of the real-time assessment and treatment of cancer pain, which has helped patients effectively reduce the physical and psychological suffering, improved the quality of life, developed a healthy self-manage-ment of patients, and has reference significance to palliative care.

Objective To compare the outcomes of traumatic flail chest with multiple injuries treated by operative fixation versus conservative approach. Methods The clinical data of 60 patients with traumatic flail chest with multiple injuries were retrospectively analysed, and the outcomes between operation group (treated by operative fixation, n=32)and non-operation group (treated by conservative approach, n=28) were compared. Results The mean time of hospital stay, ICU stay and mechanical ventilation was significantly shorter, and the prevalences of chest wall deformity, pulmonary infection, pulmonary atelectasis and respiratory failure were significantly lower in operation group than those in non-operation group (P<0.05). Six months after discharge, the pulmonary function parameters such as inspiratory capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow, total lung capacity and maximal midexpiratory flow were significantly higher in operation group than those in non-operation group (P<0.05). Conclusion Traumatic flail chest with multiple injuries treated by operative fixation may lead to less flail chest associated complications. Operative fixation has short- and long-term benefits to flail chest.