Objective To observe the quantity of drainage fluid after operation and to evaluate the application of negative pressure drainage in skin soft tissue expansion. Methods The silica gel tube of 2 mm inside diameter with multi holes on sides was set under the skin soft tissue expander in 48 patients, then drained from upper incision or another incised hole,and connected with negative pressure apparatus. Results After operation, the quantity of drainage was from less than 5 ml to no more than 50 ml, averaged 16 ml. Conclusion For an operation with expansion capability above 100～200 ml,setting the negative pressure drainage as a routine is a most simple and effective method to prevent and treat bleeding and hematoma formation.It can produce effects on reducing the early complications such as hematoma and infection.

Objective To compare the pharmacodynamics of rocuronium intermittently administered according to body surface area and real body weight and individual differences. Method Forty-two patients undergoing elective surgery under general anesthesia were enrolled into the body surface area group (BSA group) and the real body weight group (RBW group), with 21 patients in each group. The patients in the two groups were induced with 2ED95 of rocuronium according to body surface area and real body weight (16.64 mg/m2 in BSA group; 0.6 mg/kg in RBW group). Whenever T1 recovered to 10%, a dosage of 0.5ED95 was administred repeatedly for 30 min before the end of the operation. The time of neuromuscular blockade and recovery of muscle relaxation were recorded, and the dosage of rocuronium was also recorded. Results No significant difference in each index of neuromuscular block time-effect was found between the two groups (P > 0.05). The single dosage and maintainance amount of muscle relaxation were less in the BSA group than that in RBW group (P < 0.05). Compared with the RBW group, the single dosage, dosing intervals, pharmacological duration and the time TOFr recovered to 0.7 between the different individuals were less in the BSA group (P < 0.05). Conclusion The intermittent administration of rocuronium can maintain the same clinical efficacy according to body surface area as that according to real body weight , with significantly less dosageand reducing the differences of individuals in blockade time-effect of muscle relaxation.

BACKGROUND: Researches suggest that transient ischemic attack (TIA)can induce cognitive dysfunction, and cerebral blood flow and its distribution are hypothesized to be closely related to cognitive activities.OBJECTIVE: To investigate the alteration of cognitive function and provide insights into its relations with cerebral perfusion in TIA patients.DESIGN: A case-control study.SETTING: Departments of Geriatrics, Electrophysiology and Magnetic Resonance of Urumqi General Hospital of Lanzhou Military Area Command of Chinese PLA.PARTICIPANTS: Totally 35 male right-handed TIA patients aged 45-78 years with an average of (68.1±8.4) years were selected from the inpatients and outpatients in the Department of Geriatrics, Urumqi General Hospital of Lanzhou Command of Chinese PLA between January 2002 and June 2003. Another 33 healthy right handed male subjects aged 45-77 years with an average of (67.8±8.6) years coming for physical examination were recruited to serve as the control group.METHODS: Patients and control subjects were tested with event-related potentials (ERPs) and the scale of elderly cognitive function (SECF) to examine the orientation, learning and memory, span, recall 1 (association),long-term memory, naming of animals, calculation, classification, copying,language and recall 2 (relation). According to the T score transformation table, the original scores were transformed into T scores relative to the age to eliminate the impact of age, and also into T'score to eliminate the interference by the patients'education, so that cognitive function of the patients could be evaluated with T'score, and the lower the score, the poorer the cognitive function. Cases in the two groups were all tested, and TIA patients were also examined with magnetic resonance angiography (MRA).MAIN OUTCOME MEASURES: Results of ERPs, SECF and MRA.RESULTS: Of the 35 TIA patients and 33 control subjects all completed the trial. Examination of ERPs reveled significantly prolonged latency of P300 components of ERP in the TIA group [(336.2±34.2) ms] than that in the control group [(311.3±44.2) ms, P ＜ 0.05]. The scores of span, recall 1,long-term memory, naming of animals, calculation, and recall 2 in SECF in TIA group were all lower than those in control group (39.7±11.9 vs 47.4±12.0; 54.5±14.8 vs 61.8±14.5; 61.1±7.8 vs 64.7±1.7; 59.4±11.0 vs 64.7±8.8; 50.0±14.7 vs 58.1±14.2; 44.6±15.4 vs 53.2±17.8, t=4.151 0-7.292 8, P ＜ 0.05-0.01). MRA identified abnormalities in 33 of the 35 TIA patients (94%), manifested mainly by stenosis and occlusion involving the vertebral artery (54%, 19/35), bilateral anterior, middle and posterior cerebral arteries (40% ,28/70;59% ,41/70;47% ,33/70), basilar artery (5.71%, 2/35) and bilateral internal carotid artery (5.71%, 4/70) respectively.CONCLUSION: TIA patients are characterized by prolonged P300 latency with multiple cognitive impairments especially in memory and cerebral artery stenosis and occlusion as shown by MRA, suggests that TIA patients have persistent low cerebral perfusion and frequently, cognitive dysfunction in the presence of local blood supply disorder in the hemispheres.

Objective To observe the serum concentration of S100βprotein (S100β)and neuron specific enolase (NSE)in patients undergoing supratentorial tumor resection with ulinastatin treat-ment.Methods Twenty-four patients with supratentorial tumor resection,aged 18-65 years,ASA Ⅰor Ⅱ,were randomly divided into the control group (group A,n =12)and ulinastatin group (group U,n =12).Patients in group U received ulinastatin (2 kU/kg)at the beginning of the surgery,with the continuous dose of 1 kU·kg-1 ·h-1 till the end of the operation.Group A received equivalent volume of saline solution as the vehicle control.Blood samples were taken from the artery and jugular venous bulb before induction of anesthesia (T1 ),skin incision (T2 ),1 h after dura openning (T3 ),at the closure of dura (T4 ),at the end of operation (T5 )and 24 h after operation (T6 )to analyze the concentration of S100β and NSE.The concentration of S100β and NSE were determined by ELISA. Results The concentration of serum S100β and NSE increased more significantly higher at T3-T6 in group A than group U (P <0.01).The concentration of serum S100βand NSE in group U were lower than those in group A at T3-T5 (P < 0.01 ).Conclusion Ulinastatin reduces the concentration of serum S100βand NSE during surgery,indicating it alleviates brain injury during supratentorial tumor resection.

Objective To investigate the effect of preoperative anxiety on propofol EC50 for nomovement during Painless gastroscopy.Methods Thirty-one patients (without anxiety) and twenty-seven patients (with anxiety) undergoing gastroscopy under general anesthesia were enrolled on the study.Anesthesia was conducted with a target-controlled infusion (TCI) of propofol.The initial target effect-site propo fol concentration (Ceprop) was 5.0 μg/ml and was adjusted stepwise by 0.5 μg/ml by an up-down sequential method to reach no-movement.Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety (5.32 μg/ml,95％ CI:4.75-5.88 μg/ml vs 4.75 μg/ml,95％ CI:4.48-5.01 μg/ml,P ＜ 0.05).Conclusions During painless gastroscopy,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety when intravenous injected of fentanyl 0.1 μg/kg.

Objective To investigate whether the median(50%)effective effect-concentration(EC50)of propofol inducing loss of consciousness (LOC) varies. Methods 56 patients undergoing gastroscopy under general anaesthesia were enrolled on the study. Anaesthesia was conducted with a target-controlled infusion(TCI) of propofol. The initial target effect-site propofol concentration (Ceprop) was 5.00 μg/mL and was adjusted stepwise by 0.50μg/mL by an up-down sequential method to reach no-movement. Results Propofol EC50 to induce no-movement was higher in patients with anxiety than those without anxiety(6.46μg/mL vs. 5.75μg/mL,P<0.05). Conclusions During general anaesthesia ,patients with anxiety had a higher propofol EC50 for no-movement compared with those without anxiety. Differences in preoperative anxiety levels may reduce anaesthetic effects.

Objective To investigate the effects of light acute hypervolemic hemodilution on early postop-erative cognitive function in elderly patients. Methods A total of 60 patients treated by radical surgery were equally randomized to an AHH and a non-AHH control group.Using the Mini-Mental State Examination scale (MMSE),we evaluated the cognitive function of the patients.We made comparisons between the two groups in the plasma S100β levels at T0(before anesthesia induction),T1(immediately after hemodilution),T2(immediately after operating),T(36 hour after operating)and T(424 hour after operating).Results The S-100β lever at T2、T3 and T4were markedly higher than T0in both groups(P<0.05);At T3and T4,the S-100β lever was higher in non-AHH control group than AHH group(P<0.05).There was no significant difference in the incidence of postopera-tive cognitive dysfunction between the two groups(P>0.05)There was no significant difference in the incidence of postoperative cognitive dysfunction between the two groups(P > 0.05). Conclusions AHH can significantly reduce plasma S100β in elderly patients,but there is no effect on early postoperative cognitive function.

Objective:To investigate the etiology of unilateral sinonasal disease and clinical features. Method:The clinic data of 92 patients with unilateral sinonasal diseases were analyzed. Result:42 cases of chronic sinusitis (31 cases of nasal polyps), 17 cases of nasal inverted papilloma, 9 cases of sinus fungal disease, 6 cases of odontogenic maxillary sinusitis, 3 cases of maxillary choanal polyp, 4 cases of nasal blood vessels tumor, 3 cases of sinus osteoma, 6 cases of sinus cyst, 2 cases of sinonasal malignancies. Conclusion:Among unilateral sinonasal diseases, chronic sinusitis, nasal polyps are very common, but there are still more than half of the other pathological changes, the most common one is the nasal inverted papilloma. Therefore, more attention should be paid to the preoperative differential diagnosis.

The 'Conclusion' section in the Abstract was published incorrectly in the original publication of the article [1] and is corrected with this erratum as below: "Fetal exposure to the Chinese famine may be associated with an increased risk of hypertension in adulthood in women."

Objective : To investigate the neurobehavioral development of young children aged 24 to 60 months in Shunde and explore the factors influencing the development of young children and provide reference for the interven- tion of neurobehavioral development delays in young children． Methods : A retrospective cohort study was used to enroll the young children who were initially screened by the Pediatric Neuropsychological Developmental Scale (Pe- diatric Heart Scale) with a score of ≤85 was included in the study．With a score of ≤85，the young children might be at risk of developmental delays，and needed to be further diagnosed by the GESELL Developmental Diagnostic Scale，the basic information of the young children and their mothers at the time of birth were investigated，as well as basic information about the young children at the time of completing the GESELL Developmental Diagnostic Scale was collected. Results : A total of 271 young children were included，196 males and 75 females．Young children had the lowest developmental quotient (DQ) in the language domain among the five domains (P＜0. 001) ．Multiple lin- ear regression models showed : compared with girls，the language domain DQ of boys decreased by 5. 321 points (P = 0. 049，95% CI : －10. 620 －－0. 021) ，and the personal-social domain DQ decreased by 4. 474 points (P = 0. 023，95% CI : －8. 316 －－0. 631) ．Compared with young children via natural vaginal delivery (NVD) ，the gross motor domain DQ of young children via caesarean section ( CS) decreased by 4. 890 points (P = 0. 008，95% CI : - 8. 499 －－1. 281 ) ，the fine motor domain DQ decreased by 3. 373 points ( P = 0. 037，95% CI : －6. 532 - - 0. 213) ，the language domain DQ decreased by 7. 621 points (P = 0. 004，95% CI : －12. 826 －－2. 416) ，per- sonal-social domain DQ decreased by 6. 232 points (P = 0. 001，95% CI : －10. 006 －－2. 457) ．The results of bi- nary logistic regression models showed，compared with young children via NVD，the risk of gross motor domain retar- dation in young children increased ( OR = 1. 763，95% CI : 1. 003－3. 100) ，the risk of fine motor domain retardation increased ( OR = 2. 217，95% CI : 1. 235－3. 980) ，the risk of language domain retardation increased ( OR = 3. 306， 95% CI : 1. 080 －10. 124) . Conclusion Young children with suspected neurobehavioral delays were more likely to have delayed development in language domain than in other domains，boys had lower DQ in language domain and personal-social domain than girls，and the development of young children via CS was slower than that via NVD．Fo- cus should be on the language development of young children especially on the language and personal-social devel- opment of boys．Carefully chose delivery way．Focus should be placed on assessment of young children's comprehen- sive neurobehavioral development in early time.