Objective:To evaluate the effect of intraoperative dexmedetomidine (DEX)infusion during propofol intravenous anesthesia on postoperative recovery after major spinal surgery.Methods:Sixty pa-tients aged 1 8 to 65 (American Society of Anesthesiologists,ASA Ⅰ -Ⅱ),scheduled for spinal surgery from January 201 4 to May 201 4 were randomized into two groups.The DEX group (n =30)received 0.5 μg/kg of DEX ten minutes before anesthesic induction,followed by an infusion of DEX at 0.2 μg/(kg·h)intraoperatively and the control group (n =30)was given identical amounts of normal saline. At the end of surgery,the patients of both groups received patient-controlled intravenous analgesia (PCIA)with morphine 0.5 mg/h (1 mg demand dose and 8 min lockout).Heart rate and mean arterial pressure (MAP) were continually monitored during operation and in the post-anesthesia care unit (PACU).The propofol and sufentanil consumptions during operation and the morphine consumption 48 h after surgery were recorded.The time for recovery and extubation were recorded.The followed-up evalua-tions were performed to assess Ramsay scores,visual analogue scale (VAS)pain scores as well as side effects in PACU and 48 h after surgery.Results:Heart rate of DEX group was lower than that of control group after intubation and extubation and in PACU 1 0 min (P <0.05).MAP was lower in DEX group than that in control group after extubation and in PACU (P <0.05).Compared with control group,the propofol consumption during anesthesic induction,the sufentanil consumption during operation and the cumulative consumption of morphine 2 h and 6 h after surgery were decreased (P <0.05).There were no differences between the two groups as to the time for recovery or extubation.Compared with control group,the VAS pain scores were significantly decreased (P <0.01 ),the incidence of postoperative nau-sea and vomiting in DEX group were significantly decreased (P <0.05)48 h after surgery.Conclusion:Intraoperative infusion of DEX improved quality of recovery,provided good analgesia,and decreased morphine use and the incidence of postoperative nausea and vomiting after major spinal surgery.

Objective To explore the diagnostic value of nerve root sedimentation disease to symptomatic lumbar spinal stenosis (LSS) and nonspecific low back pain(LBP).Methods One hundred and eighty lumbocrural pain patients in the People's Hospital of Binzhou from Jan.2010 to Jun.2013 were divided into LSS group and LBP group,and 90 patients in each group.The rate of nerve root sedimentation in two groups was recorded.Results There were 84 cases(93.3％) with positive nerve root sedimentation in group LSS,while 0 case in LBP group,and the difference was significant (P =0.000).The pain visual analogue score (VAS) between the two groups were no significant difference (P ＞ 0.05).The Oswestry disability index (ODI) in LSS group was (60.3 ± 5.1) ％,lower than that in LBP group (66.4 ± 6.3) ％,and the difference was statistically significant (P =0.021).Cross-sectional area (CSA) of the LSS group was (68.9 ± 7.0) mm2,lower than that in LBP group ((168.2 ± 13.8) mm2),and the difference was statistically significant (t =26.173,P =0.000).There was no significant correlation between ODI and CSA (r =0.18,P =0.098).Conclusion The nerve root sedimentation disease is higher in LSS patients and positive of sedimentation disease can serve as a diagnosed marker of LSS.

Objective To evaluate the sickle renal parenchyma incision for the removal of complex staghorn renal calculi. Methods Sickle parenchyma incision was used to remove stones in 37 patients with complex staghorn renal calculi.The procedure was as follows:the kidney was disected free and the pelvis within sinus renalis was isolated.Two rows of botton style sutures were made on the renal parenchyma with 2-0 plain catgut along mid-lower 1/3 of the dorsal surface of kidney free of vessels (Brodie's line) from the renal posterior lib to the plane of lower major calyx.The renal parenchyma was opened.Then,the incision was developed from the plane of lower major calyx through the middle major calyx to the plane of upper major calyx.The shape of this incision appeared like a sickle.The renal parenchyma and each calyx along this incision were opened and so was all the stones could then be easily removed.The calyces could well be observed. Results The calculi were completely removed in all the 37 cases.21 needed intraoperative blood transfusion and the mean amount of blood was 120 ml.KUB+IVU were normal 4 weeks postoperatively with improved hydronephrosis,no intrarenal stricture and void of residual calculi. Conclusions This procedure has the advantages of little intraoperative bleeding,slight impairment of renal function,high clearence rate and is indicated for the removal of any intrarenal pelvis complex staghorn calculi.

ObjectiveTo explore puncture point and angle of skin for unipedicular vertebroplasty by imaging measurement and combining clinical practice in order to pr vide reference for clinical work.MethodsCT images of thoracic and lumbar vertebrae of imaged with multislice helical CT were random chosen.From high to low position vertebrae of easy fracture T6 to -L5,its angle between vertebraI pedfcle stalk line and 1/3 of vertebraI body stalk line fore and median of point of intersection was measured.The angle of sternocostal joints route was also measured.At the same time the distance between site of skin puncture and spinous process was measured.ResultsThe angle between the thoracic vertebraI pedicle and sagittal section was (28.2 ± 3.8) °,the lateral distance of the spinous process was ( 31.6 ± 5.4) mm.The angle of thoracic vertebraI pedicle lateral route was (35 ± 3.4) °,the distance was ( 55.2 ± 5.3 ) mm.In the lumbar vertebrae pedicle route,the angle of L1 -L4 was (29.3 ± 5.6 ) °,the distance was (38.4 ± 4.5 )mm.Ls was (39.2 ± 3.3) °,the distance was ( 71.6 ± 6.2) mm.Combining clinical practice,the lateral distance of the spinous process in thoracic vertebraIpedicle route,the best puncture point was 30 mm,in thoracic vertebraI pedicle lateral route it was 40 mm,in L1-L4 it was 45 mm,in L5 it was 60 mm.ConclusionsThe unipedicular vertebroplasty can be performed rapidly,accurately and safely,and it reduces complications,cost and time.

Intra-atrial re-entrant tachycardias (IARTs) are common late after heart surgery. Conventional mapping and ablation is relatively difficult because of the complicated anatomy and multiple potential re-entry loops. In this study we aimed to evaluate the electrophysiological characteristics and radiofrequency catheter ablation of atrial tachycardia (AT) induced by myocardial scar or incision. Methods In 6 patients (three male and three female, aged 33.3+ 11.8 years) who had AT related to myocardial scar or incision,electrophysiological study and radiofrequency catheter ablation (RFCA) were performed. Earliest activation combined with entrainment mapping was adopted to determine a critical isthmus. Results Re-entry related to the lateral atriotomy scar was inducible in 5 of6 patients. With entrainment mapping, the PPI (post-pacing interval)-TCL (tachycardia cycle length) difference was ＜30 ms when pacing at the inferior margins of the right lateral atriotomy scar. Among them, 3 patients had successful linear ablation between scar area to inferior vena cava, and 2 patients between scar area to tricuspid annulus. Re-entry involving an ASD patch was demonstrated in 1 of 6 patients. PPI-TCL differences ＜30 ms were observed when entraining tachycardia at sites near the septal patch. But linear ablation failed in terminating AT. There was no complication during procedure. No recurrence of AT related to incision was observed during follow-up except for the failed patient. Conclusion Under conventional electrophysiological mapping, adopting linear ablation from scar area to anatomic barrier, successful ablation can be obtained in patients with IRATs related to myocardial scar or incision.

Objective To investigate the activation of β-sheet breaker peptide H102 on ERK signal transduction pathway in brain of PAP double transgenic mice. Methods PAP double transgenic mice were randomly divided into model group and H102 treatment group (n=10 for each group). A group of C57BL/6J mice with the same genetic background was served as controls. H102 (5.8 mg/kg) 5 μL was infused by intranasal administration to mice in H102 treatment group, and equal volume of blank solution of H102 (chitosan, BSA) was given to mice in control group and model group. The ability of spatial reference memory was tested by Morris water maze after 30 days of treatment. Then immunohistochemistry tests and Western blot technique were used to detect the content of RAS, P-MEK and P-ERK proteins in mouse brain. Results (1) The ability of learning and memory was significantly lower in model group than that of control group. The ability of learning and memory was significantly improved in treatment group than that in model group (P<0.05). (2) The contents of RAS, P-MEK and P-ERK in mouse brain were significantly lower in model group than those of control group, and these protein ex-pressions were significantly increased in treatment group than those in model group (P<0.01). Conclusion β-sheet break-er peptide H102 can activate ERK signal transduction pathway in brain of PAP double transgenic mice, increase PAS, P-MEK and P-ERK levels in nerve cells, and improve the ability of learning and memory in PAP mice.

Objective To discuss the ultrasonic features and diagnostic value of high frequency ultrasound in the diagnosis of the injury of triangular fibrous cartilage complex (TFCC) of wrist joint.Methods The ultrasonic features of 32 patients with pathology confirmed unilateral TFCC injury were retrospectively analyzed.The preoperative MRI and ultrasound data were complete.The difference between the two methods in diagnosis of TFCC injury were contrasted.Results The major ultrasonic features of the injure of TFCC included form swelled,structures disorganized,inhomogeneous echoes,irregular echoless in damaged place.The flow signals could be displayed from the tear opening edge of the injured TFCC by CDFI.Among 32 cases of TFCC injury,there were 26 cases (26/32,81.25％) diagnosed by ultrasound and 27 cases (27/32,84.38％) diagnosed by MRI.There was no significant difference in the detection rate of the two methods for TFCC injury (x2 =0.143,P=0.706).Conclusion High frequency ultrasound can be used to diagnose the injury of TFCC accurately,and can provide imaging evidence simply and rapidly for clinical therapy.

This investigation was made to reveal the current status, research trend and research level of biomedical engineering in Chinese mainland by means of scientometrics and to assess the quality of the four domestic publications by bibliometrics. We identified all articles of four related publications by searching Chinese and foreign databases from 1997 to 2001. All articles collected or cited by these databases were searched and statistically analyzed for finding out the relevant distributions, including databases, years, authors, institutions, subject headings and subheadings. The source of sustentation funds and the related articles were analyzed too. The results showed that two journals were cited by two foreign databases and five Chinese databases simultaneously. The output of Journal of Biomedical Engineering was the highest. Its quantity of original papers cited by EI, CA and the totality of papers sponsored by funds were higher than those of the others, but the quantity and percentage per year of biomedical articles cited by EI were decreased in all. Inland core authors and institutions had come into being in the field of biomedical engineering. Their research topics were mainly concentrated on ten subject headings which included biocompatible materials, computer-assisted signal processing, electrocardiography, computer-assisted image processing, biomechanics, algorithms, electroencephalography, automatic data processing, mechanical stress, hemodynamics, mathematical computing, microcomputers, theoretical models, etc. The main subheadings were concentrated on instrumentation, physiopathology, diagnosis, therapy, ultrasonography, physiology, analysis, surgery, pathology, method, etc.
Authorship ; Bibliometrics ; Biomedical Engineering ; statistics & numerical data ; China ; Databases, Bibliographic ; statistics & numerical data ; Manuscripts, Medical as Topic ; Periodicals as Topic ; statistics & numerical data ; Publications ; statistics & numerical data

Objective To study the effect and histocompatibility of urethral extracellular matrix in repair of traumatic urethra defects in rabbits. Methods Model of traumatic urethral defects was made by resecting 1.0-1.5 cm segment of the urethra in 20 rabbits. Then, the defects were repaired by a tube of extracellular matrix of the same length. The dynamic changes of CD4+, CD8+ T cell and CD4+/CD8+ in peripheral blood were detected by flow cytometry at 1,2, 3 and 4 weeks after operation. In the meantime, the immunity response of rabbits was evaluated by lymphocyte transformation test. The repaired segments stained with hematoxylin-eosin (HE) and Van Giesen were studied by histologic and pathologic observations at 10 days, 3, 6 and 24 weeks postoperatively. The urodynamics, urethroscopy and urethrography were performed at 24 weeks postoperatively. Results There was no significant difference in aspects of stimulative index of lymphocyte transformation, T lymphocyte subsets CD4+, CD8+ T cell and CD4+/CD8+ between experimental group and negative control group. Urothelium covered the whole surface of the matrix tube three weeks after operation. The smooth muscle cells increased nearly to normal urethral wall at 24 weeks. Urethrosoopy and urethrography showed glossy matrix tube. There was no statistical difference upon urodynamies between experimental group and control group. Conclusion The urethral extracellular matrix has good histocompatibility and may be a safe and effective material for repairing urethra defects.