Brain injury is the leading cause of death after cardiopulmonary resuscitation.Clinical care for brain injury remains necessary.Therapeutic hypothermia has been shown to be effective in improving neurological outcome of children with cardiac arrest.We routinely induced hypothermia in children with coma after cardiac arrest,targeting 32 ～ 34 ℃,using cooling blankets and intravenous ice cap as primary methods for induction,for 24 ～ 72 h or much more duration,and vigilant re-warming.The objective of this article was to share our hypothermia protocol for cooling children with acute brain injury after cardiac arrest.

Pediatric intensive care unit(PICU) is the last guarantee for children whose lives were threatened.Brain injury are accompanied in many patients,in which ones dying or surviving were associated with whether their cerebral function would be recovered.Closely monitoring the brain function,especially the metabolic balance of cerebral oxygenation to detect cerebral hypoperfusion and low oxygen delivery and timely interventions being introduced can reduce mortality and longterm sequela.Current trends in monitoring cerebral oxygenation are poor in PICUs of our country.It is very helpful in evaluating cerebral function and predicting prognosis from learning characteristics of cerebral oxygenic balance and monitoring methods of cerebral oxygenation.At present,monitoring cerebral oxygen includes intracranial pressure,cerebral perfusion pressure,jugular venous oxygen saturation,brain tissue oxygen tension,cerebral blood flow,and near infrared spectrum technology and so on.

Naphazoline,Diphenoxylate, Over-the-counter (OTC) cough and cold medications, widely used for the symptomatic relief of nasal obstruction, diarrhea or common cold symptoms. But these medicines might cause poisoning even if utilized in recommended doses for treatment. The side effects of these medicines were neglected when they were used much more commonly. The clinical manifestation of these medicine poisoning were delitescence and children' s parents couldn't provide the whole history, so these medicine poisoning were often misdiagnosis, even lead to treatment failure. We explore the toxicities of these medicines ,discuss their mechanisms and clinical manifestation, and suggest why physicians should be more vigilant in specifically inquiring about them when evaluating an ill child.

Objective To discuss the application of cephalocervical CT angiography (CTA) and ABCD2 score in evaluating arterial characteristics and interventional curative effect for patients with transient ischemic attack (TIA). Methods During the period from Jan. 2010 to Jan. 2012, a total of 64 patients with clinically-diagnosed TIA were admitted to authors’ hospital. ABCD2 score evaluation and cephalocervical CTA examination were performed in all patients. The correlation of stenotic degree and distribution of the cephalocervical arteries with the ABCD2 score was analyzed. According to the stenotic degree of the cephalocervical arteries, the patients were divided into low-risk group and mid-to-high-risk group. Twenty-two patients in mid-to-high-risk group received stenting angioplasty treatment. Follow-up was made at 3, 6 and 12 months after the treatment. Results Of 64 TIA patients, cephalocervical artery stenosis was found in 52(81.25%) A total of 149 arterial segments were involved, including intracranial segment (n=81, 54.36%) and extracranial segment (n = 68, 45.64%). Patients in low-risk group mainly suffered slight or moderate arterial stenosis, while patients in mid-to-high-risk group had moderate or serious arterial stenosis (χ2 =10.126, P=0.018). The preoperative ABCD2 score was (6.41 ± 0.50). The ABCD2 scores determined at 3, 6 and 12 months after the treatment decreased to(2.88 ± 0.69), (2.82 ± 0.63) and(3.00 ± 0.71), respectively. The differences were statistically significant (F = 86.657, P < 0.05). Conclusion Cephalocervical CT angiography and ABCD2 score can reliably evaluate the arterial stenosis and interventional curative results in TIA patients.

Objective To investigate the clinic diagnosis value of CT scan and the determination of serum NSE, Cyfra21-1 for SCLC. Methods ① The CT findings and pathologic basis of 220 cases with SCLC were analyzed retrospectively.② Between February 2000 and December 2001, 120 consecutive patients with pulmonary lesions by CT scan, which suspiciously suffered lung cancer, were studied prospectively. Serum samples were obtained by venous puncture from all patients 1 week prior to surgery or puncture biopsy. The serum concentration of NSE, Cyfra21-1 were determinated using ELISA. According to the pathologic result, the diagnostic value of CT scan, NSE and Cyfra21-1 were evaluated.Results ① Most CT findings of SCLC were central and spindly or eggplant-shape mass, hilar and/or mediastinal lymph nodes enlargement.The obstructive pulmonary lesions were found rarely.② Using CT scan, NSE and Cyfra21-1 alone, the sensitivity were 75%,72.5% and 32.5%,the specificity were 73.75%, 83.75% and 48.75%,the accuracy were 74.16%, 81.67% and 43.33% respectively. With combination of CT scan and NSE, the diagnostic accuracy was 78.3%, and the sensitivity was 87.5%. However, CT scan combined with Cyfra21-1 can not be improve the diagnostic value. Conclusion SCLC has specific CT findings. The sensitivity of CT scan was 75%, combinated with NSE, its accuracy was higher(78.3%), and the sensitivity was 87.5%.

Object To provide a basis for the identification and quality control of the crud drugs of Costus L.. Methods Morphological and histological characters of the rhizomes of Costus spectosus (Koen.) Smith, Costus lacerus Gagnep.and Costus tonkinensis Gagnep. were described and illustrated, respectively. TLC of the above drugs was finished. Microscopical characters of the epidemis of leaves of these species were also compared. Results The characters involving the vessel order in vascular bundle ring at the inner side of pericycle in the transverse section, calcium oxalate crystals occurred in the vessel, the characteristic calcium oxalate crystals in the cortex and cork cell and the TLC qualitative analysis for diosgenin, etc. are important for identification of Costus L.. Conclusion These three crude drugs can be identified by the above research results.

Purpose To analyze the imaging manifestations of solitary fibrous tumors (SFT) so as to improve its diagnosis. Materials and Methods The CT and MRI findings of 24 patients with SFT confirmed pathologically were analyzed retrospectively and compared respectively with their pathological results in terms of lesion's location, size, shape, density (signal), type of enhancement and relationship with the surrounding tissues. Seven patients underwent MRI scan, 5 were with enhanced scan; 17 patients were carried out plain CT scan and 11 were with enhanced CT scan. Results The lesions in the 23 cases were solid and 1 was solid and cystic. Through the imaging diagnosis, 20 cases were diagnosed as benign tumors, 2 cases were diagnosed as malignancies, and 2 benign tumors were misdiagnosed, which showed that the diagnose accordance rate was 91.7%(22/24). On plain CT scans, 5 lesions (maximum diameter<4 cm) showed homogeneous density; 7 cases (maximum diameter>5 cm) showed heterogeneous density, 4 of which had calcification and 7 had necrosis; the shapes were round-like or lobulated. On enhanced CT scans, 5 cases presented progressive enhancement pattern, 5 cases showed fast-in and slow-out pattern, 1 case showed slight enhancement pattern. On MRI scan, 4 cases of the solid part of tumors showed isointensity signals on T1WI and isointensity or slight hyperintensity signals on T2WI, 3 cases showed isointensity or low signals on T1WI and low, isointensity or slight hyperintensity signals on T2WI, and slight hyperintensity signal on DWI, the solid part of tumors were strongly enhanced. Two malignant tumors presented features like heterogeneous density, unclear boundary, invasive growth and progressive enhancement pattern. The pathological findings demonstrated that the tumor tissues mainly consisted of spindle cells with rich fibers and vessels. Conclusion The imaging findings of benign and malignant SFT have certain features, malignant SFT have invasive growth signs. The obvious progressive enhancement of solid component which shows isointensity and hyperintensity on T1WI or T2WI may be helpful in the diagnosis of SFT; however, the final diagnosis should be confirmed with histopathology.

Aim To study the protective effects of Paeoniflorin (PF) on dopaminergic neurons in brain slice of substantia nigra treated with MPP~+ and to investigate the transcription of alpha-synuclei (α-syn) mRNA.Methods The organatypic brain slice culture of substantia nigra prepared from neonatal SD rats was placed on Millicell-CM porous membranes and cultured to day-10.Then the cultrues of slice were treated with different concentrations (0.1,0.5,1.0 mmol·L~(-1)) of MPP~+ for 24 h.Some of the cultrues treated with 0.5 mmol·L~(-1) MPP~+ also received PF (1 or 10 μmol·L~(-1)).Slices cultured in normal medium were used as vehicle control.The tyrosine hydroxylase (TH) immunohistochemical staining with the cell counting was used to determine the dopaminergic neruons.The transcription of α-syn mRNA was examined by real-time quantitative RT-PCR.Results MPP~+(0.1,0.5,1.0 mmol·L~(-1)) exposure markedly decreased the number of TH~+ cells in a dose-dependent manner (P<0.05 or P<0.01) and sharply induced the transcription of α-syn mRNA (P<0.01) in slices treated with 0.5 mmol·L~(-1) MPP~+.The addition of PF (10 μmol·L~(-1)) to MPP~+-treated slices significantly increased dopaminergic neurons survival (P<0.01) and downregulated the transcription of α-syn mRNA significantly (P<0.05).Conclusion PF can effectively inhibit the injury of dopaminergic neurons induced by MPP~+ on brain slice of substantia nigra and downregulate the transcription of alpha-synuclein.

Researchers subjective emphasis on application for the project,contempt to complete the project.To safeguard the research projects carried out smoothly and successfully completed,improve hospital credibility,the hospital in many ways to strengthen the scientific research project management,such as creating a strong scientific and academic atmosphere,the establishment of preresearch funds,hospital research,enhance service awareness,the establishment of the project evaluation system to strengthen the management of project mid-term and node title,funds management,effectively promoted the development of the hospital research.

Objective To evaluate the diagnostic value and clinical significance of 1.5T MR multiple sequence for atrial septal defect (ASD) and ventricular septal defect (VSD).Methods To collect the data of MRI and transthoracic echocardiography(TTE)of 46 patients with ASD/VSD,Among them,12 patients had surgical treatment,27 patientsDSA treatment and 7 patients no surgery or DSA treatment. The biggest defect diameter was recorded which measured by TSE,GRE,PC-MR and TTE,and the main deformity,valvular regurgitation, atrioventricular enlargement,cardiac function,maximum aperture of ASD/VSD were recorded which were confirmed by surgery.Al-so,myocardial delayed reinforcement was recorded.Results Multiple sequence check of MRI found different number of defects in 39 patients(7 patients without surgery or treatment removed );the largest defect aperture of ASD/VSD measured by TSE、GRE、PC-MR had no statistically significant(P >0.05)with TTE measurements,they had good correlation with TTE (r=0.86,0.94,0.99) (P >0.05),and PC-MR had the highest consistency with TTE.The measured results of GRE,TTE,surgical in 14 ventricular sep-tal defects of 12 cases had no statistically significant(P >0.05).the largest defect aperture between myocardial delayed reinforce-ment and not delayed reinforcement had statistically significant in 41 cases of ASD(P <0.05).MRI had more advantage in the right heart enlargement and right heart function than TTE,the differences between the two had statistically significant(P <0.05).And MRI could find intracardiac deformity and outside the heart malformation in ASD/VSD,especially outside the heart malformation. Conclusion 1.5T MR multiple sequence inspection have high diagnostic value for ASD/VSD,which can display ASD/VSD clearly, measure the defect aperture accurately,find merged deformity accurately,and can also show myocardial delayed reinforcement and judge heart function.