Objective To study the effect of sevoflurane or propofol/remifentanil general anesthesia undergoing gynecological surgery.Methods A total of 80 patients scheduled for selected gynecological surgery were divided into sevoflurane group or propofol/remifentanil group by random digits table method and 40 cases in each group.The induction of anesthesia was conducted with midazolam,propofol,sulfentanil,and rocuronium.After tracheal intubation,anesthesia was maintained with sevoflurane in sevoflurane group,and with propofol/remifentanyl target-controlled infusion in propofol/remifentanil group.Bispectral index was monitored in each group,and which was maintained 40-60.Blood pressure and heart rate was observed.At the end of operation,all anesthetics were discontinued,and the time of consciousness recovery,tracheal extubation,orientation was recorded.The incidence of agitation,nausea and vomiting within 24 h after surgery and the use of rescue drugs such as epinephrine,atropine or urapidil was recorded.Results No statistically significant difference was observed with respect to the time of consciousness recovery,tracheal extubation,orientation between two groups (P ＞ 0.05).The use of atropine and epinephrine in sevoflurane group was lower than that in propofol/remifentanil group [7.5％(3/40) vs.22.5％(9/40),20.0％(8/40) vs.32.5％(13/40)],and there was significant difference(P ＜ 0.05),and the use of urapidil in sevoflurane group was higher than that in pmpofol/remifentanil group [22.5％ (9/40) vs.2.5％ (1/40)],and there was significant difference (P ＜ 0.01).There was no statistically significant differences with respect to the incidence of agitation,nausea and vomiting within 24 h after surgery between two groups (P ＞0.05).Conclusion Propofol/remifcntanil and sevoflurane both provide satisfactory anesthesia for gynecological surgery.

Childhood autism is an extensive developmental disorder.Abnormal neuroimaging and neuropathology brain structure research of autistic children in recent years are reviewed in this paper.Brain structure researches have showed the brain volume increased in children with autism,normally occuring to the frontal lobe,temporal lobe.Brain function researches have shown that children with autism have abnormal activity in the fusiform gyrus,superior temporal gyrus,and inferior frontal lobe.Brain metabolites studies have shown that children with autism present glutamate and gamma-aminobutyric acid and serotonin metabolism disorder.Immunological studies have found that children with autism have proinflammatory factor and the emergence of a brain protein antibody.

Blood vessels are indispensible for tumor growth and metastasis.Traditional antiangiogenic strategy reduce the density and the supply of tumor blood vessels.Recent studies have shown that antiangiogenic therapy has transient and insufficient efficacy.Blockage of blood and oxygen supplies creates a hypoxic and acidic microenvironment in the tumor tissues,which fosters tumor cells to become more aggressive and metastatic.Tumor vascular normalization may be an alternative approach to treat cancers,normalize the disorganized tumor vasculature,rather than disrupting or blocking them,thus reduce tumor hypoxia as well as increase the efficacy of chemotherapy,radiotherapy and immunotherapy.

Objective To investigate the prognostic factors of young stroke patients with conventional treatment,and provide the basis for clinical diagnosis and treatment of stroke.Methods The clinical data of 72 cases of young stroke patients with conventional treatment were analyzed retrospectively.The prognostic factors were analyzed.Results In seventy-two cases of young stroke patients,18 cases of conventional treatment failed (25.00％,18/72).Univariate analysis showed that smoking,alcohol,underlying disease,dysphagia,barthel index (BI) score,U.S.national institutes of health stroke scale (NIHSS) score and Oxford handicap scale (OHS) score was closely related with the prognosis (P ＜ 0.05 or ＜ 0.01).Logistic analysis showed that the age,BI score,NIHSS score,OHS score and underlying diseases was the independent prognostic factor for young stroke patients.Eighteen cases who failed in conventional treatment fails accepted comprehensive rehabilitation treatment.Compared with that before treatment,1,3,6 months after treatment BI,NIHSS and OHS scores were significantly decreased (P ＜ 0.05).Conclusions BI,NIHSS,OHS score and underlying diseases are the independent prognostic factor for young stroke patients.Surgery and postoperative comprehensive rehabilitation in young stroke patients who failed in conventional treatment can improve patient's outcomes and prognosis.

Objective To explore the clinical value of detecting T cell subsets,immunoglobulin(Ig) ,erythro-cyte sedimentation rate(ESR),C-reactive protein(CRP) in patients with juvenile rheumatoid arthritis(JRA). Meth-ods T cell subsets(CD3+ , CD4+ , CD8+ , CD16+CD56+) was detected with flow cytometer, Ig, CRP with rate nephelome-try,ESR with Westergren's method in 40 cases of JRA,and other 40 normal children were served as normal control group. Results The level of CD3+ ,CD8+ ,CD16+CD56+ in the JRA group were lower,but CD4+ was higher than those in normal control group(P< 0.05 all) ;the level of IgA, IgG, IgM, ESR, CRP in the JRA group were all higher than those in the normal control group( P < 0.05 ). Conclusion There is an inflammation in patients with JRA, and when disease activity there is an immunological aberrance with cellular and humoral immunization.

Objectives:To determine the common allergens of patients with allergic rhinitis in Chongqing.Methods:A total of 738 cases who were diagnosed as allergic rhinitis by history and clinical presentation,underwent a skin prick test with 11 standardized aeroallergens and 10 ingestive allergens,and the important sensitizing allergens were assessed.Difference of skin prick test responses at various ages and with different gender was investigated.Results:The percent of patients with positive skin tests in inhalation allergens were as follows,dust(91.33%),acaridan(83.88%),prevemal pollen(68.97%),late spring pollen (66.67%),estivoautumnal pollen (61.25%),tobacco (58.94%) and cockroach (55.28%).Allergens in food were mainly prawn (62.47%) and crab(60.43%).Conclusion:The study shows that the dust,acaridan,prevemal pollen,late spring pollen and estivoautumnal pollen are the most important allergens in Chongqing region.

Objective　To evaluate the value of ultrasound in the diagnosis of benign and malignant ovarian teratomas.Methods　The ultrasonographic imaging features of eighty-four cases of benign and malignant ovarian teratomas were viewed by two dimensional and color Doppler ultrasonography.Results　Eighty-four cases were confirmed by pathology report that seventy-eight cases were ovarian teratomas.The accurate rate of ultrasound diagnosis was 92.9%(78/84).Among these cases,tumors which on the single side existed in sixty-nine cases (two tumors existed on the same side in two cases),and which on double sides existed in nine cases.Eighty-nine tumors were checked out all together.The ultrasonographic images of the ovarian teratomas displayed three types: mix(65 masses) , false solid (14 masses) and cyst (10 masses) type. Mix type was the major (occupied 65/89,73.0%). Multiplicate signs are shown in all of them. Malignant teratomas (3 masses,4 masses) not only appeared similar,but also more complex than the benign.Conclusions　Ultrasonography is the first examination to be selected to diagnose teratoma of the ovary. Their ultrasonographic images are charaeteristic. If the images appears disorderly inside, the malignancy should be predicted with other clinical materials.

Objective To explore the efficacy and safety of coflex interspinous dynamic fixation device implantation in the lumbar spinal stenosis. Methods Eighty-three patients with lumbar spinal stenosis were randomly divided into two groups, and 80 cases were followed up. Coflex group (38 patients) received coflex implantation,posterior lumbar interbody fusion (PLIF) group(42 patients) received PLIF treatment. Indicators of surgical trauma degree (operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time),indicators of clinical effect (waist and leg pain VAS scores,Japan Orthopaedic Association JOA score,Oswestry functional disability index ODI score),intervertebral space height and median sagittal diameter (MSO) were measured and compared between the two groups. Results In the Coflex group, the operation time, blood loss volume, wound drainage volume within 48 hours, incision pain (VAS) score after surgery 3 days,postoperative ambulation time were (104.3 ±9.5) min,(230. 7 ±29.6) ml,(110. 6 ±34. 5)ml,3. 2 ±1.3, (13. 6 ±2.0) d,which were significantly lower than those of (174. 6 ±24. 2) min,(536. 8 ±163.3) ml, (319. 2 ± 142. 8) ml,4. 8 ±2. 7, (15. 7 ±2. 6) d in the PLIF group(t= 16. 720,11. 380,8. 771,3. 320,4.018,Ps <0. 01). In the back and leg pain VAS score,JOA score,ODI score,intervertebral height and MSD,indicators after surgery were significantly improved than before surgery in both groups(Ps <0. 01). There were no significant difference before and after treatment 12 months in both groups (Ps >0. 05) on severe complications such as internal fixation loosening and spinous process fractures.Conclusion The two surgical methods both can effectively increase the foraminal area and intervertebral height to maintain the stability of the spinal posterior colum. However, Coflex interspinous dynamic fixation device implantation had more advantages,such as shorter operation time,less bleeding,less trauma,and early functional exercises.

Overexpression of DNA methyltransferases(DNMTs)is observed in many tumors. Overexpressed DNMTs silence tumor suppressor genes by catalyzing the methylation of CpG islands within the promoter regions, and therefore promote the neoplastic transformation of normal cells. Highly elevated DNMT activities have been observed in cancers including gastrointestinal cancers, breast cancer, and lung cancer and have been associated with cancer development and prognosis. Drugs and targeted therapies that inhibit DNMT activities can reactivate methylated tumor suppressor genes, promote apoptosis, and thus inhibit tumor growth.

Objective To evaluate the therapeutic efficacy and complications of fluoroscopically guided double balloon dilation in the treatment of benign colorectal anastomotic strictures. Methods Under fluoroscopic guidance, 17 patients with benign colorectal anastomotic strictures underwent transanal double balloon dilation, including 13 patients underwent resection for malignant disease, and 4 for benign conditions. 16 out of 17 patients had difficulty or frequent defecation due to partial obstruction. The remaining one patient had the stricture detected by endoscopy and barium enema after total proctocolectomy and a temporary ileostomy for ulcerative colitis. Therapeutic efficacy and complications were evaluated in the follow-up visits. Results Seventeen patients received double balloon dilation in a single session. The diameter of double balloon catheter was arranged from 30 to 40 mm. Technical success achieved in all 17 patients with complete release (n = 12, 71%) or incomplete one (n = 5, 29%) and 100% improvement of symptoms was achieved in all patients, together with no major complications such as perforation or severe hemorrhage. During the mean follow-up of 23 months (range, 1 - 62 months), one patient (6%) developed a recurrent stricture and needed a second balloon dilation six months after the initial balloon dilation. Conclusions Fluoroscopically guided double balloon dilation is an effective and safe method for treating benign colorectal anastomotic strictures. (J Intervent Radiol, 2006, 15: 543-546)