35 % and the intraoperative blood loss was expected to be 800-1 600 ml. The operations were performed under combined general-epidural anesthesia. General anesthesia was induced with fentanyl 2-4 ?g?kg-1 , thiopentone 5 mg?kg-1 and succinylcholine 1.5mg? kg-1 and maintained with isoflurane inhalation and intermittent iv boluses of vecuronium. Epidural anesthesia was performed at T5-6 (thoracic surgery), T10-11 (upper abdominal surgery) or L3-4 (lower abdominal surgery) . A mixture of 0.1% lidocaine +0.2% dicaine was used for epidural block during operation. The patients were randomly divided into 2 groups: (1) ANIH group ( n = 18) and (2) AHH group ( n = 20) . Blood volume (BV) was calculated according to following formula: BV (ml) (male) = Height (cm)? 28.5 + Body weight (kg) ? 31.6 - 2 820,BV(ml) (female) = Height(cm)? 16.25 + Body weight (kg) ? 38.46 - 1 369. 1 000-1 200 ml of 6% HES (200/0.5) and 500 ml of lactated Ringer's solution (about 25%-30% of BV) were infused at a rate of 50ml?min-1 when induction of anesthesia was started in both groups. In group I (ANIH) 400-600 ml of blood (about 10%-15% of BV) was removed through radial artery before induction of anesthesia. The removed blood was reinfused at the end of surgery. Vital signs (BP,HR,CVP and ST-T changes) , Hct, oncotic pressure and arterial blood lactate concentration were monitored during operation. Results The vital signs were fairly stable during perioperative period in both groups. Transient hypotension developed in 16.7% (3/8 in group Ⅰ ) and 15.0% (3/20 in group Ⅱ ) of patients during induction of anesthesia. CVP was significantly elevated in both groups but the increase in CVP was significantly higher in group Ⅱthan that in group Ⅰ . In group Ⅰ (AN1H) moderate hemodilution was achieved (Hct = 29.9% 2.9%) while in group Ⅱ (AHH) only mild hemodilution was achieved (Hct = 32.9% ?2.9%) .Hct was significantly higher in group Ⅰ(31.5% ?5.1%) than that in group Ⅱ (27.7% ?3.6%) at the end of surgery. Blood loss was comparable between the two groups, and oncotic pressure and blood lactate level were within normal range in both groups. Conclusion ANIH is more effective and safer than AHH without obvious adverse effects, and can avoid exceedingly high CVP commonly seen in AHH. ANIH is a hemodilution technique of choice in the elderly patients.

Objective To study the effects of hypoxic preconditioning on the Fos and Jun expression and apoptosis in cultured rat hippocampal neurons after anoxia\|reoxygenation. Methods The hippocampal neurons cultured for 12d from control and hypoxic\|preconditioning groups were exposed to anoxia environment (0\^90?l/L N\-2+0\^10?l/L CO\-2) for 4h and than reoxygenated for 24h and 72h.The expression of Fos and Jun were revealed immunocytochemically using the antiserum against Fos and Jun.The apoptosis was examied using the terminal deoxynucleotidyl transferese\|mediated biotinylated deoxyuridine triphosphate nickel and labeling(TUNEL) method and flow cytometric analysis. Results The increased of percentage of Fos and Jun positive neurons and apoptosis neurons in cultured hippocampal neurons after anoxia\|reoxygenation than those in befor anoxia.The precentage of Fos and Jun positive neurons and apoptosis neurons were less in the hypoxic\|preconditioning group than that in control aftre anoxia\|reoxygenation.Conclusion\ Hypoxic\|preconditioning increases tolerance of hippocampal neurons to anoxia and decreases the precentage in Fos and Jun expressing neurons and apoptosis neurons in hippocampus aftre anoxia\|reoxygenation in vitro. \;[

Objective To evaluate the clinical effects and adverse reaction of somatostatin combined with raw vegetable oil in treatment of intestinal obstruction From Tongchuan City People's Hospital were conducted through clinical medication.Methods From August 2012 to August 2015,A total of 364 cases of intestinal obstruction were randomly divided into observation group (182 cases) and control group (182 cases).Two groups were treated with the non-surgical treatment based on basic therapy,including gastrointestinal decompression,correctional of water,electrolyte disturbance and acid-base imbalance to prevent infection and toxication by sedative and spasmolytic.The non-surgical treatment was invalid or worse,the surgical treatment wasselected.Additionally,on the basis of non-surgical treatment,somatostatin combined with raw vegetable oil was additional treatment for the observation group.The comparison of thecurative effect,surgical treatment rate,gastrointestinal decompression,hospital stays and adverse reaction of two groups was conducted.Results The curative effect of observation group (80.22％)was superior to control group(68.68％).Compared to control group,the cases of adverse reaction in observation group was insignificantly increased (x2 =8.58,P ＜ 0.05).Conversely,the observation group showed lower surgical treatment rate (29.67％ vs 40.11％,x2 =4.37,P ＜ 0.05),lower gastrointestinal decompression [(224 ± 171) ml/d vs (543 ± 186) ml/d,t =-21.28,P ＜0.05)],and less hospital stays [(6.14 ± 2.04) d vs (10.26 ± 3.12) d,t =-4.78,P ＜ 0.05)].Conclusions The basic therapy and somatostatin combined with raw vegetable oil showed high efficiency,and cases of adverse reaction was insignificantly increased.It was worthy of promotion and application.

Background and purpose: Langerhans cell histiocytosis (LCH) is a rare complex reticulocndotheliai disease that often invades the head and neck. There in no consensus of treatment. Radiation is one of the treatment options for the localized lesions. Our aim in the study was to analyze the radiotherapeutic efficacy for LCH in the head and neck region. Methods: 8 patients with eosinophilic granuloma (EG) and 1 case with Hand-Schuller-Christian disease (HSC) were treated with radiotherapy in our hospital from July 2000 to May 2007. Their clinical data were retrospectively analyzed. Results: 5 cases of EG were treated with tumor partial excision and radiation, while the other 3 cases of EG were given radiation alone after biopsy. The HSC was administered with radiation and endocrine therapy. All the patients were followed up for 1.5-8 years. The response rate was 89%. Conclusion: Radiotherapy of LCH is an effective modality, but the optimal dose needs to be further studied.

Objective To explore the value of phase-contrast magnetic resonance imaging (PC-MR) in diagnosis of secundum atrial septal defect (ASD) in pediatric patients. Methods Totally 42 patients (aged from 9 months to 15 years) with secundum ASD proved with tansthoric echocardiographic (TTE) were evaluated with PC-MRI. Images of the flow through ASD were obtained with PC-MRI. The distances of ASD rim to superior vena cava (SVC), inferior vena cava (IVC), atrioventricular valves (AVV) and right upper pulmonary vein (RUPV), as well as the entrances of the vena cava and right upper pulmonary vein (RUPV) were assessed. Results The sizes of ASD and distances of ASD rim to the adjacent structures (SVC, RVC, AVV and RUPV) at PC-MRI were well consistent with those of TTE in 42 patients (P<0.001). PC-MRI results in 26 patients correlated well with surgical results (P<0.001). With different velocity encoding, compared with surgical results, measurements of ASD's sizes were more accurate when setting velocity from 50 to 70 cm/s than 90 cm/s. Conclusion The shape of ASD can be virtually depicted with PC-MRI. PC-MRI can accurately assess the defect size, number, rim distances to adjacent structures, therefore providing a new method for depiction of congenital heart anomaly.

Objective To investigate the effects of postoperative sleep deprivation on the expression of choline acetyltransferase (ChAT) in hippocampi of aged rats.Methods Forty-eight male Wistar rats,aged 20 months,weighing 500-600 g,were randomly divided into 4 groups (n =12 each) using a random number table:control group (group C) ; operation group (group O) ; sleep deprivation group (group S) ; postoperative sleep deprivation group (group OS).Sleep deprivation was induced in the rats by housing them on small platforms over water.They fell into the water if they lost muscle tone.All the rats had free access to food and water.In group OS,splenectomy was performed,and all the rats underwent 24 h sleep deprivation after the rats were awake.All the rats underwent 24 h sleep deprivation at the corresponding time point in group S.Morris water maze test was carried out at 24 h after operation.The number of ChAT positive cells in the hippocampal CA1 region was counted after completion of Morris water maze test.Results Compared with group C,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,and the frequency of crossing the original platform and the number of ChAT positive cells in the hippocampal CA1 region were decreased after operation in O and OS groups,and no significant changes were found in the parameters mentioned above in group S.Compared with group O,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,the frequency of crossing the original platform was decreased,and there was no significant difference in the numberof ChAT positive cells in the hippocampal CA1 region in group OS,and no significant changes were found in the parameters mentioned above in group S.Compared with group S,the escape latency was significantly prolonged,the time of staying at the original platform quadrant was shortened,and the frequency of crossing the original platform and the number of ChAT positive cells in the hippocampal CA1 region were decreased after operation in group OS.Conclusion The mechanism by which postoperative sleep deprivation induces cognitive decline is not related to the expression of ChAT in hippocampi of aged rats.

OBJECTIVE To design the detection system of the leaky surface acoustic wave(LSAW) biosensor in(liquid) phase and detect human papilloma virus(HPV) target sequence with the LSAW biosensor.METHODS A detection delay line and a reference delay line were constructed,the phase of the two delay line changes was(evaluated) in liquid phase,and real time monitoring of HPV reaction was performed by using the LSAW biosensor system.RESULTS The phase of the two delay lines had different changes in liquid phase;HPV could lead to a great change of the phase in the detection delay line,and reference delay line had no change.CONCLUSIONS The(detection) system of the LSAW biosensor in liquid phase is successfully constructed and real time monitoring of(detection) of HPV is realized.

Objective To evaluate the nutritional status of iodine of pregnant and lactating women in coastal and inland areas of Zhejiang province,and to provide scientific basis for iodine supplementation.Methods In 2009,five coastal cities,five coastal counties and three inland areas from Zhejiang province were selected by the cluster sampling method,and one sub-district(township) was randomly selected in each city (county),then one community (village) was randomly selected in each sub-district (township).Thirty pregnant women,thirty lactating women and fifty children aged 8 - 10,were randomly selected in each community(village) as the investigation objects to collect instant urine samples to detect urine iodine,and to collect thirty resident edible salt and some water samples to detect salt iodine and water iodine,if the numbers of water source were more than 5 then 1 water sample was collected by their location of east,south,west,north and center in each community(village),otherwise,the numbers of water samples collected were equal to the number of community (village).Results The medians of salt iodine of coastal city,coastal county and inland area were 28.42,25.29,and 33.24 mg/kg,respectively,and the medians of water iodine correspondingly were 5.41,11.52,and 2.80 μg/L,respectively.The medians of urinary iodine of pregnant and lactating women in Zhejiang province were 148.72 and 161.34 μg/L,respectively,which were less than that of children aged 8 - 10(231.02 μg/L,Z =8.57,8.24,all P ＜ 0.017).The medians of urinary iodine in pregnant women from different areas were ranked in order as inland areas(211.42 μg/L),coastal counties (150.51 μg/L) and coastal cities (123.33 μg/L,Z =2.80,5.31,2.42,all P ＜ 0.017),and in lactating women,the medians of urinary iodine in inland areas( 197.43 μg/L) was higher than that in coastal cities( 139.64 μg/L,Z =4.03,P ＜ 0.017).Conclusions The overall levels of iodine nutrition in lactating and pregnant women in Zhejiang province are in the appropriate level,but that of the pregnant women in the coastal cities is inadequate.

Objective To compare the normal anatomy of the anterior cruciate ligament (ACL) of fresh frozen cadaveric knee specimen in oblique coronal thin-slice section with oblique coronal magnetic resonance imaging. Methods One fresh cadaveric knee specimen was scanned with MR T1-weighted spinecho sequence.then the specimen was frozen and sliced with a band saw along the oblique coronal plane into 1.0-mm-thick sections that corresponded to the MR images,MR images including oblique coronal T1-weighted and T2-weighted images of 50 normal the knee joints were retrospectively reviewed to observe the MR imaging features of the cruciate ligament. Results Anteromedial and posterolateral bundles of ACL were clearly depicted on both anatomic slices and MR images.The anteromedial bundles originated from the posteromedial aspect of the lateral femoral condyle,coursing through the lateral intercondylar notch in an anterior,inferior,and medial direction,and inserted on the anteromedial aspect of the intercondylar eminence. The posterolateral bundles originated from the anteromedial aspect of the lateral femoral condyle,passing laterally and inferiorly through the lateral intercondylar notch,and inserted on the posterolateral side of the intercondylar eminence.The full length of ACL of all 50 individuals was showed on MR images.MRI clearly differenitated the anteromedial and posterolateral bundles of ACL and depicted the full length of the bundles.similar to the findings on sectional anatomy.Conclusion Oblique coronal MR imaging is the best way to demonstrate ACL and should be used for clinically suspected injury of ACL.

Objective To compare the clinical values of impedance method,optical method and microscopy when used to detect platelet abnormal results.Methods Platelet re-examinations by optical method and microscopy were carried out in case of low confidence degree in platelet test with impedance method by XE-2100 automatic hematology analyzer,and then the results by the three methods were compared.Results Most of the low-confidence-degree results by impedance method could be corrected by re-examination by optical method,and the remained had to turn to microscopy due to unsatisfied requirements of the instrument.Conclusion Optical method has to be involved to correct the platelet abnormal results by XE2100 automatic hematology analyzer,and microscopy should be applied in case optical method doesn't work.The three methods gains advantages and disadvantages of themselves,and can be supplementaries for one another.