Objective To investigate the effects of tetanic stimulation of peripheral nerve on intracranial direct electrical stimulation motor-evoked potentials (MEP) in patients undergoing cerebral functional area operation. Methods Eight patients undergoing elective brain tumor resection under propofol-fentanyl anesthesia with partial neuromuscular blockade were enrolled in the study. Both conventional MEP (C-MEP) monitoring and posttetanic MEP (P-MEP) monitoring were performed throughout the operation for each patient, and the two groups of data were recorded. For one group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the abductor pollicis brevis, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA, duration 5 s) to the ipsilateral tibial nerve.For the other group, direct electrical stimulation with a train of five pulses was delivered to motor cortex and pyramidal tract, C-MEP was unilaterally recorded from the tibialis anterior, and P-MEP was obtained 1 s after tetanic stimulation (frequency 50 Hz, intensity 50 mA and duration 5 s) to the contralateral tibial nerve. Randomized crossover method was used for C-MEP and P-MEP recording in each group, with an interval of 120 s. The adverse effects were observed. Results Amplitudes of P-MEP from the abductor pollicis brevis and tibialis anterior were significantly higher than those of C-MEP. Three patients had body movement during intraoperative cortex stimulation, while there was no awareness during operation and other electrical stimulation-related nervous system impairment and complications. Conclusion The application of tetanic stimulation of peripheral nerve before direct electrical stimulation can augnent the amplitudes of MEP from the abductor pollicis brevis and tibialis anterior in patients undergoing cerebral functional area operation.

Objective To use thrombelastography (TEG) and conventional coagulation tests (CCTs) to diagnose disseminated intravascular coagulation (DIC) and find a better diagnostic method.Methods Patients with potential DIC factors,DIC clinical manifestation or DIC patients suspected by laboratory tests were included after their admission into our hospital.TEGs and CCTs were detected,respectively.DIC score was evaluated.The single factor logistic regression was used to evaluate the correlation between TEG and CCTs as well as the diagnostic accuracy.Results The international normalized ratio (INR) in CCTs of the DIC patients were significantly higher,the reaction rime (R),clot formation time (K),angle rate of clot formation (α),maximum amplitude (MA),and composite index (CI) figures in TEG were significantly increased (P ＜ 0.05).The sensitivity and specificity of TEG were 82.4％,and 62.2％,which were significantly higher than 21.6％ and 47.2％ in CCTs (P ＜ 0.05).Single factor logistic regression results show that odd ratio (OR) in prothrombin time (PT) and INR of CCTs was 1.23 and 1.27,respectively.The OR in R,K,α,MA,and CI of TEG was 5.13,6.14,1.37,1.25,and 3.02,respectively.Conclusions Compared to CCTs,TEG is more indicative of the conditions of DIC patients and it might be a better way to predict the DIC risks,which is of greater value in clinical diagnosis.

Objective To explore the value of ultrasound-guided coarse needle biopsy (US-CNB)in the diagnosis of benign and malignant solid tumors.Methods The clinical data of 317 patients with solid liver lesion detected by US-CNB were reviewed retrospectively.93 cases were diagnosed by pathology after operation,and 196 cases were diagnosed by biopsy,imaging and follow-up.The material satisfaction rate,diagnosis of benign and malignant tumors and postoperative complications were discussed in this study.Results Of the 317 cases,289 cases were successfully taken,28 cases were failed,and the success rate was 91.2％.The overall sensitivity of US-CNB to tumor and non tumor were 98.7％ and 95％ respectively,with the specificity of 95％ and 98.7％ respectively.The positive predictive values were 98.7％ and 95％respectively,and the negative predictive values were 95％ and 98.7％,respectively.No serious complications occurred after puncture.Conclusions Ultrasound-guided coarse needle biopsy is a safe,accurate and effective method to diagnose solid tumors.

Objective To investigate the endoscopic prevalence of erosive esophagitis (EE) among 13 hospitals in Guangdong province of China. Methods Retrospectively reviewed all the cases (63459 cases) that received oesophagogastrodeuodenoscopy in 13 main hospitals in Guangdong province of China in 2003. Los Angeles criteria for classification of erosive esophagitis were employed as the basis of analysis. Results One thousand two hundreds and sixty-three patients (age range 3-90yr, mean 50. 2 ?17. 1 ) were found to have EE. The overall prevalence of EE was 1. 99% (1263/63459). The prevalence of EE in A, B, C, and D grade were 0. 94% , 0. 69% , 0. 21% and 0. 14% respectively. Age correlated positively on endoscopic grading of EE (F=22. 932, P

Objective To compare the value of ultrasound-guided fine-needle aspiration (FNA) and core needle biopsy (CNB) in diagnosing benign and malignant cervical lymph nodes.Methods A retrospective analysis was performed on 88 patients who received biopsy for cervical lymph node enlargement from January 2015 to May 2017.FNA (n =39) or CNB (n =49) were performed respectively to compare the sensitivity,specificity and accuracy of the two methods in diagnosing benign and malignant cervical lymph node enlargement.Results 84.6％ (33/39) of FNA cases were successfully collected,and 98％ (48/49) of FNA cases were successfully collected for definite pathological diagnosis (P =0.000).The sensitivity,specificity and accuracy of FNA and CNB in diagnosing malignant cervical lymph nodes were 90.9％ and 97.2％,94.1％ and 100％,92.3％ and 98％,respectively.Compared with FNA,there were statistically significant differences in sensitivity,specificity and accuracy in differentiating benign and malignant lymphatic lesions in cervical enlargement (P ＜0.01).The sensitivity and specificity of FNA and CNB in diagnosing cervical lymph node metastatic carcinoma were 100％ and 100％,95.2％ and 100％.Compared with FNA,there was no statistically significant difference in the sensitivity to the diagnosis of cervical lymph node metastatic carcinoma (P =0.102).Conclusions CNB is superior to FNA in sensitivity,specificity and accuracy in diagnosing cervical lymphadenopathy.However,when metastatic cancer was diagnosed,FNA was not significantly different from CNB in sensitivity (P =0.102),and FNA was recommended as the first choice.