Objective To investigate the effects of small tidal volume combined with PEEP on extravascular lung water during one-lung ventilation (OLV) in patients undergoing thoracic surgery. Methods Forty ASA Ⅰ or Ⅱ patients of both sexes aged 45-80 yr undergoing esophagectomy for esophageal cancer were randomly assigned into 2 groups (n = 20 each):group Ⅰ IPPV (VT 9 ml/kg ,RR 12 bpm) and group Ⅱ IPPV +PEEP (VT 6 ml/kg, RR 15 bpm, PEEP 5 cm H-2O). FiO2 was 100% and I:E 1:2 in both groups. Anesthesia was induced with fentanyl 3-5 μg/kg, propofol 1.0-1.5 mg/kg and vecuronium 0.10-0.15 mg/kg and maintained with continuous infusion of propofol 4-7 mg· kg- 1 · h - 1 and vecuronium 0.07-0.08 mg- kg- 1 · h - 1 and intermittent iv boluses of fentanyl. Double lumen endobronchial tube was inserted. Correct position was confirmed by bronchoscopy. Right internal jugular vein was cannulated. A 4F thermodilution catheter was inserted into right femoral artery and connected to PICCO monitor. Extravascular lung water (EVLW), EVLW index (EVLWI),pulmonary vascular permeability index (PVPI), cardiac output (CO) and oxygenation index (OI) were recorded before anesthesia (T0, baseline), at 30 min of two lung ventilation (T1), 30 min and 1 h of OLV (T2, T3),before extubation (T4) and 18 h after operation (T5). Airway peak pressure (Ppeak) was recorded at T1-4. Results EVLWI and PVPI were significantly higher in group IPPV + PEEP than in group IPPV. There was no significant difference in Ppeak, CO and OI at any time point between the 2 groups. In group IPPV there was no significant change in EVLW and EVLWI during and after mechanical ventilation, while PVPI was significantly increased at T1 as compared with the baseline before anesthesia. In group IPPV + PEEP EVLW was significantly increased at T2 and PVPI was significantly increased at T1 and T2 compared with the baseline at T0. Conclusion OLV with IPPV + PEEP results in more EVLW and it exerts no significant effect on lung function.

Objective To evaluate the effectiveness of an improved uterooperator in the interventional treatment of tube obstructional infertility, and to make a comparison with other motheds. Method One hundred cases of infertile women with tubal obstruction were divided into 3 groups and treated separately under TV fluoroscopy with 3 different methods and follow-up examination was made up to 24 months. Among the 100 cases, 60 cases were treated with improved uterooperator(109 tubes), 20 with Cook cupped coaxial catheter (36 tubes), and 20 with emulsoid double-cavity tube (20 tubes). Result Among the improved uterooperator group, Cook cupped coaxial catheter group, and emulsoid double-cavity tube group, the successful rate of selective catheterization was 92.7%, 80.6%, and 80.0%, respectively. The successful rate of recanalization was 72.3%, 72.4%, and 71.4%, respectively. The pregnancy rate was 36.4%, 35.7%, and 36.4%, respectively. Improved uterooperator has the highest successful rate in selective catheterization(? 2=4.275 5, P

Objective To study CT and MRI findings of esthesioneuroblastoma.Methods Nine cases of esthesioneuroblastoma proved pathologically were presented.There were four male and five female,with mean age of 34.6 years.CT scan in four cases and MRI in seven cases were done and 2 cases had enhanced MRI.Results The location of lesions were in nasal cavity in 2 cases and in nasoethmoid region in 7 cases.Among nine cases,six cases were seen in the right side,and three cases in the left side.On CT and MRI,the lesion demonstrated a destructive solid mass,CT value ranged 29～36 HU.The lesions appeared as hamogeneous signal intensity which was higher than tongue muscle on T_1WI,and higher than grey matter on MRI T_2WI . Turbinal and ethmoid bony destruction were showed on all nine cases. The lesions invaded into opposite nose and ethmoid sinus in four cases,intruded into intracrainial cavity in eight cases, frontal sinus in six cases, orbit in eight cases in which two cases had eye protrusion, maxillary sinas in five cases and sphenoid sinus in five cases.Conclusion A esthesioneuroblastoma can be considered if a destructive solid mass occurs in nasal cavity and ethmoid sinus,with a middle signal intensity on T_2WI.

Objective To investigate the prognostic significance of extended resection for locally advanced colorectal carcinoma. Methods Clinical data of 960 cases of colorectal cancer hospitalized for surgery between Jan 1995 and Dec 2002 were reviewed, and complication rates, perioperative mortality, 5-year survival were calcualated, prognostic factors were analyzed using Cox regression model. Results Sixty-six patients with locally advanced colorectal carcinoma were treated with extended resection, accounting for 6.9% of the total cases. Surgical complication rate in this subgroup was 27.3% (18/66), relatively higher than that of conventional resection for colorectal carcinoma (?~2 =8.82, P=0.002). The perioperative mortality was zero. Pathology showed that carcinoma invasion into the adjacent organs resected en bloc was 31% (27/88), the 5-year survival rate was 62%. The tumor spreading into the adjacent organ (Wald=7.42,P=0.005) and lymph node status (Wald=4.55, P=0.035) were found to be the independent prognostic factors. Conclusions Extended resection for locally advanced colorectal carcinoma resulted in a favorable prognosis. Postoperative complication was relatively high, but still acceptable.

OBJECTIVE: To investigate the influence of intra cranial pressure (ICP) and cerebral perfusion pressure (CPP) on neurological det erioration and outcome of severe traumatic brain injury (STBI). METHODS: A total of 245 patients with severe traumatic brain in jury were studied retrospectively with univariate and multivariate studies to ev aluate the contribution of ICP/CPP to neurological deterioration and outcome. RESULTS: The mortality rates rose from 16.2% in 142 patient s whose course of disease was smooth to 66.7% in 103 patients who suffered f rom neurological deterioration. Correspondingly, the favorable outcome fall from 54.2% in the patients without neurological deterioration to 18.3% in th ose with neurological deterioration. In the patients with clinical evidence of n eurological deterioration, the relative influence of the ICP and the CPP on outc ome was assessed. The most powerful predictors of neurological deterioration was the presence of intracranial hypertension (ICP>30 mm Hg, 1 mm Hg=0.133 kPa). The CPP also had a prognostic power on neurological deterioration when its level less than 60 mm Hg. CONCLUSIONS: It suggests that it's very important to lower the intracranial hypertension and keep the CPP not less than 60 mm Hg during the t reatment of STBI.

Adolescent ; Adult ; Age Distribution ; Analysis of Variance ; Atrophy ; epidemiology ; pathology ; Female ; Glasgow Outcome Scale ; Hematoma, Epidural, Cranial ; diagnostic imaging ; pathology ; surgery ; Hematoma, Subdural, Acute ; diagnostic imaging ; pathology ; surgery ; Humans ; Incidence ; Injury Severity Score ; Intracranial Hemorrhage, Traumatic ; diagnostic imaging ; pathology ; surgery ; Male ; Middle Aged ; Probability ; Prognosis ; Retrospective Studies ; Risk Assessment ; Sex Distribution ; Tomography, X-Ray Computed

In this paper is presented an analysis of the mechanical effect of horizontal rotating bioreactor on cell culture. Getting the microgravity of the bioreactor and the shear stress on canine mesenchymal stem cells (cMSCs) with theoretic calculating model and differential equations, we have validated the density,growth rate and modality of cultured cell by scanning electron microscopy. The horizontal rotating bioreactor which we developed could create the mechanic environment of microgravity (K<8.38 X 10(-2))and low shear stress(r<1.62 dyn/cm2) in theory. The results of scanning electron microscopy indicated that the cells' growth-speed, quantity and modality in bioreactor were better than those of cells cultured in static 24-well plate. The mechanical environment of the rotating bioreactor is propitious for keeping better modality and more rapid proliferation of cMSCs. The rotating bioreactor is a novel approach and technique it is superior to static culture.
Animals ; Bioreactors ; Bone Marrow Cells ; cytology ; Cell Culture Techniques ; instrumentation ; methods ; Cell Proliferation ; Cells, Cultured ; Dogs ; Mechanotransduction, Cellular ; physiology ; Mesenchymal Stromal Cells ; cytology ; Rotation ; Tissue Engineering ; methods

20 years)was 8.60%(48/558) , which was more than that in the second decade of life ( 5.22% ). The incidence of painful group was 9.79%(14/143),which was more than that in foot trauma group 6.78%(40/630).The positive C sign was presented in 61.1%(33/54),posterior-type coalition in 38.9%(21/54),short talar neck sign in 61.1%(33/54)and talar beak sign in 22.2%(12/54). Conclusion The talocalcaneal coalition is a common development abnormality in our country. We must pay attention to the diagnosis of talocalcaneal coalition for painful foot adulthood.

Objective To study the incidence and radiologic findings of calcaneonavicular coalition.Methods CR films of foot andankle in 1361 cases were presented,which were evaluated for acute trauma or chronic pain.There were 588 cases of foot CR and 773 cases of ankle CR,age ranged from 10 years to 91 years(984 cases of 20~40 years).The prevalence of calcaneonavicular coalition was determined and the different significance of both male and female,acute trauma and chronic pain group were analysed.Results In 1361 cases,72 cases of calcaneonavicular coalition(5.3%) were demonstrated,8.7%(47/588)on foot CR films and 3.2%(25/773) on ankle CR films.Calcaneonavicular coalition was more dipicted on foot CR films than on ankle CR films(P0.05).Conclusion The foot CR films is more superexcellent than the ankle CR films on demonstrating calcaneonavicular coalition.

Objective To study the clinicoradiologic significance of C sign.Methods 773 cases of standard ankle CR radiographs were presented for diagnosis of acute trauma and ankle pain. There were 565 males and 208 females, ages ranged from 10 to 81. There were 630 cases of acute trauma and 143 cases of painful ankle. C sign incidence, C sign figuration, distance of the medial facet of talocalcaneal joint, and the figuration of sustentaculum tali were studied. The relationship between C sign and talocalcaneal coalition was analysed.Results The incidence of C sign was 54.6%(422/773). The female incidence was 61.1%(127/208) ,which was more than that of male(52.2%,295/565)(P