Objective To investigate the accurancy of somatosensory evoked potential (SSEP) and motor evoked potential (MEP) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing carotid endarterectomy (CEA).Methods Ninety patients (71 males, 19 females, aged 18-80 years, ASA physical status grade Ⅱ or Ⅲ) undergoing CEA using general anesthesia were studied.Bilateral SSEP and MEP were monitored during CEA and the intraoperative changes of SSEP and MEP amplitude and latency were analyzed before, during and after ICA cross-clamping until CEA ended.Neurological dysfunction was investigated within 5 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of neurological dysfunction.Results Fourteen cases (15.6%) were diagnosed as post-operative neurological dysfunction.The sensitivity, specificity of SSEP in detecting the occurrence of intraoperative brain ischemia were 79%, 92%, respectively.The sensitivity, specificity of MEP was 86%, 89% respectively.The sensitivity, specificity, of SSEP+MEP was 79%, 99% respectively.Conclusion During the carotid endarter ectomy,SSEP predicts the occurrence of cerebral ischemia with a high specificity.MEP has a high sensitivity.The combination monitoring of SSEP+MEP can improve the specificity, make up for the shortcomings of single monitoring.

Objective To report one stage treatment of chronic tibial defection in children. Methods 19 children with chronic tibial defection were treated in our department when their infection was at the stage of latency. First their focuses of infection were cleared away. Next a piece of fibula with vessel pedicles whose length was equal to that of the tibial defect was taken as the support to restore the length of the tibia. Then the external fixators were applied and a mixture of antibiotic and Lebone powder was used to fill the defect. Results In 15 cases the incision healed at one stage, slight infection occurred in 4 cases whose incisions healed after treatment of 3 to 4 weeks. Follow-ups of 0.5 to 1.5 years showed that no infection occurred again, bone defects healed well and limb function was satisfactory. Conclusion To treat chronic tibial defection in children at one stage, combined therapy should be applied. Grafting of fibula with vessel pedicles and Lebone under external fixators is a good one, because it can shorten the treatment time at no cost of satisfactory effects.

Angioplasty, Balloon, Coronary ; Coronary Occlusion ; diagnostic imaging ; therapy ; Fluoroscopy ; adverse effects ; Humans ; Male ; Middle Aged ; Radiodermatitis ; etiology ; Treatment Failure

Objective To investigate the feasibility of congenital cytomegalovirus (CMV)infection screening by saliva polymerase chain reaction.Methods From November 1,2010 to February 29,2012,6733 newborns born in Changzhou Maternal and Child Health Care Hospital were enrolled.Saliva samples (0.2 ml) were collected within 3 days after birth,CMV-DNA was detected by real time-polymerase chain reaction and hearing screening was done with EroScan transient-evoked otoacoustic emissions at the same time.The positive rate of congenital CMV infection screening was calculated and clinical manifestations were analyzed.Chi square test was applied to statistical analysis.Results Totally 6733 newborns were screened and 107 of them were found to be positive with CMV DNA,the positive rate was 1.59％ (107/6733),among which 88 were asymptomatic (82.2％) and 19 were symptomatic (17.8 ％).The major clinical manifestations of the neonates with positive CMVDNA were pathological jaundice (13 cases),hepatomegaly (5 cases),granulocytopenia,thrombocytopenic purpura,anemia and small for gestational age (two cases each).Fourteen newborns had only one major clinical manifestation,three newborns had two major clinical manifestations and two newborns had three major clinical manifestations.There was no statistical difference between newborns with positive and negative CMV DNA on hearing screening [hearing loss in one ear:8.4％ (9/107) vs 5.8％ (382/6626); hearing loss in two ears:3.7 ％ (4/107) vs 2.4 ％ (159/6626),x2 =2.776,P=0.241].Conclusion It is feasible to screen congenital CMV infection with saliva sample.

Objective To investigate the proper dose of propofol injected intraperitoneally ( i.p.) in neonatal rats and to study the regional distribution of propofol at different doses in the neonatal brain.Methods Part I:Sixty postnatal 7-day-old rats were randomly divided into 5 groups, which received different doses of propofol injected i.p.The behavior, anesthetic intervals and arterial blood gas were recorded.Part II: Twenty neonatal rats were randomly divided into 2 groups:anesthesia group ( group A) and sedation group ( group S) , and were injected propofol i.p.at the proper dose ac-cording to the results of Part I.Rats were decapitated when they reached the ideal anesthesia depth.The regional concen-tration of propofol in different regions of the brain was examined by high performance liquid chromatography.Results 25 mg/kg propofol i.p.was the sedate dose for neonatal rats, while 75 mg/kg i.p.was the anesthetic dose.In the group S, the concentration of propofol in the thalamus was significantly higher than in other regions (P<0.05), while in the group A, the concentrations of propofol in the frontal and parietal cortex were obviously lower, and the concentrations of propofol in the hippocampus and cingulate gyrus were obviously higher than that in other regions (P<0.05).Conclusions Propo-fol is a suitable anesthetic for neonatal rats and its distribution in the brain is quite different when given at different doses.

BACKGROUND:An effective freezing-thawing technique is crucial for the clinical application of human umbilical cord mesenchymal stem cells(UC-MSCs).OBJECTIVE:To investigate biological characteristics of UC-MSCs after cryopreservation.METHODS:UC-MSCs were isolated from human umbilical cord and frozen in liquid nitrogen.The survival rate and the suppressive effect of γ-interferon(IFN-γ)of cryopreserved-thawed and fresh human UC-MSCs were compared.Furthermore,the multiple potentials and phenotype of UC-MSCs were estimated after cryopreservation.RESULTS AND CONCLUSION:There was no significant difference between cryopreserved-thawed and fresh human UC-MSCs on the survival rate and the suppressive effect of IFN-γ of peripheral blood mononuclear cells(PBMCs).After cryopreservation,human UC-MSCs had the potential differentiation and the phenotype of mesenchymal stem cells.

Objective To provide an optimal working process for crossmatching by full-automatic blood typing instrument.Methods Two workflows were applied to crossmatch test by full-automatic blood typing instrument.One was diluting red blood cells of donor samples to concentrate of 1%,the other was detecting directly the donor′s packed red blood cells.Compared consistency and processing time of the two different workflows.Results Cross match results of two workflows were consistent well(U=0,P>0.05).The average processing times before testing and undergoing testing were not significantly different(t=0.692,t=0.562,P>0.05),whereas the average processing times after testing and throughout testing were significantly different(t=146.485,t=67.053,P<0.05).Conclusion The workflow of diluting donor′s sample before testing saved processing time and better suits hospital having a large quantity of specimens.

Objective To compare the difference of ultrasound-guided anterior sciatic nerve block by multiple injection and single injection.Methods Among 90 patients undergoing lower limb operation,aged 18-68 years old,47 patients were males and 43 patients were females,all falling into ASA Ⅰ-Ⅲ.The patients were randomized to ultrasound-guided anterior sciatic nerve block by multiple injection (group M,n=45) single injection (group S,n=45).Local anesthetic of 0.5% ropivacaine hydrochloride 20 ml was used.The width,thickness and depth of sciatic nerve and blocking performance time were recorded.Sensory and motor blockade on the operated limb were evaluated every 10 minutes after injection of local anesthetic for 30 minutes and complications were observed in two groups.Results The width,thinkness and depth of sciatic nerve on the ultrasound screen were not statistically significant in the two groups.The performance time of group M was longer than that of group S (P<0.05).The proportion of patients with sensory blockade of each nerve significantly differed between the two groups: for superficial peroneal nerve at 10,20,and 30 minutes,for the sural nerve at 20,30 minutes,for the tibial nerve at 30 minutes,that of group M was higher than that of group S (P<0.05).A significantly greater rate of motor blockade was observed for the dorsal flexion of foot and toes extension in group M than that of group S at 30 minutes (P<0.05).The complications of nausea,vomitting and tinnitus were not different in two groups.Conclusion Multiple injection needs more operation time compared with single injection,but its onset time of sensory and motor blockade is quicker,the complications were not different.

Neuromyelitis optica spectrum disorder (NMOSD) is an autoimmune disease of the central nervous system that is characterized by inflammatory demyelinating lesions and axonal degeneration in optic nerve and spinal cord. It has high relapse rate and high disability rate. In recent years, as the studies on mechanisms of NMOSD, related immune therapy strategies have been developed rapidly. These immunologic interventions are collectively called the disease modifying therapy, which are helpful in improving the course and outcome of the disease. In this review, the latest treatment progress in NMOSD is summarized to guide clinical choice and application of the medication.

Objective To establish the phenobarbital addiction rat model by the modified drug‐admixed‐food(DAF) method . Methods Rats were selected as the experimental animal .The modified DAF method was adopted to construct the model .The initial dose of phenobarbital 75 mg/kg was given mixed and the dase was gradually increased day by day ,which continued for 45 d .The es‐tablished model was verified by the precipitated withdrawal method and the natural withdrawal method for judging whether the model construction succeeding .Results The convulsion rate in the DAF precipitated withdrawal group was higher than that in the control group(P< 0 .01) ;the withdrawal symptoms scores in the DAF natural withdrawal group were higher than those in the con‐trol group(P< 0 .05) ;the relieving degree of body mass in the two withdrawal groups was greater than that in the control group (P< 0 .05) .The brain section in the mode group revealed obvious cellular apoptotic change .Conclusion DAF is simple and feasible for establishing the phenobarbital addiction rat model .