Anesthesia is the most crucial part of clinical surgery in modern medicine,and it is highly risked due to complications of general anesthesia.Researches have proved that intraoperation monitoring depth of anesthesia efficiently reduced the dosage of anesthetics and led to earlier recovery,so that the risk of anesthesia has been minimized.Currently,the research on depth of anesthesia monitoring methods has become an international hotspot.This paper reviews the methods for monitoring depth of anesthesia,including bispectral index,auditory evoked potential,Entropy and heart rate variability,and highlights advantages,disadvantages of these methods and the relationship between these methods.This paper also introduces the relationship between heart rate variability and the depth of anesthesia monitoring,the method for analyzing heart rate variability in both time domain and frequency domain,which laid a theoretical foundation for the research on monitoring depth of anesthesia.

Objective: To investigate the expression of human telomerase reverse transcriptase (hTERT)in benign and malignant gastric diseases and its clinical significance. Methods: The expression of hTERT in 126 gastric tissue specimens obtained by surgery and endoscopy were studied by SP immunohistochemical method. The specimens included 10 cases of nomal mucosa,26 of chronic gastritis, 22 of benign ulcer,5 of leiomyoma, 3 of hyperplastic polyps, 50 of gastric cancer, 2 of maligmant lymphoma and 8 of sarcoma. In precancerous lesions,there was 54 cases of atypical hyperplasia,including 18 low grade, 25 of intermediate and 11 high grade. The positive expression rates and relations of clinical characters were analyzed. Results: hTERT was not or seldom expressed in normal and benign gastric diseases, while it was highly expressed in malignant lesions.There was a significant difference between them(P

Objective:To compare and analyze the value of diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) of 1.5T magnetic resonance (MR) in differential diagnosis for localized prostate cancer, chronic inflammatory response and benign hyperplasia.Methods: 80 patients with localized prostate cancer were enrolled in the research. The signal to noise ratio (SNR) of DWI, ADC value and semi-quantitative classification of DWI on lesions were measured, and the diagnostic efficiencies of them were compared by using ROC curve.Results: In the 80 patients with localized prostate cancer patients, there were 52 malignant lesions and 43 benign lesions in peripheral band, and there were 31 malignant lesions and 46 benign lesions in central gland. The ADC values of prostate cancer in peripheral band and central gland were 0.91±0.12 and 0.86±0.15, respectively, and they were significantly lower than that of normal tissue (1.68±0.23 and 1.28±0.31) and benign lesions (1.24±0.21 and 1.12±0.16). The semi-quantitative classifications of DWI for benign lesions were significantly higher than that for malignant lesions in peripheral band and central gland, respectively (x2=20.88,x2=12.14;P<0.05). For the diagnostic efficiency of ADC, the sensitivities of benign and malignant lesions in peripheral band and malignant gland were 91.3% and 79.1%, respectively, and the specificities of them were 89.6% and 70.2%. And they was significant higher than the corresponding sensitivities (71.2% and 51.3%)and specificities (78.4% and 65.8%) of DWI imaging.Conclusion: Both of DWI and ADC of 1.5T magnetic resonance are the important indexes in differential diagnosis for prostate cancer, chronic inflammatory response and benign hyperplasia, while ADC value is better than DWI image in the clinical efficiency.

Objective To investigate the effect of Salvia miltiorrhiza extracts on morphine physical dependence in mice. Methods The physical dependence model was induced by repeated sc morphine daily in mice and then withdrawal symptom was induced by ip naloxone. Different doses of S. miltiorrhiza extracts were administrated by ip during or after the induction phase of morphine dependence, and effects of S. miltiorrhiza extracts both by preventive and acute administration on naloxone-precipiated withdrawal symptom in mice were investigated. The potential physical dependence of S. miltiorrhiza extracts was studied. Results Compared to morphine model group, preventive administration of S. miltiorrhiza extracts (100—200 mg/kg) could reduce the number of naloxone-induced withdrawal jumps (P

ObjectiveTo investigate the expression and clinical significance of CD40 in the spleen of cirrhotic portal hypertension. MethodsExpression of CD40 was determined with S-P immunohistochemistry in spleen specimens from 50 cases of cirrhotic portal hypertension and 15 healthy individuals. ResultsThe CD40 positive rates in normal spleen and cirrhotic spleen were 86.7% and 36.0%, respectively. There was a significant difference between the 2 groups (P＜0.05). There was a negative correlation between the expression of CD40 and Child grades of liver function and cirrhotic splenic types(P＜0. 05). Conclusion CD40 might reflect the changes of splenic immune function,which might be one of more exact clinical examination indexes of splenic immune function.

Objective To evaluate the indications and clinical efficacy of the different surgical methods for lumbosacral tuberculosis.Methods 112 patients suffering from lumbosacral tuberculosis from January 1998 to October 2011 were reviewed retrospectively.Based on American Spinal Injury Association (ASIA) grading system,31 case was classified as grade C,32 as grade D and 49 as grade E.The affected locations were L5,S1 in 66 cases,L4-S1 in 32,and L5-S2in 14 cases.41 cases (posterior group) underwent posterior pedicle screw instrumentation,debridement and allograft; and 38 cases (anterior group) underwent one-stage anterolateral debridement plus allograft and internal fixation.33 (posterior-anterior group) cases experienced posterior pedicle screw instrumentation and anterior debridement and allograft.All cases underwent routine support and anti-tuberculosis treatment before and after operation.The change of erythrocyte sedimentation rate (ESR),signs of tuberculosis activity,graft fusion,neurological recovery and correction of deformity were evaluated in follow-up and compared among three groups.Results The average operating time in posterior,anterior and posterior-anterior group was (150±22) m in,(140± 18) min,(180± 1 8) min respectively.ESR and C-reactive protein (CRP) were recovered to normal 3 months post surgery.The quality of life total score of lumbosacral tuberculosis patients was very low (55.54 ± 9.23).After surgery and drug treatment,the total score and each dimension scores of the SF-36 were significantly improved.Postoperative ASIA classification and 1umbosacral angle were significantly improved.Tuberculosis recurrence occurred in three cases,fixation loosening in two cases,fixation fracture in one case,and all above cases were cured after revision surgery.The others all were cured and bone graft fusion was determined.Conclusion The quality of life of lumbosacral tuberculosis patients were impacted seriously,and which could be significantly improved with surgical intervention.According to the patient MRI,CT characteristics,surgical approach selection was based on lesion location.Effective internal fixation was based on the extent of damage in bone structure and anatomical characteristics.Following above principles,satisfactory clinical results could be achieved.

Objective To investigate the therapeutic effect of the meso-cavo-atrial shunt (MCAS) in the treatment of combined Budd-Chiari syndrome (BCS). Methods The clinical data of 17 cases of combined BCS with all or bilateral hepatic vein occlusion and long range occlusion or obstruction of inferior vena cava (IVC) were admitted to the Qilu Hospital from February 2000 to May 2004. All patients were treated by MCAS with artificial blood vessels. The pre- and postoperative clinical symptoms, the IVC and portal venous (PV) pressures, the incidence of postoperative complications and the patency rate of the artificial vessels were analyzed. The survival of patients was analyzed using the Kaplan-Meier analysis, and the data were analyzed using the chi-square test and t test. Results No patient died during the perioperative period, and the symptoms of 15 patients disappeared or were relieved after operation, with a significant difference compared with those before operation (χ2 =9.78, P <0. 05 ). Three patients had complications after the operation. The postoperative PV and IVC pressures were decreased by 1.2 cm H2O (1 cm H2O =0.098 kPa) and 18.5 cm H2O, respectively. There were significant differences in the decrease of IVC and PV pressures ( t = 2.38, 3.06, P < 0.05 ). The 1-, 3-, 5-year survival rates were 16/17, 15/17 and 14/17, respectively, and the 5-year patency rate of the artificial vessels was 14/17.Conclusions MCAS can simultaneously relieve IVC and PV hypertension for patients with combined BCS. The postoperative complication rate was decreased, the 5-year survival rate and the patency rate of the artificial vessels were improved after the treatment, so MCAS is an optional surgical method for treating combined BCS.

Objective To investigate clinical result of hepatectomy and porta-enterostomy in the treatment of Bismuth type Ⅳ hilar cholangiocarcinoma.Methods Nine patients with Bismuth type Ⅳ hilar cholangiocarcinoma underwent accurate hilar resection(portal parecnchyma resection including about Ⅰ cm of the hilar part of the segments 5 and 4b and caudate lobe beyond the tumor),and the biliary drainage was reconstructed by Roux-en-Y portal parecnchyma-jejunum lpop anastomosis.None of the biliary radicals had to be ligated and all of them were drained into thus constructed"biliary pool".Results Hilar resection was successfully performed in all cases,and there was no postoperative mortality.Aspartate transaminase and alanine transaminase and serum bilirubin decreased evidently four weeks later.Three patients presented postoperative complications.One patient developed a transient anastomotic leakage,while one patient developed self-limiting hemobilia,wound infection occurred in one patient.All three patients were treated conservatively and recovered.The mean Karnofsky performance score was 86,with which they could carry on normal activity with minor symptoms of disease.Two patient died after 9 months and 17 months of extensive metastasis and intrahepatic metastasis respectively.The remaining seven patients are alive by a mean followup of 24.9 months after surgery without any signs of recurrence.Conclusions With accurate hilar resection and portal parecnchyma-to-enterostomy,the patients considerably benefit from the preservation of liver parenchyma and patent biliary drainage and radical resection.So the Hew technique prolongs the survival time and enhances the quality of life of the patients.

Objective To investigate the related factors of postoperative hypocalcemia after thyroid carc-er surgery.Methods 346 cases of thyroid carcer patients undergoing surgery from Jan .2013 to Dec.2013 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed .Results 129 cases developed hepocalcemia after thyroid surgery .Among the related factors that may cause postoperative hypocalcemia , the scope of surgery , parathyroid injury and secondary surgery might play important roles .Conclusions The inci-dence of postoperative hypocalcaemia is high after total thyroidectomy .Patients with reoperation and lymph node dissection have an increased rate of postoperative hypocalcaemia .In order to reduce hypocalcaemia incidence ,sur-gons need to protect parathyroid blood supply in thyroid surgery and give calcium after surgery .

Objective To study the applied value of multi-slice spiral CT(MSCT)in pulmonary lesions.Methods 68 cases with massive hemoptysis caused by lung tumor or other reasons underwent 16-slice spiral CT scan including plain and contrast-enhanced scan.Volume reconstruction(VR),multiplanar reconstruction(MPR),maximum intensity projection(MIP)and curved planar reconstruction(CPR)were performed using original images.The origin,number and shape of vessels feeding lesions were observed.Results Among 68 cases(two failed),the blood supply of pulmonary lesions was from bronchial artery in 60 cases,from the intercostals artery in 8 cases,from the internal thoracic artery in 5 cases,from the left subclavian artery in 6 cases,from the right inferoir phrenic artery in 5 cases,from the celiac trunk artery in 3 case and from the right renal artery in 1 case.The blood supply was from single artery in 50 cases,double arteriae in 10 cases and three arteriae in 6 cases.The supply arteriae were vascular plexus in 55 cases,meandering in 8 cases,net in 2 cases and aneurysm formation in one cases.Conclusion MSCT can clearly display the vessels feeding pulmonary lesions.