Objective To assess the value of enhanced multislice spiral CT (MSCT) scan using fat-dense enema for the staging of colorectal carcinoma.Methods 33 cases with colorectal carcinoma confirmed by colonoscopy were examined by enhanced MSCT scan ,from the dome of the diaphragm to symphysis pubica,after bowel cleaning,administration of smooth muscle relaxant, and rectal fat-dense contrast agent insuffation .Carcinomas were staged with TNM by axial,multiplannar reconstruction(MPR) and CT virtual endoscopy (CTVE) images. The staging results on CT were compared with that of postoperative pathological examination in all cases.Results All the 33 colorectal carcinoma were demonstrated clearly by MSCT ,the total accurate rate in staging with the TNM classification was 78.78%.The sensitivity and positive accurate values for T staging were 100%and 87.88%(29/33),respectively. The sensitivity and positive accurate values for in detecting lymph node involvement were 86.36%(19/22)and 68.18%(15/22), respectively. Five cases in M stage were all diagnosed correctly. Conclusion Using fat-dense contrast medium and enhanced multislice spiral CT is of very important value in staging of colorectal carcinoma.

Objective In order to enhance the understanding of Churg- Strauss syndrome, the clinical manifestations and the pathological features of 15 patients were reviewed. Methods The clinical and patho- logical findings of 15 patients with Churg- Strauss syndrome admitted to Peking Union Medical College Hospi- tal were retrospectively analysed. Results In 15 cases, the initial clinical manifestations were poly- mononeu- ropathy, gastrointestinal disorders and skin lesions. Peripheral eosinophilia was significant in all cases. Biopsies were taken in all cases. The typical pathological features usually demonstrated in diffiferent stage of the dis- ease. Conclusions If a patient shows a clinical manifestation of fever, skin lesions, neuropathy, abdominal pain and diarrhea, as well as eosinophilia in peripheral blood, the diagnosis of Churg- Strauss syndrome should be considered. It is necessary to take biopsies from several sites at different time.

Objective To study the clinical effects of shortening the drainage time for patients with dural tears after posterior spinal sur -gery.Methods A total of 120 patients with dural tears after posterior spinal surgery were randomly divided into study group and control group,60 patients in each group .Patients in control group had wound drainage tubes removed after 5 days and patients in study group had wound drainage tubes removed after 3 days.The disappearance time of leakage ,incision healing time and complication rate were compared between two groups.Results The disappearance time of leakage in study group was (13.7 ±3.8)days which was significantly less than (20.0 ±5.1)days in control group(P<0.05).The incision healing time in study group was (22.7 ±4.9)days which has no significant difference with (23.9 ± 5.7)days in control group.The postoperative infection rate was 3.3%(2/60) which was significantly less than 20.0%(12/60) in control group(P<0.01).Conclusion Shortening drainage time can decrease the disappearance time of leakage and postoperative infection rate .

Objective To investigate the risk factors for nosoeomial pneumonia in elderly stroke patients(aged 60 years and over). Methods The clinical data of 259 patients with nosoeomial pneumonia from Jan 2002 to June 2007 were collected and the risk factors were retrospectively analyzed. Results The morbility rate of nosocomial pneumonia in elderly stroke patients was 41.3%,and the risk factors were aging,Iong hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine (all P＞0.05). Conclusions The morbility rate of nosoeomial pneumonia in elderly stroke patients was high,and the risk factors are aging,long hospitalization,unconsciousness,type of stroke,and underlying diseases,smoking,tracheal intubation,tracheotomy,application of respiratory machine.

l 1H-MRS was good for clinical purpose.

Objective To observe the response and relationship between astrocytes and neurons to hypotension rats. Methods Transient hypotension animal models were induced by injecting sodium nitroprusside. The expression, distribution and relationship pattern of Fos-、GFAP- or TH- positive reaction in rat brain were studied with a triple method combining anti\|GFAP, Fos and TH immunohistochemical staining. Results Fos and GFAP positive staining appeared in some brain regions related with blood pressure regulation. The distribution of GFAP\|positive astrocytes was similar to that of Fos\|positive neurons. Fos\|and GFAP\|positive neurons exhibited clear character of nuclei and subnuclei distribution. Many FOs and TH single labeled neurons, or Fos and TH double labelled neurons in medulla oblongata and locus coeruleus arounded by GFAP positive processes were found and formed three kinds of complex\|like structures. Conclusion\ The present results indicated that the astrocytes were sensentive to the changes of blood pressure. The distribution of astrocytes had the specificity of functional location. We suggestal that the astrocytes and neurons might be involved together in information precessing within brain.\;[

Objective To observe the instant reactions and relationship of astrocytes(ASs) and neurons(Ns) in rat forebrain after the unilateral tibia and fibula bone fracture. Methods With immunohistochemical triple staining method,the expression of Fos-protein,glial fibrillary acidic protein(GFAP) and tyrosine hydroxydase(TH) were observed. Results Here we showed 1.After the nociception of the treatment,GFAP-like immunoreactive (-LI) ASs exhibited clear character of nuclei distribution in the lateralmedial habenular nucleus(LHb),paraventricular nucleus of the hypothalamus(Pa),supraoptic nucleus(SON),suprachiasmatic nucleus(SCh),bed nucleus of of stria terminalis(BST),central amygdaloid nucleus(Ce) medial amygdaloid nucleus(Me) and cortex;2.The distribution of Fos-LI Ns and GFAP-LI ASs in above nuclei were similar,there were close relationship between Fos-LI Ns and GFAP-LI ASs.3.There were many double-labelled Fos/TH-LI Ns that were surrounded by the GFAP-LI ASs,and formed the neuron-astrocyte complex(N-ASC).Conclusion The ASs as well as Ns of the above nuclei or regions may be involved in instant response and adjustment of the lower extremity bone fracture nociception simultanneously.

Objective To observe the instant reactions and relationship of astrocytes(AS) and neurons in rat spinal cord after the unilateral tibia and fibula bone fracture. Methods With single or double immunohistochemical staining method,the expression of Fos-like immunoreaction(-LI), glial fibrillary acidic protein(GFAP-LI), and protein kinase C(PKC-LI) were observed. Results Here we showed 1^ After the nociception of the treatment the PKC-LI,Fos-LI astrocytes and neurons,and GFAP-LI astrocytes were distributed in dorsal horn of rat lumbar spinal cord,predominantly in the superficial layer.2^ The distribution of Fos-LI neurons and Fos/GFAP-LI AS in dorsal horn of rat lumbar spinal cord were similar,there were close relationship between Fos-LI neurons and GFAP/Fos-LI AS.3^ The peak time of GFAP/Fos-LI AS expressive was 45?min after fracture,while that of Fos-LI neurons was 90?min,the peak time of PKC-LI astrocytes expressive was earlier than that of PKC-LI neurons.Conclusion The AS as well as neurons in dorsal horn of rat lumbar spinal cord might be involved in the instant response and adjustment of the lower extremity bone fracture nociception simultanneously.

Objective To investigate the clinical significance of noninvasive detection of end-tidal carbon dioxide partial pressure (PetCO2) in the management of children with acute asthma, and to evaluate the association between PetCO2 and artery blood gas carbon dioxide partial pressure ( PaCO2 ). Methods This was a prospective,double blinded study of children aged 5 ～ 14 years old treated for acute asthma in a pediatric emergency department. PetCO2 and PaCO2 measurements were taken before therapy and after each nebulization treatment ( maximum of three). Various clinical parametesr were recorded. Patients with PaCO2 and PetCO2 measurements within 8 minutes of each other were eligible for inclusion. Patients with cardiac disease,chronic pulmonary disease, poor tissue perfusion, or metabolic abnormalities were excluded. Results Sixty five children were enrolled. The initial PetCO2 value was (34. 8 ±8. 6) mm Hg (95% confidence interval =34. 0 to 36. 1). The PetCO2 value of post-treatment was (33.2 ±8.2) mm Hg (95% confidence interval =32. 5 to 34. 4) ,which was decreased significantly than that before treatment(P ＜ 0. 01 ). Fifty seven PetCO2-PaCO2 paired values were available from 57 patients. The values of PetCO2 and PaCO2 were ( 34. 8 ±7. 6) mm Hg and (40. 6 ± 8. 3 ) mm Hg, respectively. PetCO2 and PaCO2 values were highly positively correlated ( r = 0. 92,P ＜ 0. 000 1 ). Conclusion Noninvasive bedside measurement of PetCO2 in children with acute asthma in emergency department is feasible. Continuous PetCO2 monitoring can provide a reliable assessment of pulmonary status. PetCO2 can serve as an important adjunct index in the clinical management of pediatric patients with acute asthma.

This paper discusses how to build a virtual laboratory in medicine based on virtual technology,and studies the virtual reality,virtual instrument,virtual laboratory and its features and significance in experiment teaching.