Objective To compare the efficacy of mechanical ventilation (MV) with low tidal volume (LTV) plus positive expiratory end pressure (PEEP) and conventioal MV in the treatment of traumatic acute respiratory distress syndrome(ARDS). Methods From Oct 1997 to Oct 2003, 26 cases of traumatic ARDS patients were treated by conventioal MV(group A, n=11) or MV with LTV plus PEEP(group B,n=15), and clinical data of the patients were recorded and compared. Results There were no statistical difference in the PaO 2 of blood gas analysis and hemodynamic indices between the two groups, while the PaCO 2 was higher in group B than that in group A(P

Objective To observe a new phosphodiesterase-4 inhibitor Ro 20-1724 on ketamine anesthesia-induced learning and memory impairment and cAMP/PKA-CREB-BDNF signal pathway in immature rats.Methods Twenty-four 21 day-old SD rats were randomly divided into 4 groups (n=6 each):control group (group C) ;ketamine group (group K) ;ketamine+Ro 20-1724 group(group K+Ro) and ketamine+vehicle (0.1％ ethanol) group (group K+E).Ketamine 70 mg/kg was injected intraperitoneally(IP) once a day for 7 consecutive days in groups K,K+Ro,and K+E.Ro 20-1724 0.5 mg/kg and equal volume of vehicle were injected IP at 30 min after IP ketamine each time respectively.Morris water maze was used to assess learning and memory ability after 2 days normal feeding,the escape latency and frequency of passing the platform were recorded.The animals were killed after water maze test and the cAMP,PKA,p-CREB,and BDNF protein expression in hippocampus were detected.Results Repetitive ketamine anesthesia significantly prolonged the escape latency (P＜0.01),decreased the frequency of passing the platform(P＜0.01),and down-regulated the expression of cAMP,PKA,p-CREB,and BDNF protein ((280±31) pmol/mg vs (210± 19) mol/mg,P＜0.01 ; 1.32±0.11 vs 1.13±0.12,P＜0.01 ; 2.61 ±0.22 vs 2.03 ± ±0.19,P＜0.01 ; 1.51 ±0.14 vs 1.16±0.10,P＜0.05) ; Compared with group K,Ro 20-172,significantly attenuated the escape latency time(P＜0.05,P＜0.01)and increased the frequency of passing the platform(P＜0.01),and ameliorated the expression of cAMP,PKA,p-CREB,and BDNF protein ((210± 19) pmoL/mg vs (240± 27) pmol/mg,P ＜0.05;1.13±0.12 vs 1.28±0.12,P＜0.05;2.03±0.19 vs 2.32±0.21,2.32±0.21;1.16±0.10 vs 1.37±0.11,P＜0.01).There was no difference between group K+Ro and group C,and between group K+E and group K(P＞0.05).Conclusion ketamine anesthesia-induced learning and memory impairment can be improved by Ro 20-1724,and cAMP/PKA-CREB-BDNF signal pathway in hippocampus participated in the changes.

Objective To valuate the effect of Ro20-1724 on ketamine-induced apoptosis in hippocampal neurons of neonatal rats.Methods Hippocampal neurons from newborn Sprague-Dawley rats were obtained and cultured in vitro.The primary hippocampal neurons were randomly divided into 4 groups (n =24 each) using a random number table:control group (group C),ketamine group (group K),solvent control group (group E),and Ro20-1724 group (R group).The neurons were incubated for 72 h in the normal culture medium in group C.The neurons were incubated for 72 h in the culture medium containing ketamine 150 μmol/L in group K.In E and R groups,after the neurons were incubated for 30 min in the culture medium containing ketamine 150 μmol/L,the culture medium was then replaced,0.01％ ethanol (final concentration) and 1 × 10-3 μmol/L Ro20-1724 (final concentration) were added to the culture medium,respectively,and the neurons were then incubated for 72 h.After 72 h incubation,the cell viability was detected by MTT assay,the cell apoptosis was detected by flow cytometry,the expression of Bcl-2 mRNA and Bax mRNA was determined by RT-PCR,and synaptophysin Ⅰ expression was detected by Western blot.The apoptosis rate was calculated.Results Compared with group C,the survival rate was significantly decreased,the apoptosis rate was increased,the expression of Bcl-2 mRNA and synaptophysin Ⅰ was down-regnlated,and Bax mRNA expression was up-regulated in K and E groups (P ＜ 0.05 or 0.01).Compared with group K,the survival rate was significantly increased,the apoptosis rate was decreased,the expression of Bcl-2 mRNA and synaptophysin Ⅰ was up-regulated,and Bax mRNA expression was downregulated in R group (P ＜ 0.05 or 0.01).Conclusion Ro20-1724 can inhibit ketamine-induced apoptosis in hippocampal neurons of neonatal rats and correction of Bcl-2/Bax imbalance is involved in the mechanism.

Objective To study the findings of brain metastases with MR perfusion weighted imaging(PWI).Methods PWI and conventional contrast MR were performed in 20 patients with brain metastases.The diameters of metastases were measured on conventional contrast MR images.The rCBV pseudo-color map was generated using packaged software FUNCTOOL and the rrCBV of peripheral and central part of lesions,perilesional edema were measured.Results 55 lesions were showed on conventional contrast MR images.On the rCBV pseudo-color map,19 lesions were inhomogeneously enhanced while the other 36 lesions were homogeneously unenhanced equal and to contralateral cortex.The diameters of the two groups were statistically different.Conclusion Brain metastases may have different features on PWI images,which are dependent on their sizes.

Objective To investigate the incidence of postoperative hepatic metastasis,clinicolpathological characteristics and the prognosis for pancreatic cancer. Methods Totally 83 cases with pancreatic cancer admitted in our hospital during January 2007 to September 2012 was retro?spectively analyzed according to clinicolpathological data. Results Postoperative liver metastasis occurred in 31 cases with a metastatic rate of 37.3%. The size(χ2=9.606;P=0.002),vascular invasion(χ2=4.794,P=0.029)and UICC stage(χ2=5.318,P=0.021)were correlated with he?patic metastasis. Univariate analysis revealed the poor prognosis in pancreatic cancer patient with hepatic metastasis(χ2=9.967,P=0.002). Cox re?gression analysis revealed hepatic metastasis as an independent prognostic factor(P=0.001). Conclusion Pancreatic cancer has a high possibility of hepatic metastasis. Postoperative hepatic metastasis was one of the independent factors for the prognosis of pancreatic cancer. Tumor size,vascular invasion and UICC stages were risk factors for postoperative liver metastasis of pancreatic cancer.

Objective To compare the short-term clinical outcomes of hand-assisted laparoscopic surgery(HALS),laparoscopic-assisted surgery (LAS)and open surgery(OS)for colorectal cancer treatment. Methods The clinical data of 74 patients underwent HALS,LAS and OS for colorectal cancer treatment between October 2011 and December 2015 were assessed retrospectively. All the surgeries were performed by the same surgical team. The intraoperative details,postoperative recovery,postoperative complications,oncologic results and cost were compared among the three groups. Results A total of 24 patients in HALS group,25 patients in LAS group and 25 patients in OS group were finally included. The gen-eral data and oncologic baseline were comparable among the three groups. The comparative results showed that the operative time increase d and in-cision length shortened gradually in OS group,HALS group and LAS group(P<0.05). HALS group was favor of less number of trocars used com-pared with LAS group(P<0.05),but there was no statistical difference of the conversion rate between the two groups(P>0.05). In terms of post-operative recovery,postoperative complications and oncologic results,there was no statistical difference between the three groups(P>0.05). As for cost,the total cost and operative cost of OS group were lower than HALS group and LAS group(P<0.05),but there was no significant differ-ence between HALS group and LAS group(P>0.05). The material cost increase gradually in OS group ,HALS group and LAS group(P<0.05), and there was no significant difference on the part of other cost among the three groups(P>0.05). Conclusion HALS,LAS and OS are compen-satory with each other,and clinicians can choose the reasonable procedure according to personal proficiency and situation of patients.

Objective To evaluate the relationship between the serum estradiol levels and susceptibility to thromboangitis obliterans(TAO) in a population of Uighurs from Xinjiang.Methods Clinical data were concluded 500 Uighur healthy male through the method of multistage and cluster sampling randomly in Xinjiang Kashi area,300 cases of Hans male came from the healthy physical examination in Xinjiang Uygurs Autonomous Region Pepole's Hospital,examining the serum estradiol levels and analysising whether had the statistical significance between Uygurs and Hans nationality.Results The estradiol levels of Uighur male was (31.49 ± 12.55) pg/ml,the hans was (26.68 ± 12.40) pg/ml,single factor analysis,the difference with plasma estradiol levels have statistical significance between ethnic groups (t =5.267,P ＜0.05),and serum estradiol levels of uygur people was higher than Hans,and the estradiol levels with different smokers and age groups,there was no statistically significant difference (t =0.346,F =1.820,P ＞0.05).Logistic regression analysis indicated that only ethnic difference have statistically significant influence on estradiol levels (P ＜ 0.05).Conclusions The serum estradiol levels of Uighur healthy male in Xinjiang are higher than Hans.The high serum estradiol levels may be a susceptible factor of thromboangitis obliterans to Xinjiang Uygur.

Objective To establish a MRI grading diagnostic model for chronic pancreatitis (CP) to acquire better combination for CP diagnosis and improve the diagnostic ability of CP grading.Methods To collecte the data of 68 CP patients who were clinically diagnosed and 23 health volunteers from Dec 2012 to Oct 2014.There were 23 mild CP, 14 moderate CP and 31 severe CP according to Cambridge classification.3.0 T MRI data were analyzed, and 14 features were extracted to compare the MRI features among groups.The single ordinal regression analysis was conducted on the variables with significant difference between groups, and the collinearity was diagnosed.The factor analysis was used for multicollinearity.The multiple ordinal logistic regression was finally conducted to establish the regression model.Results There was no significant difference between control groups and CP groups on pancreas divisum (X14), but significant differences were found in other 13 features (P<0.05).Single ordinal regression analysis of 13 features showed that all features except pancreatic parenchymal bubble (X12) were significantly correlated with CP grading diagnosis(P<0.05).The effect of multicollinearity was validated among 9 continuous variables.Three common factors were identified, including F1(X3、X4、X5、X9、X8), F2(X7、X6) and F3 (X1、X2) which represented the exocrine function, the features of main pancreatic ducts and pancreatic parenchyma, respectively.Six features were implemented into the multi Logistic regression model, which included F1, F2, F3, X10 (the visualizations of branch pancreatic duct after secretin stimulation), X11 (pancreatic shape) and X13 (the filling defects of main pancreatic duct).Finally, the most appropriate regression model was gotten, which was the scale model of the probit link function.The model′s diagnostic accuracy for normal, mild CP, moderate CP, severe CP and total CP was 96.65%,100%, 71.42%,100% and 94.50%, respectively.Conclusions The ordinal logistic regression model proposed in this study may accurately predict the CP grades and can offer valuable references for clinic diagnosis and therapy of CP.

Objective To analyze the imaging findings and misdiagnosis of intraductal papillary mucinous neoplasm (IPMN),to improve diagnosis level and decrease misdiagnosis rate.Methods The images of 130 patients were suspicion or diagnosis of IPMN, and the other pancreatic lesions but confirmed IPMN by pathology.Two radiologists collected materials, analyzed the reasons of misdiagnosis, and found out countermeasures.Results A total of 130 patients confirmed by pathology were available for analysis, in which there were 105 (80.7%) of IPMN, and 25 (19.2%) of other pancreatic lesions.The most misdiagnosed patients were between IPMN and chronic pancreatitis(CP),serous cystadenoma(SCN).All patients were divided into mild to moderate group and severe to infiltrating carcinoma group based on pathologic grades.There was significant difference between two groups in cystic diameter, wall nodule, separation and dilation, the diameter of main duct, and intra-or extrahepatic biliary tract(P<0.05).The most common causes of misdiagnosis included that the radiologists didn't combined with the patient's clinical features,and didn't reconstruct images or perform MRCP scan when the relationship between the lesions and the pancreatic duct was unclear.Conclusion It is important that the radiologists need to combine with the patient's clinical features, clear the relationship between the lesions and the pancreatic duct, and fully master imaging findings.The recurrent pancreatitis maybe result from IPMN, and IPMN for a long time would lead to CP.

Objective Study of interleukin-6 (IL-6),erythrocyte sedimen-tation rate (ESR),C-reactive protein (CRP) in diagnosis and treatment of abdominal aortic aneurysm.Methods Between June 2014 and May 2016,we detected of abdominal aortic aneurysm in 62 cases that were diagnosed and treated at Department of Vascular Surgery,People's Hospital of Xinjiang Uygur Autonomous Region including interleukin-6,erythrocyte sediinen-tation rate,and C-reactive protein.Results There was no significant difference between interleukin-6,erythrocyte sedimen-tation rate and C-reactive protein in the patients with and without complications.The correlation analysis results of interleukin-6,erythrocyte sedimen-tation and C-reactive protein were confirmed to have positive correlation respectively.Compared with non special types of rupture (48.0 ± 34.2) pg/ml,interleukin-6 was higher in special types of rupture (187.6 ± 110.4) pg/ml.Conclusions Preoperative detection of interleukin-6,erythrocyte sedimen-tation and C-reactive protein,combined with patient history and imaging examination were help for predict cause,choose better surgical approach and predict the prognosis in certain guiding significance.