A certain amount of potassium chloride is required to correct the hypokalemia occuring commonly during perioperation,but the overdosage may be harmful. To investigate the proper dose of KCl,40 adult rabbits were randomly and evenly assigned to be intravenously infused with normal saline(group Ⅰ),or saline containing 4,25 or 50 mmol/L KCI (group Ⅱ,Ⅲ,Ⅳ),at rate of 10 ml?kg~(-1)?h~(-1) during operation respectively. As compared with those before operation,the serum level of potassium decreased significantly in group Ⅰ and Ⅱ, changed unsignificantly in group Ⅲ,and increased in group Ⅳ during and after operation;the potassium amounts in liver and skeletal muscles increased markedly after operation. S-T segment was depressed in group Ⅰ and Ⅱ,T wave became peaked in group Ⅳ, and ECG remained normal in group Ⅲ. it is indicated that intravenous KCl infusion at concentration 25 mmol/L and rate of 10ml?kg~(-1)?h~(-1) may properly correct the hypokalemia during perioperation,and the occurance of perioperatine hypokelemia may be related to the uptake of liver and skeletal muscles

Ten mongrel dogs,divided randomly into a control group (A) and a cerebroplegia group (B) ,were supported by closed-chest cardiopulmonary bypass,subjected to 2 hours of hypothermic circulatory arrest at 18 C. In group B, oxygenated asanguineous solution 50ml/kg was infused into the carotid artery at the onset of arrest. and 10 ml/kg was supplemented every 30 minutes during 2hours arrest. Nothing was infused in group A. Then all animals were rewarmed to 37 C and killed 6 hours later At five time points cerebral cortex was collected to study adnosine triphosphate (ATP),malondialde hyde (MDA) and ultrastructure. Electroencephalography (EEG) was recorded continuously. In group A, ATP content decreased gradually from the beginning of arrest to the end of the experiment (P

Humans ; Hypoxia-Ischemia, Brain ; etiology ; Infant, Newborn ; Phosphorylation ; Protein Phosphatase 2 ; physiology ; Receptors, N-Methyl-D-Aspartate ; chemistry ; physiology

Objective To study the features of hippocampal atrophy (HA) by MRI in mild Alzheimer's disease(AD) patients. Methods Fifteen mild AD patients and 30 healthy controls were included in this study and all subjects were examined by both MRI and MMSE. The differences in the hippocampal volume between the mild AD and the control were analysed, and relationships between the hippocampal volume and age, MMSE scores were evaluated. Results The hippocampal volume of the mild AD was decreased significantly than that of the controls 〔(2 08?0 46)cm 3 vs (3 11?0 19)cm 3, t =2 71, P 0 05). Conclusions MRI-based HA could be used to differentiate the mild AD patients effectively from the healthy subjects and could also be regarded as a status marker for the early clinical diagnosis of AD.

Objective To observe the features of the manifestations of fundus fluorescein angiography (FFA) in multiple sclerosis (MS) and their value in clinical diagnosis. Methods The clinical data of 42 patients (84 eyes) with MS diagnosed by magnetic resonance imaging (MRI) and examination of cerebrospinal fluid (CSF) were retrospectively analyzed. The clinical data included visual acuity, ocular fundus examined by direct ophthalmoscope after mydriasis, FFA, visual field, CSF,visual evoked potential (VEP) and MRI examination. Results In 42 patients (84 eyes),the positive detectable rate of examination of direct ophthalmoscope, CSF, visual field, VEP, and MRI was 36.9%, 21.4%, (71.4%, and) 83.3% respectively. Abnormal results of FFA were found in 44 eyes (52.38%), including papillitis in 4 eyes (4.76%)at the early stage with extended physiological scotoma and central scotoma; neuroretinitis in 7 eyes (8.33%)at the medium stage with central or para- central scotoma; optic atrophy in 33 eyes(39.29%) at the late stage with centripetal constriction and even tubular visual field. Conclusion The main angiographic features of MS are papillitis, neuroretinitis and optic atrophy. The manifestations of FFA combined with the results of examination of CSF,visual field, VEP and MRI is helpful for comprehensive and exact diagnosis of MS.

ObjectiveTo investigate the effects of different therapeutic methods on borderline hypertension with metabolic syndrome patients. MethodsNinety borderline hypertension with metabolic syndrome patients were divided into three groups by random digits table with 30 cases: control group,conventional therapy group and intensive therapy group. The control group was given regular observation, the conventional therapy group took drug according to the disease situation; and the intensive therapy group not only formulated the aim of therapy, but also received diet control, sport therapy, healthy education and drug therapy. After 1 year's follow-up, the patients' changes were compared. ResultsAfter 1 year's follow-up,the levels of FPG, 2 h PG, 24 h mAlb and IMT were significantly increased(P ＜ 0.05 ), and the levels of other index had no significant changes (P＞ 0.05) in control group. The levels of FPG,2 h PG,TC and TG were significantly decreased and IMT was significantly increased(P ＜0.05), the levels of other index had no significant changes(P ＞ 0.05 ) in conventional therapy group. The levels of SBP, DBP, PP, FPG, 2 h PG, TC,TG,hs-CRP,24 h mAlb and HOMA-IR were significantly decreased and HDL-C, ABI were significantly increased (P ＜ 0.01 or ＜ 0.05 ) in intensive therapy group. After treatment, the levels of ABI and H DL-C were significantly higher and SBP, DBP, PP,TG, hs-CRP, 24 h mAlb, HOMA-IR, IMT were significantly lower in intensive therapy group than those in conventional therapy group (P ＜ 0.01 or ＜ 0.05 ). ConclusionsDrug therapy is efficient in borderline hypertension with metabolic syndrome patients, and intensive therapy can obviously improve the insulin resistance, to control the developing of hypertension can delay the vascular

ObjectiveTo investigate the effect of immunoglobulin G (IgG) extravasated from blood circulation on the expression of toll-like receptor 4 (TLR4) induced by peripheral lipopolysaccharide (LPS) in rat brain. Methods The rats were divided into four groups in random, 5 rats in each. Group one received LPS 100μg/kg by intraperitoneal administration, normal saline was given by intravenous injection 6 hours later; group two was injected with adrenalin (AD) 15μg/kg intravenously; group three was treated with LPS intraperitoneally, AD was injected 6 hours later; group four was injected normal saline intravenously as control. For all groups, the animals were sacrificed 30 min after the last injection, and the brains were taken for investigation of the TLR4 expressions by immunofluorescence staining and RT-PCR. Result Immunofluorescence staining showed that IgG immunoreactive product was patch-like, distributed in the brain parenchyma in all the animals that received AD. In the LPS+normal saline group, IgG was found merely around the blood vessels. Meanwhile, in LPS+AD animals, TLR4 immunoreactive product coexisted with microglia marker Iba-1 within the IgG extravasated area. The double-labeled cells dispersed in the brain parenchyma and near to the cerebral vessels. In the LPS+saline group, TLR4 positive cells were endothelial-like. RT-PCR results indicated that the expression level of TLR4 in the LPS+AD group were significantly higher than that in the LPS+saline group or AD group or the saline control (P<0.01). Conclusion Extravasated circulating IgG may enhance the TLR4 expression in the rat brain induced by peripheral LPS.

Objective To investigate the clinical effects of preoperative eye position training on femtosecond laser-assisted laser in situ keratomileusis(FL-LASIK)? Methods One hundred and sixty-eight myopia patients(328 eyes)scheduled for selective FL-LASIK were randomly divided into the experiment group of 85 cases(166 eyes)and the control group of 83 cases(162 eyes)?The patients in the control group were given the routine preoperative education and the patients in the experiment group received the preoperative intervention of eye position besides routine preoperative education? The two groups were compared in terms of intraoperative changes of eye position,corneal topography and the postoperative visual acuity? Results The frequency of eye position adjustment and machine stopping in the experiment group was significantly smaller than that of the control group(P < 0?001)? But no significant differences were found between the two groups in corneal topography and the postoperative visual acuity(P > 0?05)? Conclusion Preoperative training of eye position may maintain ideal eye position and reduce the frequency of downtime due to eye position adjustment during FL-LASIK,which may ensure the successful completion of FL-LASIK?

Objective To investigate the outcome of intraductual papillary mucious neoplasms (IPMN) of the pancreas after surgical resection. Method Clinical data of 76 patients with intraductal papillary neoplasms of the pancreas undergoing surgical resection at Zhongshan Hospital, Fudan University between January 1999 and December 2008 were retrospectively analyzed. Results Among the 76 patients,49 were male, 37 were female. 32 had noninvasive IPMNs, including adenomas( n = 16), borderline tumors (n =6 ), carcinomas in situ (n = 10 ). 44 had invasive IPMNs. Lesions were present in the head in 63 cases, in the body or tail in 10, in the whole pancreas in 3. There were significant difference in age,jaundice, weight loss, asymptomatic cases and CA199 value between noninvasive and invasive IPMNs.Three patients underwent total pancreatectomy, 59 patients underwent pancreaticoduodenectomy, 4 patients underwent pancreaticoduodenectomy with portal vein resection and reconstruction, six patients underwent distal pancreatectomy, two patients each underwent central pancreatectomy or enucleation. The overall postoperative morbidity rate were 28.9%, there was no operative mortality. Positive pancreatic margin was identified in seven patients of noninvasive neoplasms, among thoee one developed recurrence after 67 months. The five-year survival rate for patients with noninvasive and invasive neolpasms was 100% and 35% ,respectively. Size and lymph node metastasis were significant prognostic factors after surgical resection of the invasive IPMNs. Conclusions Surgical resection provides a favorable outcome for patients with noninvasive IPMNs. In contrast, invasive IPMNs was associated with a poor survival. Early resection is essential for improving survival. Long-term follow-up is necessary for all patients with IPMNs after resection.

Objective To discuss the diagnostic methods and management of ruptured abdominal aortic (aneurysm)(AAA) and to analyse the main factors that influence prognosis.Methods The clinical data of 15 cases of ruptured infrarenal AAA treated in our hospital from 1998~2004 were retrospectively analysed. The main clinical manifestations were abdominal pain and/or back pain,low blood pressure or shock, and (pulsating) abdominal mass. 8 cases were diagnosed by DSA and/or sCTA; Doppler ultrasonic examination (suggested) rupture of abdominal aortic aneurysm in 2 cases; 2 cases had known history of AAA prior to (rupture); and 3 cases were diagnosed during operation. All of the patients underwent surgical operation. (Successful) clamping of the abdominal aorta above the neck of AAA was accomplished in 13 cases. Of these, the aorta was occluded below the diaphragm in 4 cases, and below the renal arteries in 9 cases.Results Seven cases(46.6%) died in the perioperative period. 2 died of blood loss from aneurysm that ruptured into the free abdominal cavity, 1died of myocardial infarction 5 days postoperatively, 2 died of respiratory failure 3 days and 7 days postoperatively, and 2 died of renal failure 4 days and 8 days after operation. Severe (complications) did not develop in the remaining patients.Conclusions Patients who present with the trilogy of abdominal pain and/or back pain, low blood pressure or shock and pulsating abdominal mass can be (diagnosed) easily. CT and Doppler ultrasonic examination are indicated for patients with questionable diagnosis and have stable vital signs. Operation is effective treatment for ruptured AAA. The crux of the operation is to mack an aortic occlusion proximal to the site of rupture of aorta to effectively control bleeding. Patients with rupture of AAA into the free peritoneal cavity or those with acute myocardial infarction, acute renal failure or respiratory complications had poor prognosis.