Objective To investigate the effectivity of bispectral index(BIS)and auditory -evoked potentials index(AEP index)in monitoring the depth of desflurane anesthesia in the elderly. Methods Sixty patients(ASA gradeⅠ～Ⅱ)without obvious auditory and psychiatric dysfunction undergoing general anesthesia were enrolled in this study,and they were devided into the elderly group (n=30)and the non-elderly group(n=30)according to the age.After the endotracheal intubation,the lungs were ventilated with desflurane in oxygen.End-tidal concentrations of desflurane were maintained at 0.6,1.0 minimum alveolar concentrations(MAC)and 1.3 MAC for 20 minutes, respectively.The changes of BIS,AEP index,mean arterial blood pressure(MAP)and heart rate (HR)were recorded simultaneously.Results In the elderly and non-elderly groups,BIS were 94.14?6.5 and 94.5?4.6(P＞0.05),and AEP index at pre-anesthesia were 87.2?11.7 and 89.2?6.9(P＞0.05)respectively,which showed no statistic difference between two groups.BIS and AEP index decreased significantly in each time point at pre-anesthesia compared with those during anesthesia in two groups (P＜0.05).In the periods of increasing concentration of desflurane,BIS decreased gradually in two groups(P＞0.05),but BIS in the elderly group were higher than in the non-elderly group at the same end-tidal desflurane concentration(P＞0.05),and BIS negatively correlated with the end-tidal desflurane concentration in two groups.In the elderly group,AEP index decreased significantly at the concentration of 1.0 MAC and 1.3 MAC of desflurane compared with that of 0.6 MAC(P＜0.05),but there was no difference in AEP index with increasing end-tidal desflurane concentration from 1.0 MAC to 1.3 MAC(P＞0.05).At every concentration of desflurane,AEPindexintheelderlygroupwaslessthaninthenon-elderlygroup(P＜0.05).Conclusions BIS and AEP indexes correlate well with the end-tidal desflurane concentration,and are valuable for monitoring the depth of desflurane anesthesia in the elderly.AEP index can predict the difference in depth of anesthesia at the same end-tidal desflurane concentration between the elderly and the non-elderly.

Adult ; Embolism, Amniotic Fluid ; etiology ; therapy ; Female ; Humans ; Pregnancy

This was a retrospective study of dentigerous cysts in people from the Singapore-Malaysian region. The purpose of this study was to present the clinicopathologic features of dentigerous cysts in the Oriental population and to compare these data with those from other reported studies. Biopsy records from 1981 to 1993 of 119 cases of dentigerous cysts from patients in Malaysia and Singapore showed that 36.1% of patients were female and 63.9% patients were male. Among patients with cysts, 70.5% were Chinese, 23.2% were Malays, 2.7% were Indian and 3.6% were other ethnic groups. The mean age of these patients was 30.2 +/- 17.3 years with a peak incidence occurring in the second and third decades. The location of the lesions was almost equal to the maxilla (50.9%) and the mandible (49.1%). There was a marked predilection for the posterior mandible (42.7%) followed by the anterior maxilla (38.2%). Histologically, 90.8% of the cysts were lined by a non-keratinised stratified squamous epithelium. The cyst linings were mainly thin (90.0%) with 38.7% of cases having a mixed thick and thin lining. Mucous metaplasia was observed in 9 (7.6%) cases. Rushton bodies were seen in 3.4% of cases. Cholesterol clefts in the epithelial lining and lumen were found in 16.8% cases while 12.6% of cases exhibited cholesterol clefts in the cyst wall. Other cellular structures within the cyst wall were lymphocytes (66.4%), plasma cells (52.1%), Russell bodies (16.0%) and histiocytes (4.2%). Odontogenic keratocysts were observed in 5.0% of cases. One case of adenomatoid odontogenic tumour was also observed. Epithelial atypia was seen in 9.2% of cases, islands of stratified squamous epithelial cells in 8.4% of cases while one case showed a combination of these two features. In conclusion, some clinical features seen in this study are similar to that for the Caucasian population such as prevalence in male, peak incidence in the second and third decades and the predilection for the posterior mandible and anterior maxilla. Histopathologically, odontogenic keratocyst and adenomatoid odontogenic tumour were observed in dentigerous cysts.
seconds ; Singapore ; Maxilla ; Mandible ; Malaysia

Objective To observe the significance of preoperative peripheral serum inflammatory cyto-kines and blood routine in predicting postoperative DVT in patients with neurosurgery.Methods A total of 156 pa-tients from the Department of Neurosurgery form April 2016 to April 2017 were recruited in this study.According to the incidence of postoperative deep venous thrombosis(DVT),patients were divided into DVT group(48 cases) and non-DVT group(108 cases). The date blood routine(including hematocrit,hemoglobin,neutrophil count, monocyte count,white blood cell count,platelet count)and serum inflammatory cytokines(including TNF-α,IL-1β,IL-1β,IL-6,IL-8)of two groups by t tests were compared.The possible risk factors for postoperative DVT in neurosurgical patients were analyzed by multivariate analysis logistic regression.The predicted cutoff value is deter-mined by plotting the subject's working characteristic(ROC)curve.Results Between the control group and DVT group,there were significant differences in preoperative blood neutrophil count,hemoglobin,TNF-α,IL-6 and IL-8(P < 0.05). Multivariate analysis logistic regression showed that the level of neutrophil count and concentration of serum TNF-α concentration were increased,indicating they may be the risk factors of DVT.For the neutrophilic granulocyte count,the value of specificity and sensibility was 82.7%and 61.7%respectively.For the TNF-α level, the value of specificity was 72.3% and the value of sensibility was 83.1%. Conclusion The level of preoperative neutrophil count and the concentration of TNF-α have value in predicting the occurrence of postoperative DVT in neurosurgical patients.

Objective:To study the metabolism of pedunculoside treated with rat intestinal bacteria in vitro. Methods:Pedunculo-side and rat intestinal bacteria were incubated in vitro for 0, 4, 8, 24 and 48 hours under anaerobic condition. After extracted repeat-edly by ethyl acetate, the metabolites in the incubation media were qualitatively and quantitatively analyzed by HPLC. Results:Totally 90. 8% of pedunculoside was transformed to M2 after incubated with rat intestinal bacteria in vitro for 48 hours, and a detailed compari-son of HPLC profiles between M2 and rotundic acid showed M2 was rotundic acid. Conclusion: Pedunculoside can be metabolized to rotundic acid by rat intestinal bacteria in vitro.

Objective To compare the clinical therapeutic effect of radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy (RECTL) with traditional radical resection of esophageal carcinoma(TREC).Methods 80 patients receiving RECTL and 80 patients receiving TREC were chosen in our hospital.The general conditions during operation,pathologic data,postoperative complications and recurrence or metastasis rates were compared between two groups.Results Compared with TREC group,RECTL group had longer operation time 、less bleeding、less postoperative chest drainage liquid amount and less postoperative morphine administration (P ＜ 0.05 or P ＜ 0.01).The postoperative hospital stays were not statistically different between the two groups(P ＞0.05).The length of resected esophagus specimen and tumor near end cutting edge length in RECTL group are longer than that in TREC group,but with the former no statistically different(P ＞0.05) and the latter statistically different(P ＜ 0.05).There were no statistical differences about the number of dissected lymph nodes and the incidence of complications and local recurrence by cut plant between the two groups(P ＞ 0.05).The incidence of postoperative reflux gastritis was 7.1％ in RECTL group and 45 ％ in TREC group,with significantly statistical difference(P ＜0.01).The two groups had similar recurrence or metastasis rate(P ＞ 0.05).Conclusion Radical resection of esophageal carcinoma under combination of thoracoscopy and laparoscopy,with small wound and early recovery,has the same effect as traditional operational resection of esophageal carcinoma.

Objective To compare the iodine intake,image quality and radiation dose of dual-source CT coronary artery angiography between the low concentration isotonic contrast agent with iterative reconstruction technique of sinogram affirmed iterative rEconstruction (SAFIRE) and common concentration contrast agent with filtered back projection (FBP).Methods One hundred patients [58 men,42 women; age:(62± 11)y] were enrolled in this study.Fifty consecutive patients (Group A) were scanned with FBP and common concentration contrast agent and another 50 consecutive patients (Group B) were scanned with low concentration isotonic contrast agent and iterative reconstruction technique.The image quality were assessed by two experienced radiologists with a double blinded fashion in a five score scale.The attenuation of coronary artery,scan time,imaging noise,signal-to-noise ratio (SNR),contrast-to-noise ratio (CNR),radiation dose and iodine intake between these two groups were compared using two sample t test.The observer agreement for image quality was calculated using Kappa statistics.Results All examinations were completed successfully.There was no statistical difference (P＞0.05) between two groups in clinical characteristics and scan parameters.There was no statistical difference for the mean subjective image quality of group A (4.4±0.7) and group B (4.3±0.8) (t=0.924,P＞0.05).The Kappa value between two radiologists was 0.887 (P＜0.01)on image quality.The mean attenuation of coronary artery segments was higher than 300 HU,especially in group A (386.1±51.5) HU,which was slightly higher than the group B (384.1±77.1) HU,but there was no statistical difference (t=0.157,P＞0.05).The SNR and CNR in two groups did not have significant differences (P＞0.05).The total iodine and iodine injection rates were 21.0 g,17.5 g/s in Group A and 16.2 g,13.5 g/s in Group B,respectively.The iodine intake was decreased by 22.9％ in Group B.The effective radiation dose in Group B (1.09±0.19) mSv was significantly (t=20.260,P＜0.01) lower than that in Group A (2.85±0.59) mSv,with the radiation dose reduced by 61.8％.Conclusion Low concentration isotonic contrast agent and iterative reconstruction technique can significantly reduce the radiation dose and iodine intake in CT coronary artery angiography and achieve the same image quality using common concentration contrast agent with FBP.

Objective: To investigate the impairment status of vestibular and limb peripheral nerve of patients with auditory neuropathy, improve the understanding of auditory neuropathy in general. Method: Vestibular function tests and nerve conduction velocity (NCV) examinatoin were performed on 28 young patients with auditory neuropathy which confirmed by clinical auditory tests diagnosis from March 1999 to November 2000. There were 14 males and 14 females, ranging in age from 22 to 28 years old. Results: Vestibular dysfunction was encountered in 22 of 28 (78.57%) suffering from auditory neuropathy. Limb peripheral nerve impairment was found in 11 of 28 patients (39.29%) of auditory neuropathy. The caloric responses were normal symmetric responses in 6 of 28 (21.43%,6/28), and weaken bilaterally in 20 of 28 (71.43%,20/28)respectively. On the NCV examination, both motor conduction velocity (MVC) and sensory conduction velocity (SCV) were normal in 17 (60.71%,17/28), abnormal in 4 (14.29%,4/28). Four cases showed abnormal MCV and SCV. And pure MCV abnormality and pure SCV abnormality were found on 4 and 3 cases respectively. Conclusion: The pathological process affecting the auditory nerve may also affect the vestibular nerve and other peripheral nerve. This seemed possible in view of fact that auditory neuropathy may affect one nerve (mononeuropathy) or multiple nerves (polyneuropathy).

OBJECTIVEThe aim of the present study is to explore the effects of exhaustive exercise-induced oxidative stress on the antioxidant capacity and diformability of rat red blood cells.

METHODSRats were divided into three group (n = 10): sedentary control (C), exhaustive running exercise (ERE) and moderate running exercise (MRE) groups. Animals in the ERE group started treadmill running at a speed of 20 m/min speed with a 5% gradient, and reached a speed of 25 m/min with gradient 15% in 20 min. Running was continued until exhaustion. MRE group rats running at a speed of 20 m/min with a 5% gradient for 40 min. The levels of free thiol in erythrocyte membrane protein, lipidperoxidation levels and membrane protein components were analyzed. The red blood cell deformability of different groups was also observed.

RESULTSThe results showed that red blood cells were damaged by severe oxidative stress and the anti-oxidative capacity decreased significantly under exhaustive exercise conditions. Besides, lipid peroxidation and protein sulfhydryl cross-link based clustering of membrane were found after exhaustive exercise, and polymers high molecular weight (HMW) was formed. The elongation index (EI) was found to decline significantly in the ERE group compared with the C and MRE groups under shear stress (control group, 0.41 +/- 0.01 at 3 Pa and 0.571 +/- 0.008 at 30 Pa; ERE group, 0.314 +/- 0.013 at 3 Pa and 0.534 +/- 0.009 at 30 Pa; P < 0.05 and P < 0.01, respectively).

CONCLUSIONThese exercise-induced oxidative injure result in a significant decrease in deformability of rat erythrocytes, which in turn leads to dysfunction in the microcirculatory.

Animals ; Disease Models, Animal ; Erythrocyte Deformability ; Fatigue ; metabolism ; physiopathology ; Male ; Oxidative Stress ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley

Objective To analyze obese children serum lipid level in order to understand the relationship between serum lipid and cardiovascular disease in obese children.Methods One hundred and fifty-three children(109 male and 44 female)aged 4-16 years old with obesity who attended the outpatient clinic of Beijing Children′s Hospital were collected.Percentage body fat (%BF),body fat (BF),fat-free mass (FFM) was estimated by using bioelectrical impedance analysis (BIA) and calculate.Waist and hip circumference,waist-to-hip ratio (WHR) was estimated by soft tape measure and calculate.Skinfold thickness of scapular bone below (S) and triceps muscle (T),S/T rate was estimated by skin fold meter and calculate.Serum total cholesterol (TC),triglyceride(TG),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),apolipoprotein(Apo) AI and Apo B levels were also measured.SPSS 11.0 software was used to analyzed the data.Results The cardiovascular disease related was the prevalence of high TC levels(3.3%)or high LDL-C level(6.0%) and high TG level(24.7%) was rather low.HDL-C level was reduced in 31.3% of obese children.In children over 10 years old,%BW and %BF showed a weak correlation with HDL-C(r=-0.202,-0.211).Conclusions In obese children,serum lipid as well as Apo level should be exa-mined in order to evaluate angiocardiopathy.