Objective To evaluate the safety of plasma volume replacement with HAES 130/0.4 during non-cardiac surgery in terms of hemodynamic stability, blood gases, hepato-renal function, blood coagulation and adverse reactions. Methods This was a five center prospective study comparing the safety and efficacy of HAES 130/0.4(6%) with HAES 200/0.5(6%)in a double-blind fashion. The selection criteria included ASA Ⅰ Ⅱ patients of both sex, aged 18-65yrs undergoing non-cardiac surgery of which the intraoperative blood loss was expected to exceed 400ml. Patients whose Hb

Objective To analyze the clinical characteristics of leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis.Methods Fourteen patients diagnosed as leucine-rich gliomainactivated protein 1 antibody-associated encephalitis in Capital Medical University Xuanwu Hospital from January 2012 to January 2015 were recruited.The clinical manifestation,brain magnetic resonance imaging,cerebrospinal fluid findings and biochemical examination of these patients were analyzed.Results The case series of 14 patients had an average age of (48.93 ± 15.60) years (range 27-67 years) with a male to female ratio of 2.5∶ 1.All patients presented with short-term memory loss.Nine patients experienced dementia.Additionally,among the 14 patients,12 experienced seizures,8 experienced faciobrachial dystonic seizures,10 had psychiatric symptoms,and 8 showed sleep dysfunction.Two patients were transferred into intensive care unit because of deteriorating symptoms and were provided operated mechanical ventilation.Thirteen of 14 patients exhibited abnormalities in their brain magnetic resonance imaging,with lesions in temporal lobe and hippocampus.Six patients had abnormal cerebrospinal fluid findings,8 patients showed hyponatremia (serum Na+ ＜ 135 mmol/L),while 5 patients co-existed with other autoantibodies.Screening for malignant tumors revealed normal findings.During 2 years follow-up,3 patients relapsed.Conclusions Leucine-rich glioma-inactivated protein 1 antibody-associated encephalitis is an autoimmune encephalitis characterized by short-term memory loss,faciobrachial dystonic seizures and hyponatremia.Lesions in brain MRI always involve in temporal lobe and hippocampus.This disease can relapse and is seldom associated with tumor.

Objective To analyze the improvement of clinical symptoms,relapse and neurological functional recovery and the prognostic factors of anti-N-methyl-D-aspatate receptor (NMDAR) encephalitis.Methods Follow-up was conducted for 51 hospitalized patients with anti-NMDAR encephalitis at the Department of Neurology,Xuanwu Hospital,Capital Medical University from June 2012 to April 2015.The neurological functional recovery was evaluated through modified Ranking Scale (mRS),and the prognostic factors were analyzed.Results Among the 51 patients with anti-NMDAR encephalitis,89％ (45/51) were completely recovered or remained mild neurological dysfunction (mRS score ≤ 2).The prognosis of main clinical symptoms was as follows:78％ (35/44) of the mental and behavior disorders were fully recovered,94％ (32/34) of the seizures were controlled and 65％ (21/31) of the cognitive deficiency were completely recovered;25％ (13/51) of the patients relapsed.Comparison of clinical data of initial on-set among complete recovery patients group (mRS score =0),partial recovery patients group (mRS score =1 or 2) and poor prognosis patients group (mRS score ≥ 3) showed that initial clinical manifestation with memory deficiency (17,9,6 cases respectively;x2 =6.664,P=0.036),involuntary movements(19,4,5 cases respectively;x2 =7.976,P =0.019) and central hypoventilation (5,0,2 cases respectively;x2 =6.124,P =0.047) had statistically significant difference.Conclusions The majority of anti-NMDAR patients have favorable prognosis,but some of the patients may remain various degrees of neurological deficiency,including mental and behavior disorders,cognitive deficiency and seizures.Initial clinical manifestation with memory deficiency,involuntary movements and central hypoventilation may indicate a poorer prognosis.

Objective To improve the sensitivity of MR molecular imaging by using targeting and magnifying effects of biotin-avidin system (BAS). Methods After preparing biotinylated monoclonal antibody HAb18, the number of biotin molecules coupled to each antibody and the binding capacity of biotinylated antibody were determined. Two-step pretargeting tumor imaging was first achieved by intravenously injecting biotinylated monoclonal antibody HAb18 into 8 BALB/c nude mice bearing QGY-7723 tumor cells line. 24 h later, Gd-DTAP-streptavidin (Gd-DTPA-SA) was injected. Gd-DTPA-HAb18 and Gd-DTPA were respectively injected intravenously into the other 12 tumor-bearing mice as contrast groups. MR imaging was performed before and 10, 30, 60 min, 3, 6, 12, 24 h, and 48 h after injection of MR contrast agents. All images were obtained using SE T_1-weighted imaging sequence. After MR imaging, enhancement time course of three different groups was determined by using enhancement data measured in the region of interest in the tumor. Enhancement ratio and contrast-to-noise of tumor were also calculated. Results The average number of biotin conjugated with each monoclonal antibody molecular was 20. And the immunoactivity of biotinylated antibody was 91%. In two-step pretargeting strategy, SI of tumor increased slowly and reached the maximum value at 6 h after injection of Gd-DTPA-SA, enhancement ratio and CNR of tumor had significant difference with other two enhancement methods. The enhancing effect of tumor was still perceptible even after 48 h. When using Gd-DTPA-HAb18, the tumor enhancement pattern was slow and slight. Even at 24 h after injection of Gd-DTPA-HAb18, enhancement ratio of tumor was 13.5%. After Gd-DTPA was injected, signal intensity of tumor increased rapidly, and reached the maximum value at 30 min after injection of Gd-DTPA, and then decreased rapidly. Conclusion Two-step pretargeting strategy based on BAS has specific and signal magnifying effects in tumor MR imaging. It can increase the number of gadolinium that bind to the tumor and provide new approach to MR molecular imaging.

Objective To evaluate the anatomical and developmental characteristics of inner ears and establish a normalized inner ear multi-slice computed tomography (MSCT)measurement standard.Methods The raw data of 81 normal head MSCT cases were amplified and reconstructed in inner ear areas and multi-plannar reformation (MPR)was used to measure diameters of the inner ears.-test was used to inspect the difference between sides and genders,one-way analysis of variance was adopted for different age groups. Significance level α=0.05,P <0.05 was considered statistically significant.Results There was no statistical significance in measured values of inner ears in different age groups,genders and sides.Not all the shapes of bony semicircular canals were completely circu-lar or elliptical.In lumen,posterior semicircular canal was maximal and superior semicircular canal was minimal.In height,posterior semicircular canal was maximal and lateral semicircular canal was minimal.In width,superior semicircular canal was maximal and lateral semicircular canal was minimal.Conclusion Measurement specifications of inner ear on MSCT are initial established,main structures of inner ear can be clearly displayed by post-processing of head MSCT raw data.

Objective To study the effects of hyperbaric oxygen (HBO) preconditioning (PC) on motor function and mitochondrial apoptosis after spinal cord injury (SCI) in rats.Methods Thirty-six healthy,male Wistar rats were randomly divided into 3 groups (each n =12):a control (CON) group,an SCI model group and an HBO-PC group.The SCI group and the HBO-PC group after 7 sessions of HBO-PC treatment were subjected to SCI modeling using Allen's method.The CON group was not given any special treatment.Two weeks after the modeling,Basso,Beattie,and Bresnahan BBB scale was used to rate the rats' locomotor function,and the T8 segment of the rats' spinal cords was removed.After extracting total RNA from the spinal cord tissue,real-time quantitative PCR was used to detect the mRNA expression levels ofcaspase-3,cytochrome C (CYC),Bak,Bax,Bcl-x and Bcl-2 in the spinal cord tissue.Results Two weeks after modeling,compared with the CON group,the average BBB locomotion score of the SCI model group had decreased.In contrast,caspase-3,CYC,Bak and Bax mRNA expressions had increased significantly.Compared with the CON group,the average BBB locomotion score of the HBO-PC group had decreased,caspase-3 expression had increased,and Bax mRNA expression had decreased,but the differences in the changes between the two groups were not statistically significant.Bak mRNA expression increased and CYC expression decreased,and the difference between the two groups was statistically significant.Compared with the SCI model group,the average BBB locomotion score of the HBO-PC group increased while caspase-3,CYC,Bak and Bax mRNA expressions decreased,but none of these differences between the two groups was statistically significant.Bak mRNA expression increased and CYC mRNA expression decreased,and those differences between the two groups were statistically significant.Bcl-x and Bcl-2 mRNA expression in the CON,HBO-PC and SCI model groups were significantly different.Conclusion HBO-PC can reduce the loss of motor function after SCI,at least in rats.The mechanism may be related to reducing neuron mitochondrial apoptosis.

Objective To explore the optimal concentration of heparin sodium solution, which to seal up intravenous indwelling needle, in patients with Ⅳ thrombocytopenia. Methods A total of 90 patients withⅣthrombocytopenia who required intravenous indwelling needle were randomly divided into three groups which namely A, B and C groups with 30 cases each. A group was sealed up the tube of intravenous indwelling needle with 1 ml heparin sodium solution of 6.25 U/ml, B group with 12.50 U/ml and C group with 25.00 U/ml. The change of the platelet count, plasma prothrombin time (PT), activated partial thromboplastin time (APTT), plasma fibrinogen (Fbg) after extubation were observed in three groups and the incidence of blocking up and retention time were compared among three groups. Results The change of the platelet count, PT, APTT, Fbg were showed no statistical significance among three groups (P>0.05). The incidence of blocking up was 66.7%(22/30) in A group , 43.3%(13/30) in B group and 16.7%(5/30) in C group. They were showed statistical significance (χ2=15.000, P < 0.01). Retention time of tube above or equal to 3 days were observed respectively 13 person (43.3%,13/30) in A group, 21 cases(70.0%, 21/30) in B group, 25 patients(83.3%, 25/30) in C group. All above were showed statistical significance (χ2=11.000, P<0.01). Conclusions Heparin sodium 25.00 U/ml sealing up the tube of intravenous indwelling needle is safe in patient with Ⅳthrombocytopenia, which will reduce the ration of blocking tube and extend the life of tube.

Objective To evaluate the feasibility and safety of thoracoscopic radical resection of non-small cell lung cancer(NSCLC)patients under laryngeal mask anesthesia. Methods A total of 40 patients with NSCLC from March to August 2016 in NanFang Hospital of Southern Medical University were recruited and divided into two groups,the laryngeal mask anesthesia(n=20)and the intubation anesthesia group(n=20). Patients from two groups were followed up. Post-operativerecovery ,systemic inflammation response and quality of life were assessed. Results There was no significant difference between the laryngeal mask anesthesia and the intubation anesthesia group in the operation time ,the lowest oxygen saturation ,the maximum end-tidal carbon dioxide partial pressure and the surgical field and the satisfaction of anesthesia and blood loss. Post-operative time to eat ,postoperative use of antibiotics , postoperative hospital stay and drainage time were much shorter in the laryngeal mask anesthesia group ,which also had lowerlevel of white blood cells ,neutrophils and C-reactive protein. Patients with NSCLC undergoing laryngeal mask anesthesia had much higher scores in the quality of life evaluation. Conclusion Thoracoscopic radical resectionunder laryngeal mask anesthesia is safe and feasible for NSCLC patients. It has advantages in reducing the systemic inflammatory response ,accelerating the recovery rate and improving postoperative life quality.

Objective To observe the effects of vasedilator stimulated phosphoprotein (VASP) of small intestine mucous membrane on the intestinal barrier dysfunction during hemorrhagic shock (HS) in rats. Methods Forty Wistar rats were divided into normal group, HS 1 hour, HS 2 hours and HS 4 hours groups, as well as HS 2 hours + cyclic adenosine monophosphate (cAMP) treatment group. The activity of sermn diamine oxidase (DAO), content of hematoplasma D-lactic acid of each group were determined, and their relationship with the expression of VASP was analyzed. Results The expression of VASP was increased, serum DAO activity and hematoplasma D-lactic acid content were decreased by cAMP in rats at 2 hours after HS. There were differences upon the levels of VASP expression, DAO activity and hematoplasma D-lactic acid content between HS 2 hours group and HS 2 hours + cAMP treatment group ( t = 18.62, 9.28, 2.83, P < 0.05 ). The serum DAO activity increased while VASP expression decreased significantly after HS, which showed an obvious negative correlation between the two indexes (r=-0.95, P<0.05). Conclusions The decrease of VASP contributes to the intestinal barrier dysfunction after HS in rats, while the intestinal barrier dysfunction can be alleviated by cAMP.

Objective To investigate the clinical efficacy of acupoint catgut embedding in treating breast cystic hyperplasia of blood stasis-phlegm pattern.Methods One hundred and three patients with breast cystic hyperplasia of blood stasis-phlegm pattern were randomly allocated to a treatment group of 53 cases and a control group of 50 cases. The treatment group received acupoint catgut embedding and the control group took Rupi Sanjie granules. The symptom/sign scores and the qi stagnation transformation score were recorded and sex hormone levels were measured in the two groups before and after 12 weeks of treatment. The clinical therapeutic effects were compared between the two groups.Results The cure rate and the total efficacy rate were 50.9% and 92.5%, respectively, in the treatment group and 46.0% and 90.0%, respectively, in the control group. There were no statistically significant differences in the cure rate and the total efficacy rate between the two groups (P>0.05). There were statistically significant post-treatment differences in the symptom/sign scores (pain, mass hardness, mass range, mass size and accompanying symptoms scores) between the two groups (P<0.05). At the three-month and six-month follow-ups, there were statistically significant differences in the pain, mass range and accompanying symptoms scores as compared with at the end of treatment in the treatment group, and between the treatment and control groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the qi stagnation transformation score in the two groups (P<0.01,P<0.05). There was a statistically significant difference in the qi stagnation transformation score at the three-month and six-month follow-ups compared with at the end of treatment in the treatment group (P<0.05). There was a statistically significant difference in the qi stagnation transformation score between the treatment and control groups at the end of treatment and at the three-month and six-month follow-ups (P<0.05). There was a statistically significant pre-/post-treatment difference in the E2 content in the two groups (P<0.05). There were statistically significant pre-/post-treatment differences in the P and PRL contents in the treatment groups (P<0.05).Conclusion Acupoint catgut embedding is an effective way to treat breast cystic hyperplasia of blood stasis-phlegm pattern.