Objective To evaluate the mid-term outcomes of endovascular repair of descending thoracic aortic aneurysm(DTAA) in high-risk patients.Methods Twenty four patients with DTAA received stent-grafts implantation between January 2001 and July 2007 and their clinical data were retrospectively analyzed.All patients were considered high-risk for open surgical repair due to the location or rupture of the aneurysm,high age and severe comorbidities.Spiral computed tomography angiography and 3-dimentional reconstructions were performed at 1,3,6 and 12 months postoperatively and thereafter every year.Results The primary operational success rate was 100%.There were 2 deaths(8.3%) during perioperative period due to multiorgan failure and acute myocardial infarction respectively.Two(8.3%) patients had severe post-operational complications(1 stroke and 1 acute renal insufficiency).Eleven cases of type Ⅰ(46%) endoleak were detected immediately after the operation and among them,the endoleak disappeared after balloon dilatation in 3 cases while the other 8 patients were treated conservatively.Follow-up of 1 to 60 months(mean 18.6?4.2 months) was completed in 19 patients(79.2%).Stent displacement with type Ⅰ endoleake was found in 1 patient at 4 years after the operation and delayed type Ⅲ endoleak occured in another patient at 2 years post-operation.Both patients received endovacular repair again and the endoleaks were closed successfully.One patient died of colon cancer during the follow up.Complete thrombosis of the thoracic aneurysm sac and no stent migration or endoleak was found on the followup CT at 3 months after the operation in all the patients.The decrease in maximal aneurysm diameter was 0-18 mm(mean 6.3?3.1 mm).The prosthetic vascular grafts implanted in 4 patients with preliminary carotid subclavian bypass surgery were patent during the follow-up period.Conclusion Treatment of descending thoracic aortic aneurysm in high-risk patients with endovascular approach showed acceptable early mortality and morbidity and may be considered as a treatment alternative for carefully selected patients.

This paper introduces the principles of an Environmental Temperature Supervising Network System, explain its hardware and software structure and the function of network system. The whole system is proved stable and reliable by experiment. It may have some profit in the market and great future in the application.

Objective To discuss the clinical significance of vancomycin plasma concentration monitoring and its relationship with adverse reactions in treatment of elderly patients. Methods The clinical records of 32 patients aged over 70 years admitted in the Emergency Medical Department of Sichuan Provincial People's Hospital were collected. Based on the diagnosis and laboratory examinations on admission, the patients were treated with cefoperazone+sulbactam or moxifloxacin, while in patients with severe infections, intravenous drip of carbapenem antibacterial drugs were given. After treatment for 3-5 days, when no effective results were obtained, according to the pathogenic results achieved from cultures of blood, sputum, secretions, catheter, etc, the corresponding treatment was given. If the infection was caused by positive bacteria mainly methicillin-resistant Staphylococcus aureus (MRSA) sensitive to vancomycin, the original antibiotic was replaced by vancomycin or vancomycin combined with other antibiotic; intravenous drip of vancomycin 1 g in 250 mL normal saline was given, once in 12 hours, with a speed of 10 mg/min or not over 15 mg/min. The function of liver and kidney, and auditory impairment were observed, and the correlation between vancomycin plasma concentration and adverse reactions was analyzed. Results The total incidence of adverse reactions in elderly patients with different serum vancomycin trough concentrations was 37.50%(12/32) in which the highest incidence was kidney damage 18.75%(6/32) followed by the hearing loss 9.38%(3/32) and liver damage 9.38%(3/32). There were no statistical significant differences in the rates of adverse reactions among the different vancomycin trough concentrations (<10, 10-20,>20 mg/L) and [37.50%(6/16), 38.46%(5/13), 33.33%(1/3), all P>0.05], that meant along with the increase of vancomycin concentration, no tendency of increment of adverse reactions was seen. Of the 32 cases, there were 13 treated by vancomycin combined with other antibiotic, the combination rate being 40.63%. There were 2 cases of hepatic impairment (11.83%), 1 case of renal impairment (7.69%) and none hearing damage in patients treated with combination of antibiotic therapy. Therefore no correlation was concluded between the occurrence of adverse reactions and the combination therapy ( r=0.15, P>0.05). Conclusions In elderly patients over the age of 70 years, there is a higher incidence of kidney damage in the application of vancomycin. Thus, the monitoring of vancomycin plasma concentration in elderly patients has instructive significance in its clinical use.

OBJECTIVE: To evaluate and compare outcomes effects of Chinese recognition materials in post-lingually deafened patients with cochlear implant. METHOD: Thirty-two post-lingually deafened cochlear implant users participated in the study. Each one of them was given a series of speech recognition tests including the speech recognition score of monosyllable words, spondee words, Chinese BKB sentences and MHINT in quiet, as well as speech recognition threshold of HOPE corpus in babble noise. Speech recognition scores and thresholds were compared among these test materials using histograms , scatter diagrams and statistical methods. RESULT: Recognition scores for spondee words, Chinese BKB sentences and MHINT were affected by ceiling effects, with 1,14 and 4 cases scored 100% respectivelty. Meanwhile, 17, 26 and 14 cases scored more than 85% correspondingly. On the other hand, speech recognition scores for monosyllable words in quiet and speech recognition threshold for HOPE corpus in babble noise were not affected. CONCLUSION For a considerable part of post-lingually deafened patients using cochlear implant, some Chinese speech recognition materials have demonstrated different degrees of ceiling effects. While speech recognition scores for monosyllable words in quiet and recognition threshold for HOPE corpus in noise can evaluate the performance of speech recognition abilitymore objectively.
Cochlear Implantation ; Cochlear Implants ; Humans ; Language ; Noise ; Speech Perception ; Treatment Outcome

Carbon Monoxide ; physiology ; Humans ; Nervous System Diseases ; physiopathology ; Neurotransmitter Agents ; physiology ; Nitric Oxide ; physiology

Objective: To observe the controlled hypotension effects of nicardipine in 2 different ways for spinal tumor operalion. Methods: Twenty-four adult patients, scheduled for selective spinal tumor operation, were randomly divided into 2 groups. In groupⅠ(n=12), the nicardipine was infused at a rate of 10 μg*kg-1*min-1 and the infusion continued until MAP was at the level of 7.33-8.66 kPa, and then the rate was decreased to 1 μg*kg-1*min-1. In Group Ⅱ(n=12), nicardipine was given 0.01-0.02 mg/kg as the load dose, then infused at 1-2 μg*kg-1*min-1. Results: During the period of controlled hypotension, cardiac index(CI) increased significantly, other hemodynamic variables were stable and no hypertension rebound occurred in both groups. Reaching time of target blood pressure in groupⅡ was shorter than that in groupⅠ（P＜0.05）. The dose required to obtain target blood pressure in group Ⅱwas less than that in group Ⅰ（P＜0.05）. BP recovery time from discontinuing nicardipine infusion to pre-hypotension level,bleeding volume and transfusion volume were similar between 2 groups（P＞0.05）.During mass bleeding,　serious arrhythmia and oliguria did not occur in any case. Conclusion: Controlled hypotension with nicardipine is rapid, stable and easily controlled without hypertension rebound. Nicardipine has considerable protective effects on heart and kidney during mass bleeding. The method of bolus injection followed with intravenous infusion is more suitable to clinical application.

Objective: To observe the inhibitory effect of scopolamine(Spm) and chlopromazine (Clo) on withdrawal syndromes in morphine dependent rats. Methods: The intensity of withdrawal syndromes on the model of morphine dependent rats was recorded after single or muiltiple subcutaneous administration(sc) of Spm and Clo at different doses. Results: Withdrawal syndromes were markedly decreased when single Spm 1 mg/kg and Clo 0.5 mg/kg combined with morphine were injected (P<0.05). Spm+Clo(sc) had much stronger effects on inhibiting withdrawal syndromes after intraperitoneal (ip) naloxone in morphine dependent rats (P<0.01). Conclusion: Spm can act on Ach-receptor and relieve morphine withdrawal syndromes. Clo may have a synergistic action with Spm via α2-receptor in the locus coeruleus of the rat brain stem.

Objectives To investigate HPV infection and its correlati on with the expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibito r of metalloproteinase-1 (TIMP-1) in vulvar squamous cell carcinoma (VSCC). Meth ods HPV6/11 and 16/18 DNA were detected using in situ hybridization in 26 case s of VSCC, 21 cases of vulvar intraepithelial neoplasia (VIN) and 10 specimens o f normal skin. The expression of MMP-9 and TIMP-1 was measured by immunohistoche mical method in these three groups. Results The infection rates of HPV6/11 and 16/18 in VSCC and VIN were 69.23% (18/26) and 38.46% (10/26), 42.86% (9/21) and 28.57% (6/21) respectively, and no HPV6/11 or 16/18 DNA was discovered in norma l skin epidermis. The expression rates of MMP-9 and TIMP-1 in VSCC, VIN and norm al skin epidermis were 92.31%(24/26) and 76.92% (20/26), 90.45% (19/21) and 80.9 5% (17/21), and 80.00% (8/10) and 50.00% (5/10) respectively. MMP-9 expression in HPV positive lesions was higher than that in HPV negative lesions, but no sig nificant difference of TIMP-1 expression was observed in HPV positive and negati ve lesions. Conclusions HPV infection may play a role in the development of VS CC. The higher expression of MMP-9 comparing with that of TIMP-1 may be an early marker of tumor progression in VSCC, and HPV infection may facilitate the invas ion and metastasis of VSCC.

Objective T o explore the crim inal characteristics of forensic psychiatry expertise in depression patients and schizophrenics w ith hom icide behavior. Methods A total of 40 depression (depressive episode) patients and 50 schizophrenics w ith hom icide behavior w ere random ly assigned into the study group and control group, respectively. D ata of dem ographic and crim inal characteristic of the tw o groups w ere collected by a self-designed questionnaire, and then w ere com pared. Results T here w ere no statis-tical differences in age, education level and career betw een study and control groups (P>0.05). C om pared w ith the control group, the victim s in the study group w ere m ainly the patient's children and parents, and m ost offenders had suicidal behavior after hom icide (70% ). In study group, the m otives of crim e w ere m ainly extended suicide and indirect suicide, and m ost offenders had attem pted suicide (85% ) and dim inished capacity of crim inal responsibility (70% ), w hich in control group had no capacity of crim inal responsibility (56% ). E xcept for crim inal site, there w ere statistical differences in other crim inal charac-teristics betw een tw o groups (P<0.05). Conclusion T here are different crim inal characteristics betw een de-pression patients and schizophrenics w ith hom icide behavior in forensic psychiatry, and these characteris-tics should be considered w hen these tw o diagnoses are distinguished in forensic psychiatry expertise.

Objective To evaluate the pelvic floor function in post-hysterectomy patients. Methods Transperineal pelvic ultrasound was used to observe the pelvic organs in post- hysterectomy patients, and parameters of pelvic floor were measured. Taking the inferior margin of public symphysis as the reference plane,the shape and motion of the proximal urethra and bladder neck were observed at rest and on maximum Valsalva maneuver. Bladder neck-symphyseal distance(BSD) and retrovesical angle were measured. And the bladder neck descent(BND),urethral rotation angle and the rotation angle of the bladder neck were also calculated. Interclass correlation coefficients were calculated to evaluate the consistency of data. Results At rest,the BSD and retrovesical angle were (-2.73±0.37)cm and (119.00±22.40)°, while on maximum Valsalva maneuver was (-0.25±0.67)cm and (114.74±21.50)°,respectively. BND was (2.46±0.59)cm,the urethral rotation angle and the rotation angle of the bladder neck was (70.68±19.91)° and (60.81±17.34) °,respectively. Combined with pelvic ultrasound and clinical manifestations,29 cases of pelvic floor dysfunction after hysterectomy were diagnosed (58.00%, 5 cases of stress urinary incontinence, 8 cases of proctoptoma and 16 cases of bladder prolapse). The consistency was very high in measuring BNS, retrovesical angle at rest and on maximum Valsalva maneuver and BND by different observers. The interclass coefficient was 0.90,0.89,0.91,0.88,0.92,respectively. And the interclass coefficient of urethral rotation angle and the rotation angle of the bladder neck was 0.79, 0.88,respectively. These results showed a good interobserver agreement. Conclusion Transperineal pelvic ultrasound is a simple,reproducible and noninvasive imaging method, which can reveal the position and function of female pelvic organ dynamically and evaluate postoperative pelvic floor function.