Objective To measure the length and diameter of the main bronchus using three-dimensional reconstruction from spi-ral chest computerized tomography scans in Chinese patients,and to evaluate the relationship between the BMI of patients and the length and diameter of main bronchi in order to provide the basis for pre-operative tracheal intubation.Methods 100 males and 100 females,who were scheduled to undergo a chest CT scan for physical examination,the diameter at the carina of the left and right main bronchus were measured.The length of the main bronchi extending from the carina to the line that is vertical to the bronchial wall at the starting point from the branches of the upper lobe was measured at the workstation.Results the length of the men’s right and left main bronchus was (1 9.7±5.2)mm and (50.3 ±4.7)mm.the length of the women’s right and left main bronchus was (18.2±4.1)mm and (46.3±4.5)mm,The length of the left main bronchus(LMB)was about 3-4 times greater than right main bronchus(RMB).the cross-section of the men’s left and right main bronchus was (175.3±29.6)mm2 and (209.4±32.7)mm2 ,the cross-section of the women’s left and right main bronchus was (120.5±24.8)mm2 and (144.4±33.7)mm2 .There was no signifi-cant relationship between the length and diameter of main bronchi and the BMI of patients.Conclusion The results showed that there was no direct relationship between the diameter and the length of main bronchi and the BMI of patients.BMI is not the criteri-on for choosing double-lumen tube (DLT)size.We proposed that three-dimensional reconstruction be used to measure the size of the main bronchi and determine the optimal size of the DLT in a clinical setting.

Objective To investigate the effect of rocuronium of on the function of acetylcholine receptor (AchR)/channel in cone neurons of hippocampal cortex in rats.Methods SD rats of both sexes (2-5 days old) were killed by decapitation. Brain was immediately removed and hippocampal cortex was cut into slices which were incubated in decalcified and magnesium-free artificial cerebro-spinal fluid (CSF) and mechanically dissociated and then digested in artificial CFS containing 2.5% trypsin. Cell suspension was prepared. The AchR/channel function was studied in the absence and presence of various concentrations of rocuronium (0, 0.05, 0.1, 0.2, 0.4mmol? L-1) and/or atropine 0.1 mmol ?L-1 using patch clamp technique.Results (1) The conductance, open probability (P0) and short term open constant (?01) were significantly higher in R-0.05 group than those in the control group (R-0) , but there was no significant difference in long term open constant (?02) , short term close constant( (?c1) and long term close constant(?c2) between the two groups. The conductance, P0 ,?01 ,?02 , ?c1, and ?c2 were significantly longer or higher in R-0.0, 0.2 and 0.4 groups than those in control group. (2) There was no significant difference in the conductance, P0 , ?01 , ?02 , ?c1 , and ?c2, between R-0.5 and control group but those in R-0.0, 0.2 and 0.4 groups were significantly higher or longer than control group, when rocuronium was used with atropine. Conclusions AchR/channel ( muscarinic and nicotinic ) in cone neuron of hippocampal cortex were excited by different concentrations of rocuronium. The results suggest that adverse effect may be induced on CNS by rocuronium in case it permeates the injured blood-brain barrier.

ObjectIve To InvestIgate the balance between cerebral O2 supply and consumptIon and glucose metabolIsm durIng supratentorIal tumor resectIon under total Intravenous anesthesIa (TIVA) wIth propofol. Methods Twenty-four patIents of ASA grade Ⅰ- Ⅱ aged 20-55 undergoIng electIve supratentorIal tumor resectIon were randomly dIvIded Into 2 groups : lIdocaIne group (A, n = 12) and control group (B, n - 12) . After sedatIon wIth Intravenous scopolamIne 0.3 mg, mIdazolam 0.02 mg?kg-1 and droperIdol-fentanyl mIxture 0.03 ml? kg-1 radIal artery was cannulated for Bp monItorIng and blood samplIng and left Internal jugular veIn was cannulated retrogradely and the catheter was advanced cephalad untIl jugular bulb for blood samplIng. In lIdocaIne group anesthesIa was Induced wIth lIdocaIne 1.5 mg?kg1, propofol 2 mg?kg1, droperIdol-Ientanyl mIxture 0.04 ml?kg-1 and pIpecuronIum 0.15 mg ? kg1 and maIntaIned wIth propofol InfusIon at 6-8 mg?kg-1?h-1 and IntermIttent I. v. boluses of fentanyl and pIpecuronIum. LIdocaIne was Infused after InductIon of anesthesIa at 11.7 mg ?kg1? h-1 for 20 mIn then InfusIon was maIntaIned at 2 mg ?kg1? h-1 .In control group lIdocaIne was replaced by normal salIne. The patIents were mechanIcally ventIlated (VT 6-8 ml?kg1 , RR 12-14 bpm) and PETCO2 was maIntaIned at 29-31 mm Hg In both groups. Blood volume and hemodynamIcs were well maIntaIned durIng operatIon. Blood samples were taken from artery (a) and jugular venous bulb (jv) sImultaneously before InductIon of anesthesIa (T0, baselIne), at IntubatIon (T1), whIle tumor was beIng Isolated (T2) and resected (T3) and at the closure of dura (T4 ) , for blood gas analysIs and determInatIon of Hb and glucose and lactate concentratIon. The dIfference In arterIal and jugular bulb O, content ( Ca-jvO2 ) , cerebral O2 extractIon rate (O3ER), glucose extractIon rate ( GER) and lactate productIon rate (LacPR) were calculated. Results The two groups were comparable wIth respect to demographIc data, duratIon of operatIon and the amount of propofol and fentanyl used. SjvO2 was sIgnIfIcantly lower, Ca-jvO2 greater and O2ER hIgher at T1 In group A than In group B. There was no sIgnIfIcant dIfference In GER and LacPR between the two groups. ConclusIon A bolus of lIdocaIne 1.5 mg?kg-1can increase cerebral O2 extraction during induction and intubation but lidocaine infusion at 2 mg?kg-1?h-1 has no significant effect on cerebral O2 supply/demand and glucose metabolism.

Objective To evaluate the diagnostic value of CT target scanning combining with changing position for pulmonary nodules in special location .Methods CT target scanning combining with changing position was performed in 22 patients with pulmo‐nary nodules adjacent to heart or in posterior costophrenic angle ,which were found with routine spiral CT scanning .For objective analysis , the signal‐noise‐ratio (SNR) and contrast‐noise‐ratio (CNR) of lung were calculated .In terms of subjective assessment ,the image quality was rated on a 3‐point scale (0-2) for pulmonary inflation ,gravity‐dependent pulmonary perfusion and severity of artifacts , respectively .The CT features of pulmonary nodules were compared between different scanning techniques .Moreover ,the diagnostic confidence for pulmonary nodules was evaluated .The paired t test ,Wilcoxon signed‐rank test and Kappa test were used for statisti‐cal analysis .Results In comparison with conventional spiral CT scanning ,CT target scanning combining with changing position im‐proved the subjective image quality scores (P<0 .01) ,increased the signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR) , showed more detailed CT features (P<0 .05) ,and improved the confidence of diagnosis (P<0 .01) .Conclusion CT target scanning combining with changing position technique can show detailed features ,which should be recommended as the optimal scanning tech‐nique for pulmonary nodules adjacent to heart or in posterior costophrenic angle .

Objective To investigate whether the perfusion of the solitary pulmonary nodules (SPNs) is homogeneous derived with 16-slice spiral CT and 64-sliee spiral CT. Methods Eight-five patients with. SPNs (diameter≤4 cm; 57 maliagnant;15 active inflammatory; 13 benign)underwent multi- location dynamic contrast material-enhanced serial CT. One scan was obtained every 1 seconds during 11- 41 seconds without scanning interval after injection, one scan was obtained at 90 seconds. TOSHIBA AquilionMerconi 16 : The section thickness was 8.0 mm for lesions 3.0-4.0 cm, 6. 0 mm for 2.0- 3.0 cm,4.0 mm for 1.5-2.0 cm,3.0 mm for 1.0-1.5 cm and 2.0 mm for lesions <1.0 cm. GE Lightspeed 64:The section thickness was 8.0 mm for lesions3.0-4.0 cm and 2.5 mm for <3.0 cm. Precontrast and posteontrast attenuation on every scan was recorded. The peak height , perfusion, ratio of peak height of the SPNs to that of the aorta and mean transit time of three central valid sections were calculated. The significance of the difference among groups was analyzed by means of ANOVA. Results The peak heights in three sections were ( 30.95±14.53 ), ( 25.10±13.32), (32.37±15.85) HU, respectively, the perfusions (33.01±21.35), (23.70±12.87), ( 29.00±15.47) ml·min-1·100 g-1, the ratios of peak height of the SPN to that of the aorta (13.58±6.41) %, (10.95±5.76) %, (13.64± 6.20)% and the mean transit times (11.61±5.74),(11.97±3.55), (13.44±3.74) s. Statistically significant differences were found among three sections in the peak height(F= 5.913,P=0.003), perfusion (F=6.464, P=0.002), ratio of peak height of the SPN to that of the aorta (F=5.333, P=0.005) and mean transit time (F= 3.837, P = 0.023). No statistically significant differences were found among three sections in precontrast attenuation ( F =0.032, P = 0.968). Conclusion The volume perfusion of the SPNs is inhomogeneous,it is suggested to evaluate blood flow patterns of the solitary pulmonary nodules with CT volume perfusion imaging.

Objective To evaluate multi-detector computed tomography(MDCT)features of lung cancer associated with cystic airspace,and to improve diagnostic accuracy.Methods 21 pathologically or clinically confirmed lung cancer associated with cystic airspace were retrospectively analyzed with regard to clinical data,pathological types and TNM stage,SUMmax and MDCT features.For dynamic follow-up CT scans,the lesion dynamic change was evaluated.Results There were 21 cases (1 1 adenocarcinoma,6 squamous carcinoma)in total. The lesion was predominant cysts in 2 cases(9.52%),cysts with GGO mixed lesions in 3 cases(14.29%),cysts with solid mixed lesions in 14 cases(66.67%),cysts with GGO and solid mixed lesions in 2 cases(9.52%).Four morphological patterns,20 cases had solid nodules,solid nodule protruding externally from the cyst wall was in 5 cases (23.81%),solid nodule protruding internally from the cyst wall was in 1 case (4.76%),solid tissue intermixed within clusters of cysts was in 14 cases(66.67%),the lesion presenting as circumferential thickening of the cyst wall was in 1 case (4.76%).The frequency of following features accounted for more than 60% of all MDCT signs,including round shape (66.67%),lobulation (80.95%),blood vessel passing through the cyst (76.1 9%),pleural indentation (80.95%);while the frequency of multiple cysts,irregular inner wall and septum in cyst in 19 lesions(90.48%)was more than 90%.With respect to the relationship between lesion and bronchus,bronchus passing through the cyst was the most common sign,accounting for 38.10%(8/21).Average CT enhancement value was 28.27 HU±7.27 HU(range 14.2-40 HU).Average SUVmax was 6.05(range 4.5-9.8),indicating marked FDG uptake.Two lesions manifested as progressive wall thickening and increased size of the cyst,and one lesion showed decreased size of the cyst and enlarged nodules in follow up CT.Conclusion The irregular inner wall,septum in cyst and blood vessel passing through the cyst are the most three important signs for the diagnosis of malignant lesions.

Objective The sensitivity and specificity of 18 FDG PET/CT are poor in the diagnosis of gastric cancer .Gastric signet ring cell carcinoma and Mucinous gastric carcinoma is known to have low fluorodeoxyglucose (18FDG) uptake,but not known for poorly differentiated gastric adenocarcinoma .This study was to investigate the value of 18 FDG PET/CT in the diagnosis of poorly differ-entiated gastric adenocarcinoma . Methods We retrospectively analyzed the results of 18 FDG PET/CT of 34 cases of histologically confirmed poorly differentiated gastric adenocarcinoma .We recorded the volume , location , and gastric wall invasion depth , and maxi-mum standardized uptake value ( SUVmax) of the tumors and analyzed the relationship of 18 FDG uptake with the clinicopathologic pa-rameters. Results By 18 FDG-PET/CT, poorly differentiated gastric adenocarcinoma was diagnosed in only 67.6% of the patients (23/34).SUVmax was found to be significantly correlated with age , gastric wall invasion, and tumor size (P<0.05), but not with gender , tumor location , tumor pathologic subtype , lymph node metastasis , and distant metastasis ( P>0 .05 ) .Logistic regression a-nalysis showed the tumor size to be the sole factor influencing the 18 FDG uptake of poorly differentiated gastric adenocarcinoma ( OR=0.37, 95%CI 0.154-0.920, P=0.03). Conclusion The di-agnostic value of 18 FDG-PET/CT is but limited for poorly differentia-ted gastric adenocarcinoma , and attention should be paid to its false-negative results .

Objective To evaluate special diagnosis and treatment of occult breast cancer. MethodsDiagnostic means used included breast roentgenography,selective mammary ductography, fine needle aspiration and excision biopsy in 28 cases. ResultsBreast roentgenography detected 4 cases ( 7/16), selective mammary ductography identified 4 cases(4/6). The definite diagnosis rate by lump biopsy and immunohistochemistry was 10 cases (10/13). Postoperative follow-up was abtained in 18 cases,with 5 dying of recurrence or distant metastases. Among them 4 patients underwent only axillary node excision. Conclusion Nipple discharge,localized thickening the gland are very important clue to the diagnosis of occult breast cancer.Lump biopsy and immunohistochemistry is a mainstay for the final establishment of the diagnosis of breast cancer. Radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment modality for occult breast cancer.

0.05), there were significant statistic differences of any other two TI values (P0.05), there were significant statistic differences of any other two TI values (P0.05 ) , there were significant statistic differences of any other two TI values (P

OBJECTIVE:To study the effect of hydrophilic/hydrophobic nano-silica with different adding amount on the stabili-ty of lipo-emulsion. METHODS:Glycyrrhetinic acid lipo-emulsion 4 mL was taken,respectively adding into 0.5%,1.0%,1.5%(m/m,the same below) hydrophilic nSiO2,and 0.4%,0.75,1.0% hydrophobic nSiO2,incubating 2 h in 30 ℃ water;the same batch of Glycyrrhetinic acid lipo-emulsion was treated as blank control. The forms were observed under electron microscopy after treatment,absorbance value was determined,the stability parameter (KE) was calculated according to the absorbance value,then the adding amount of nSiO2 was optimized,3 batches of preparations was prepared,and the verification test was conducted. RE-SULTS:The spherical structure was Glycyrrhetinic acid lipo-emulsion in the electron microscopy,the substance wrapping its sur-face white ring (fully wrapped) or semi-circular structure (not fully wrapped) was nSiO2. KE of hydrophilic nSiO2 were 4.66%, 5.01% and -2.08%,and KE of hydrophobic nSiO2 were 3.02%,4.51% and 7.24%. The optimized adding amount of hydrophilic nSiO2 was 0.2%,0.3% and 0.4%,hydrophobic nSiO2 was 0.1%,0.2% and 0.3%;KE were 6.19%,3.05%,7.84%,8.42%, 2.41%,2.93%,respectively. The optimal adding amount was 0.3% hydrophilic nSiO2 and 0.2% hydrophobic nSiO2;the 3 batches of preparation showed the optimum stability in its own adding amount. CONCLUSIONS:Both hydrophilic and hydrophobic nSiO2 can improve the stability of Glycyrrhetinic acid lipo-emulsion,and preferably 0.3%,0.2%.