Objective To discuss the relative factors and clinical features of the elderly patients with craniocerebral trauma so as to improve the level of diagnosis and treatment of craniocerebral trauma.Methods A retrospective study was conducted on 139 patients with craniocerebral trauma treated in our department from June 2006 to August 2009. The post-injury pathogenesis, Glasgow Coma Scale (GCS)score, injury type, major complications and treatment method were summarized and analyzed to find the correlation of various factors with prognosis. Results It was revealed that the mortality was closely related with GCS score, injury type and post-tranmatic complications. The lower GCS score induced higher mortality. The high mortality was manifested in patients with craniocerebral trauma who presented diffuse cerebral edema, contusion and laceration combined with multiple hematomas and brain stem injury. The prognosis was impacted by lung infection, failure of respiratory function, hemorrhage in upper digestive tract, or simultaneous 2-3 complications after craniocerebral trauma. Conclusions The prognosis is directly affected by injury severity, injury type and complications of craniocerebral trauma. The elderly patients demonstrate delayed reaction, which deserves active early examinations and treatment to improve the prognosis.

Objective To investigate the protective role of dexmedetomidine in rats with endotoxin-induced acute lung injury (ALI).Methods Forty-eight adult male SD rats were divided into four groups (n=12 each) according to the random number table: control group, lipopolysaccharide (LPS) group, dexmedetomidine (DEX) treatment group and DEX pretreatment group.ALI was induced in rats by femoral intravenous injection of LPS (8 mg/kg).Rats in DEX treatment group was given DEX (50 μg/kg) for 2 minutes via the femoral intravenous injection 0.5 hour after LPS injection, followed by maintenance pump injection of DEX (5 μg·kg-1·h-1).Analogously, rats in DEX pretreatment group was given DEX (50 μg/kg) for 2 min via the femoral intravenous injection 0.5 hour before LPS injection, followed by maintenance pump injection of DEX (5 μg·kg-1·h-1).By contrast, control group received the same amount of normal saline intravenously.All rats were sentenced to death and their carotid blood samples were collected6 hours after all injections.Superior lobe of the right lung was examined under light microscope and the histologic findings were tested using the difusse alveolar damage (DAD) score.Middle lobe of the right lung was used to calculate the lung tissue wet/dry weight (W/D) ratio.Samples of collected carotid blood were taken to measure levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6.Bronchoalveolar lavage fluid (BALF) obtained from bronchoalveolar lavage was collected to measure levels of TNF-α and IL-6.Results Lung tissue injury was obvious after LPS injection and DAS score was improved as well.However DEX therapy reduced the lung damage as well as the DAD score, especially obvious in DEX pretreatment group (P<0.05).W/D ratio was obviously increased in other three groups compared to control group, but further comparison showed that W/D ratio was lowered in DEX treatment and pretreatment groups compared to LPS group, especially obvious in DEX pretreatment group (P<0.05).Levels of TNF-α and IL-6 were higher in other three groups than control group, but further comparison showed that levels of TNF-α and IL-6 were decreased in DEX treatment and pretreatment groups compared to LPS group, especially obvious in DEX pretreatment group (P<0.05).Levels of TNF-α and IL-6 in BALF were higher in LPS and DEX treatment groups than control group and were higher in LPS group than DEX treatment(P<0.05).Further comparison showed level of TNF-α in BALF similar between DEX treatment and pretreatment groups (P>0.05), but IL-6 in BALF was significantly lower in DEX pretreatment group than DEX treatment group (P<0.05).Level of total protein in BALF was increased in LPS group compared to control group and was decreased in DEX treatment and pretreatment groups compared to LPS group, but there were no significant differences between DEX treatment and pretreatment groups (P>0.05).Conclusion Either preoperative injection of DEX or DEX treatment has protective effect in rats with LPS-induced ALI, while preoperative injection of DEX has been proved to be more effective.

Objective To study the distribution characteristics of myocardial fat infiltration and to analyze the function of the left ventricle (LV).Methods The images of patients who performed coronary CT angiography (CTA)in Siemens DSCT were reviewed retrospectively.The imaging characteristics and location of myocardial fat infiltration were recorded and the LV function was analyzed by Siemens Syngo.via software.Results Totally 4 477 patients were enrolled in this study.Among them,myocardial fat infiltration of the LV was found in 94 (accounting for 2.1%)patients.The fat infiltration was mainly located underlying the endocardium,including the inferior,anterior,lateral and posterior walls of the LV,as well as the inferior part of the interventricular septum.The enhancement image showed low intensity in the myocardium with fat infiltration.Conclusion The characteristics of myocardial fat infiltration can be well displayed by DSCT,as well as the LV function.DSCT can provide both morphological and functional information of the heart via one scan.

Objective ToevaluatethepredictivevalueofpreoperativeMRIsignalintensityindifferenttexturesofpituitaryadenoma (PA).Methods Accordingtotheinclusioncriteria,47casesofPA werecollected,including37softcasesand10firmcases.Different texturesofPAonMRIsignalintensityanddynamicenhancementcharacteristicswereanalyzed.Results T2WIintensitybetweentwo texturegroups(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSFandSER)hadsignificantstatisticaldifferences(P＜0.05).T1WIintensity betweentwotexturegroups(T1WIPA/T1WIPN )hadnosignificantstatisticaldifference(P＞0.05).TheT2signalintensity(T2PA/T2WM、T2PA/T2GM、T2PA/T2CSF)andSERinsoftgroupwashigherthanthatinthefirmgroup.Predictivevalueofthetextureof PAbyusingtheROCcurveofT2PA/T2WM,T2PA/T2GM,T2PA/T2CSF,T1PA/T1PNandSER wereobtained,andtheareasunder theROCcurvewere0.857,0.835,0.856,0.630and0.781respectively.ThelargestareaundertheROCcurvewasT2PA/T2WM (P＜0.05).Conclusion MRIT2signalintensityisrelatedtothetextureofPAandthoseindexescanbeusedtojudgethetextureofPA.

Objective::To explore the feasibility of the rapid identification system(MALDI-Biotyper System) of microorganisms for rapid identification of Pseudomonas aeruginosa and clinical isolation of Staphylococcus aureus. Method::Identification quality control and clinical isolation were conducted for drug resistance of S. aureus by microbial rapid identification system and broth dilution method. The scores of microbial rapid identification system were compared with the MIC value of broth dilution method. The drug resistance of P. aeruginosa was simultaneously identified to determine the accuracy and applicability of the rapid identification system of microorganisms. Result::The scores of the microbial rapid identification system showed that the score of sensitive quality control strain S. aureus was higher than 2.000, and the that of resistant strain of methicillin-resistant S. aureus(methicillin-resistant S. aureus, MRSA)was between 1.700 and 2.000.The score of clinically isolated S. aureus was between 1.700 and 2.000, which suggested the drug resistance and was consistent with the MIC value of the broth dilution method. At the same time, the systemic identification value of the P. aeruginosa, which is independent of the quality control sensitive strain, was greater than 2.000, showing sensitivity and it was a sensitive strain itself, which was consistent with the results. Conclusion::The microbial rapid identification system scoring method can be used for the rapid identification of the drug resistance of S. aureus and P. aeruginosa.