Objective To investigate the relationship among the depth of midazolam induced sedation, the plasma midazolam concentration and quantified electroencephalogram(EEG) and determine the appropriate depth of sedation during regional anesthesia Methods Twenty adult ASA I II patients(male 7,female 13)scheduled for thyroid adenoma or cyst operation under cervical plexus blockade were studied The age ranged from 19 57 years [mean (46 4?9 5)yr] and weight from 40 83kg[mean (63 1?10 3)kg] Patients with liver or kidney disorders or habitually taking benzodiazepine were excluded The patients were premedicated with phenobarbital sodium 0 1g Dorsalis pedis artery was cannulated for blood sampling Besides blood pressure, heart rate and SpO 2, quantified EEG (BIS and 95%SEF) were continuously monitored and recorded Level of sedation was assessed using the modified observer's assessment of alertness/sedation (OAA/S) scale The BIS, 95%SEF and plasma midazolam concentration (Cm)were correlated with the OAA/S scores using nonparametric Spearman's rank correlation analysis Results As depth of sedation deepened from an OAA/S score of 4 to 1, BIS value decreased from 91 5?2 6 to 63 1?5 7, 95%SEF from 21 4?2 0 to 15 2?2 9 and plasma midazolam concentration increased from (120 8?55 2)ng/ml to (533 0?139 4)ng/ml BIS, 95%SEF and Cm were all well correlated with the OAA/S score The coefficients of correlation between BIS, 95%SEF, Cm and OAA/S score were 0 952,0 674 and -0 856 respectively Conclusions Cm, BIS and 95% SEF are all well correlated with the depth of midazolam induced sedation and can all be used to monitor the depth of midazolam induced sedation, but BIS is the best among them BIS value 75 82 and OAA/S score 2 3 are the most appropriate level of sedation during regional anesthesia

Objective Auditory evoked potential index (AAI) has been proposed for monitoring anesthetic depth. The aim of this study was to compare tins new technique with hispectral index (BIS) and 95% spectral edge frequency (SKF) for assessing anesthetic depth during emergency from propofol-isoflurane anesthesia. The ability of these techniques in distinguishing consciousness from unconsciousness was also evaluated. Methods Thirty six ASA I - II patients ( 15 male, 21 female) undergoing elective surgery under propofol-isoflurane anesthesia were enrolled in the study. Age ranged from 18 to 75 years and body weight from 35 to 80 kg. Patients with psychoneural diseases or hearing disturbances were excluded. The patients were premedicaled with phenobarbitai sodium 0.1g and airopine 0.5mg. Anesthesia was induced with rnidazolam 0 .05-0.1 mg.kg1,fentanyl 5- 10ug.kg1 and vecuronium 0. 1-0.2mg.kg-1 and maintained with propofol infusion (8-16ml. h 1) and isoflurane inhalation (0.5% -1.0%). Intermittent IV boluses of vecuroniuni were given when needed. The patients were transported to recovery room after surgery. AAI, HIS, SKF and hemodynamic parameters were monitored and recorded on entering the recovery room, before extubation, during extubalion, 5, 10, 20 min after exlubation and before release from recovery room. Results AAI, BIS and SEF were 40.9?11.7,73.64?10.8 and 17.5?2.8 respectively on entering recovery room and increased to 72.6 ?11.0, 88.2?7.3 and 22.5?2.6 during exlubation. The increase in AAI was significantly greater. The mean values of AAI before and after responding to light glabellar tap or loud auditory stimulus were 36. 1?11.5 and 52.4?12.3 respectively, the mean values of BIS were 71.9?11.5 and 78 . 6?11.9 and of SKF 16.7?3.0 and 18. 6?3.2 .Only AAI demonstrated a significant difference detween consciousness and unconsciousness. Conclusion AAI, HIS and SKF all increase gradually during emergence from anesthesia. AAI is most sensitive among the three techniques and is most useful in detecting the transition from unconsciousness to consciousness.

Objective To explore vascular endothelial growth factor-C (VEGF-C),vascular endothelial growth factor receptor 3 (VEGFR-3) in the bladder cancer tissue of the expression and the relationship with the tumor lymph node metastases of bladder cancer tissue,Methods The VEGF-C,VEGFR-3 expression was detected by Elivision TM plus two footwork.Results In 18 cases of bladder cancer organization,VEGF-C expression positive rate was 72％,VEGFR-3 express positive rate was 67％.VEGF-C in the bladder cancer of the transfer of the expression level compared to the lymph nodes of the transfer of the lymph node has not occurred to high.Conclusion In the bladder cancer organization and the surroundinglymph nodes,VEGF-C,VEGFR-3 expression level and lymph node metastasis is closely related.VEGF-C,VEGFR-3 expression intensity can be used as a lymph node metastasis in bladder cancer index.

A total of 156 elderly patients (aged ≥ 70 years) with symptomatic bladder outlet obstruction as a result of benign prostatic hyperplasia (BPH) underwent trmsurethral photoselective vaporization (PVP). Pre- or post-operative urine flow rate, residual urine volume level, International Prostate Symptom Score (IPSS), and quality of life (QOL) score were recorded. Our data showed that maximum urine flow rate and residual urine volume were improved at 1, 12, 24, and 36 months following the treatment. There was statistically significant difference in IPSS and QOL when the intervention was considered (P < 0. 05). PVP might be a treatment of choice for high-risk elderly patients with obstructive BPH.

Objective To determine the prescription of selegiline transdermal patches.Methods The selegiline transdermal patches were prepared and the ingredient amount of selegiline transdermal patches was determined according to the orthogonal design.Results The best prescription of selegiline transdermal patches：3%selegiline,3%Azone,15%RS100,60%PSA.Conclusion Selegiline is suitable for the transdermal therapeutic systems.Orthogonal design of prescription was suitable to study selegiline transdermal patches.

Objective To investigate the characteristic of MRS in patients suffered diffuse axonal injury (DAI)in acute and suba-cute stage,and the correlation between MRS changes and the severity of disease.Methods We reported MRI and proton magnetic resonance spectroscopy studies of 3 6 head-inj ured patients in acute and subacute stage.Proton magnetic resonance spectra were ac-quired from the white matter and gray matter of bibateral frontal lobe that on conventional MRI appeared normal by using 2D MRSI at 3.0T MRI .30 volunteers as contronl were studied at the same time.Results In patient group,N-acetylaspartate/creatine ratios were (2.14±0.15)and (1.71±0.08)choline/creatine ratios were(1.35±0.13)and (1.03±0.08)for the white matter and the gray matter,respectivily.The brain N-acetylaspartate/creatine ratio was reduced and the choline/creatine ratio was increased in pa-tient group compared with the controls.The increase in the choline/creatine ratio was significant even in the moderate and severe in-j ured groups.Furthermore,there was a significantly correlation between the severity of head inj ury and the N-acetylaspartate/cho-line ratio,and changes in patients with metabolite ratios of the GCS score had a strong correlation.Conclusion We conclude that DAI patients with normal conventional imaging manifestations of the frontal lobe appear metabolite ratio change,suggesting the existence of local cerebral inj ury,and it has a strong correlation between the prognosis and MRS changes.MRS may provide an useful method that can tell us the severity of the brain inj ury in patients with DAI .

Objective To retrospectively analyze echocardiography findings and left hearst function in patients with patent ductus arteriosus (PDA) after transcatheter closure. Methods 28 patients admitted between January 2012 and December 2012 in our hospital for PDA transcatheter closure were included. Assessment of cardiac structure, hemodynamics and cardiac function parameters during preoperation and in postoperation 3 days, 1 month and 6 months were studied. Results Statistical significant difference was found at 3 days, 1 month and 6 months postoperation when compared with pre-operation in terms of left atrial diameter, left ventricular end-diastolic diameter, left ventricular end systolic diameter and other doppler measurements ( all P < 0. 05 ) . Six-minute walk test ( 6MWT) tolerance improved when compared to preoperation level (P < 0. 05). Better improvement in LVEF and LVES was observed in patients age ≤14 years old when compared to patients > 14 years old after operation ( P < 0. 05 ) . Conclusions Transcatheter closure of PDA can improve cardiac function and correct early hemodynamic abnormalities patients in younger age group show more benefit from the procedure.

Objective To establish a finite element model of the T2-L5 thoracolumbar spine and verify its validity,to provide numerical model support for exploring the dynamic response characteristics and injury mechanism under spinal impact loads.Methods A three-dimensional(3D)finite element model of the T2-L5 thoracolumbar spine was established based on CT scanning data.The load-rotation angle curve of the T12-L1 segment under different moments(flexion,extension,rotation,and lateral bending conditions)was calculated and compared with the data reported in the literature.Free-fall loads at different heights were applied to the finite element models of the T2-6,T7-11,and T12-L5 spine.The peak axial force and bending moment were obtained by finite element simulation analysis and compared with data reported in the literature.Results The maximum rotation angle of the T12-L1 finite element model was-2.24°-1.55° under moments in different directions,which was in good agreement with the literature data.The peak axial force of T2-6,T7-11,and T12-L5 spine finite element models subjected to different free-fall loads was 1.7-5.3 kN,1.3-5.5 kN,and 1.3-7.5 kN respectively,which were within the error range reported in the literature.Stress nephograms of the spine and intervertebral discs showed that the vertebral body was first stressed from the outer edge.The intervertebral disc was subjected to the main load by the nucleus pulposus,consistent with the actual spinal injury mechanism.Conclusions The T2-L5 spine model established in this study can correctly simulate the biomechanical behavioral characteristics of the spine under different working conditions,and the analysis results are effective.

Objective: To observe the effects of axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata on repairing defects after radical resection of scalp carcinoma in patients. Methods: From February 2006 to December 2015, twenty-one patients with scalp carcinoma were admitted to our hospital, and the carcinoma invaded external lamina or full-thickness of skull and dura mater. After perfect preoperative examination, carcinoma and scalp tissue in 3 to 5 cm from the edge of carcinoma, external lamina or full-thickness of skull and invaded dura mater were resected and sentinel lymph nodes around carcinoma were cleaned in 3 to 4 days after admission. The postoperative defects with size reached from 11 cm×8 cm to 22 cm×18 cm. The flap transplantation was performed at the same time when quick frozen pathological examination results of resected scalp carcinoma margin tissue, skull, dura mater margin and basal tissue, and sentinel lymph nodes showed completely negative. Defects in 3 elderly patients were repaired by single or multiple axial scalp vascular network flaps, with the resected flaps size ranged from 12 cm×7 cm to 19 cm×14 cm. Defects in the other 18 patients were repaired by anterolateral thigh perforator flaps with fascia lata, with the resected flaps size ranged from 13 cm×10 cm to 23 cm×19 cm and the resected fascia lata size ranged from 8 cm×7 cm to 10 cm×10 cm. The head donor site of flap was repaired by medium thickness skin of head and back; the thigh donor site of flap was repaired by medium thickness skin of thigh on the same side. All patients gave up postoperative radiotherapy, chemotherapy, and other follow-up treatments. Results: After operation, the flap and skin in all patients survived completely, with no vascular crisis or other condition. During the follow-up for 6 months to 9 years, all patients showed good appearance except for baldness in operation area of head, with no obvious malformation in head donor site of flap and skin, no swollen external hernia in the brain tissue, and no local recurrence or distant metastasis of carcinoma. The appearance of thigh donor site of flap and skin was good, with normal muscle strength and movement of lower limbs. Conclusions Patients with scalp carcinoma were performed with radical resection of carcinoma, and axial vascular network flap of scalp or anterolateral thigh perforator flap with fascia lata were applied to repair the postoperative defects, with good appearance of head operation area and no local recurrence or distant metastasis of carcinoma.

Objective:To discuss the effect of low-dose ionizing radiation on the health of radiation workers, and provide a basis for occupational health risk assessment of radiation workers.Methods:In January 2020, 3165 radiation workers who performed radiation occupational health examinations in Guangzhou Prevention and Treatment Hospital for Occupational Disease from January 2017 to December 2019 were selected as the research objects, and compared and analyzed the health status of radiation workers with different examination types (pre-job, in-job and off-job) , types of work, gender, and length of service.Results:The off-job occupational radiological health examination was rare at 2.3% (74/3165) . The abnormal detection rate of chest radiographs, renal function, thyroid function, and blood routine of the radiation workers in-job group was higher than that of the pre-job group ( P<0.05) . No statistical difference was found in the abnormal detection rate of the examination items during the in-job group and the off-job group ( P>0.05) . The blood routine abnormality detection rate of medical application group and industrial application group were higher than those of nuclear fuel group ( P<0.05) . The abnormal detection rate of blood pressure and renal function of male radiation workers was higher than that of females, while the abnormal detection rate of blood routine of females was higher than that of males ( P<0.05) . The abnormal detection rate of electrocardiogram, chest radiograph, blood pressure, renal function, thyroid function, and blood routine of radiation workers increased with increasing working age ( P<0.05) . Conclusion:Occupational health status of radiation workers is not optimistic. Radiation occupational health monitoring should be strengthened, special attention should be paid to off-job radiation occupational health examination, focusing on the sensitive indicators of sensitive personnel, improving radiation protection conditions, and effectively protecting the occupational health of radiation workers.