Objective To study the effects of sitting position on pulmonary hemodynamics and intrapulmonary shunt (Qs/Qt) during neurosurgery. Methods Twenty eight patients scheduled for posterior fossa and posterior cervical spinal surgery, were anesthetized with sevoflurane fentanyl pancuronium or enflurane fentanyl pancuronium after intravenous induction. Pulmonary hemodynamics were monitored with Swan Ganz catheter technique and Qs/Qt was calculated from the data of arterial and mixture venous blood gas analysis, including the following parameters: CI, RAP, MPAP, PCWP, PVRI, pHa, PaCO 2, PaO 2, PaO 2/FiO 2 and Qs/Qt. The detection time points were as the follow: before anesthesia induction, before sitting position, immediately ,60 min and 120min after sitting position, and at the supine position after termination of surgery.Results After induction of anesthesia and during operation at sitting position, CI decreased significantly (P0.05).Conclusions During neurosurgical procedure under general anesthesia and sitting position, pulmonary vascular auto regulation can be preserved and pulmonary oxygenation can be kept in normal.

Objective: To investigate the relationship between the ac tive granulae in mast cells and infant hemangiomas of parotid gland. Methods: Surgical samples of parotid gland hemangioma were obtained from 40 infants under the age of 6 months and those of normal parotid gland tis sue from 5.The samples were investigated by safranin staining,alcian blue and th ionine staining, and image analysis technique. Results: Th e percentage of thionine positive cells vs tissue area in hemangioma and normal parotid gland tissue was 1.132?0.195 and 0.335?0.122 ( P

Chest Pain ; Humans ; Microcirculation

Objective To assess the effect of surgical repair of medial orbital wall combined with orbital floor fracture via lower lid subciliary approach. Design Retrospective case series. Participants 18 cases of medial orbital wall combined with orbital floor fracture. Methods All patients underwent the reconstruction of orbital wall via lower lid subciliary approach. The composite hydroxyapatite was implanted into the surface of medial orbital wall and orbital floor after lacriminal cyst was completely dissected and protected during the operation. Orbital axial and coronal CT, three-dimension CT scan have been used in all the cases preoperalively and postoperatively. Preoperative CT was compared with postoperative CT. Main Outcome Measures Clinical symptoms and complications. Results All patients were followed up for 3 to 18 months. The postoperative scar of infracillary skin was not obvious. The composite hydroxyapatite was not rejected and dislocated in all cases postoperatively. No postoperative epiphora was found in either case. Preoperative diplopia and enophthalmos were corrected. Conclusion The treatment of medial orbital wall combined with orbital floor fracture via an isolated lower lid subciliary approach was feasible. But the incision was only used in the treatment of inferior medial orbital wall combined with orbital floor fracture, especially the transition area fracture between the orbital floor and medial orbital wall.

Objective:To study the effect of Xiaoyao Powder on Alzheimer's disease in hippocampal CA 3βregion of rats PP-2A,GSK-3βexpression.Methods:Rats were randomly divided into four groups , including model group, western medicine group,Chi-nese medicine group were treated with intraperitoneal injection of D-gal and A-β1-42 peptide bilateral hippocampal injection mold-ing, physiological group only with equal volume of sterile saline intraperitoneal and hippocampal injection molding .The model was completed, normal group, model group were perfused with saline , western medicine group and Chinese medicine group were treated with oxiracetam solution and Xiaoyao decoction , four groups of intragastric volume was 0.5 ml/100 g, 1 time a day, continuous 28 d. After intragastric administration of isolated rat brain immediately , packet marking in 4℃4%glutaraldehyde solution of glass container , stored at 4℃.Repair piece, cut from the hippocampus, embedded in paraffin, sliced.Dilution of PP-2A for 1∶200, GSK-3βdilution of 1∶150.Images were analyzed by using Image-pro Plus 5 image analysis system, data were conducted by SPSS11.5 statistical analysis software, the comparison between 4 groups by single factor analysis of variance , between the two two groups was compared by LSD-t test, the test level of α=0.05.Results:The expression of PP-2A positive cell number and the positive area , average optical density, integral optical density index , in Xiaoyao Powder orally intervention compared with the model group increased significantly (P<0.01);GSK-3βabove indices were significantly decreased than that in model group after Xiaoyao Powder after intragastric ad -ministration (P<0.01).Conclusion:Xiaoyao Powder can up regulate the expression of PP-2A and down regulate expression of GSK-3β, may be condensed A-β1-42 peptide induced hyperphosphorylation of Tau has certain inhibition .

OBJECTIVETo establish the RT-PCR method to type the influenza virus.

METHODSAfter amplifying the virus by cell culture, we carried out RT-PCR by using two pairs typing primers and four pairs subtyping primers to detect the influenza virus.

RESULTSIn those 23 samples which had cytopathologic changes, there were 10 positive strains detected by RT-PCR assay including seven A type (six H3N2 subtype and one H1N1 subtype) and three B type.

CONCLUSIONThis method is rapid, specific and sensitive and possesses great value for practical application in the surveillance of influenza virus.

Objective To prepare anti-folic acid (FA) polyclonal antibody and develop a new non-balanced competing chemiluminescence analysis for clinical detection of FA.Methods Established the detection method by added FITC-FA-analogs and FAHRP-antibody in the light emitting plate,which coated with anti-FITC antibody,to form the immune response complex of FITC/antibody-FITC-FA-analogs/FA-antibody-HRP.Then methodology evaluation was performed to evaluate the method performance;and further compared the detecting results with non-FITC system detection system and Electrochemiluminescence system (Roche Elecsys 2010).Results The ELISA results showed that the prepared anti-FA antibodies can recognize serum FA specificly.The methodology evaluation indicated that the linear correlation coefficient of the standard curve was 0.990 0;the analytical sensitivity was 1.21 ng/mL;the range of linear detection was 1.21～ 38.80 ng/mL;The coefficient variability of intra-assay was ＜5 ％,which was better than the results of non-FITC detection system;and the correlation coefficient was 0.908 1 compared with the Elecsys-2010 detection system.Conclusion The established chemiluminescence immunoassay for human serum FA has a good sensitivity and specificity,and suitable for clinical serum FA quantitativedetecting.

Objective: To explore the changing features of plasma amino-terminal pro-B-type natriuretic peptide (NT-proBNP) level in patients with hypertrophic obstructive cardiomyopathy (HCM) after alcohol septal ablation (ASA). Methods: A total of 82 HCM patients treated by ASA in our hospital were studied. According to plasmalevel of NT-proBNP, the patients were divided into 2 groups: High NT-proBNP group and Low NT-proBNP group,n=41 in each group. Plasma NT-proBNP was examined by ELISA; ventricular septal thickness (VST), left ventricular posterior wall thickness (LVPWT), maximal ventricular wall thickness (MLVWT) and left atrial diameter (LAD) were measured by echocardiography. There were 50 patients ifnished 1 year clinical or in-hospital follow-up, their NT-proBNP level and echocardiography were detected at 2 days and 1 year post-operation.The relationship between echocardiography parameter and NT-proBNP level was assessed; NT-proBNP was compared between pre- and 2 days, 1 year post-operation. Results:①In all 82 patients: compared with Low NT-proBNP group, High NT-proBNP group had increased VST (23.66±6.46) mm vs (20.79±4.56) mm,P=0.035, LVPWT (12.79±2.99) mm vs (11.50±2.35) mm,P=0.048, MLVWT (28.03±5.66) mm vs (25.18±4.81) mm,P=0.027 and LAD (40.73±4.86) mm vs (38.08±6.17) mm,P=0.049.②In 50 patients who ifnished 1 year follow-up study: compared with pre-operation, NT-proBNP level was slightly increased at 2 days post-operation (1841.79±1310.88) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.066, while decreased at 1 year post-operation (1038.46±714.03) fmol/ml vs (1552.15±951.57) fmol/ml,P=0.000. Conclusion: Plasma NT-proBNP level was affected by atrial size and ventricular thickness in HCM patients, it may obviously decrease during long-term follow-up period.

Objective To analyze the correlation between septal branch characteristics and the prognosis of alcohol septal ablation ( ASA ) in patients with hypertrophic obstructive cardiomyopathy . Methods The clinical , echocardiographic , angiographic and procedural characteristics were analyzed retrospectively in 55 patients.Good prognosis was defined as left ventricular outflow tract gradient decreased by 50%at long term follow-up.The characteristics of septal branch were analyzed in terms of QCA .Results There were no differences in the length of the ablated septal branch , sizes of the adjacent branches , distances between the septal branch and the ostia of the coronary arteries and the volume of alcoholo consumed ( all P>0.05).Compared with poor prognosis group (n =27), the diameter of the ablated septal branches were significantly larger in the good prognosis group ( n=28 ) [ ( 1.75 ±0.36 ) mm vs.( 1.48 ±0.41 ) mm, P=0.012].The distance between the ablated branch and its adjacent branch was farer in the good prognosis group [(18.80 ±10.20)mm vs.(13.04 ±6.65)mm, P=0.020].In multivariate analysis, the diameter of the ablated branch (OR 9.258,95%CI 1.427-60.069, P=0.020)and the distance between the ablated septal branch and its adjacent septal branch (OR 1.102,95% CI 1.002-1.213, P =0.046) were found to be independent risk factors for good prognosis of ASA .Conclusions The diameter of the ablated septal branch and the distance between its adjacent septal branch are associated with better prognosis of ASA .

Objective To establish and validate a modified rat thromboembolic stroke model.Methods After taking femoral arterial blood and mixing it with thrombin,they were injected into PE-50 catheter for preparing in vitro thrombosis in 60 Sprague-Dawley rats.A thromboembolic cerebral ischemia model induced by catheterization of the right external carotid artery and the small blood clot emboli were injected into the internal carotid arteries.Thirty rats were randomly divided into a large number of emboli group (n =10 with 12 emboli),a median number of emboli group (n =10 with 10 emboli) and a small number of emboli group (n =10 with 8 emboli).Two hours after embolus injection,the neurological deficit score was performed and the success rate of the model was compared in all groups.Twenty-four hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage,infarct volume,bleeding incidence and mortality after cerebral infarction were evaluated.The high success rates of the modeling in the emboli groups were selected and they were randomly divided into either a normal saline group (n =12) or a recombinant tissue-type plasminogen activator (rtPA) group (n =12).The rats were given normal saline and rtPA at 3 hours after embolus injection.Before embolus injection and 2,6,12 and 24 hours after embolus injection,the neurological scores were performed respectively; 24 hours after embolus injection,the rats were sacrificed and the brains were removed for 2,3,5-triphenyltetrazolium chloride staining.The hemorrhage rate,infarction size,degree of cerebral edema,and blood-brain barrier permeability were evaluated.Results Only 40％ of rats had neurological deficits in the small number of emboli group,and the infarct volume was only 10.54 ± 2.82％.The success rates in the median and large number of emboli groups were 80％ and 100％ respectively.They were all significantly higher than those in the small number of emboli group (P =0.011 ).The infarct volume was also significantly greater than that in the small number of emboli group (F =40.897,P =0.000).After administration of rtPA,the mean survival time of the rats in the large number of emboli group was less than 24 hours,so the median number of emboli group was selected to study the thrombolytic effect of rtPA.The infarct volume and neurological function score in the rtPA group were improved significantly compared to the normal saline group (t =7.728,P =0.000),while there were no significant differences in the hemorrhage rate,degree of brain edema and blood-brain barrier permeability between the 2 groups.Conclusions The stability and reproducibility were good in the modified thromboembolic cerebral ischemia model injected with 10 emboli,the neurological function was improved significantly after thrombolysis,and it was applicable to the experimental study of pathophysiology of cerebral ischemia and thrombolytic therapy.