Objective To study the relationship between Lidocaine blood drug level and the cause of death from Lidocaine anaphylactic shock. Method Comparing and analyzing the blood drug levels by HPLC between two groups of people whose various indexes are normal before the surgery. Group 1 included 8 cases who accepted Lidocaine as anesthetic and died from Lidocaine anaphylactic shock. Group 2 included 11 cases who also took Lidocaine as anesthetic and passed the surgery smoothly. Results Lidocaine blood level of Group 1 (1.61?0. 45mg/L) is lower than that of Group 2 (2. 44 ?0. 47mg/L). Conclusion Lidocaine blood drug level has nothing to do with the cause of Lidocaine anaphylactic shock.

Objective To study the experimental protocol for purification and analysis of hematopoietic stem cells(HSC)and myeloid lineage-committed progenitors.Methods According to differentiation antigen expression pattern on hematopoietic stem cells(HSC) and progenitors during hematopoietic development,HSC and progenitors from bone marrow of 14 healthy mice were analyzed and sorted by magnetic nanoparticles and 4-color or 6-color flow cytometry using multiple antibody panels.Sorted HSC and progenitors were further tested by methylcellulose colony forming unit(CFU)and serial replatingassays.Results The expression of hematopoietic progenitor cells(HPC)was 10-fold higher expression than that of HSC.However,replating activity of common myeloid rogenitors(CMP)was only half of that of HSC.And there was almost 120 replating activity observed in granulocyte/macrophage lineage-restricted progenitors(GMP)and megakaryocyte/erythroeyte lineage-restricted progenitors(MEP).Conclusion Multiparametric flow cytometry could be used to isolate and count HSC and myeloid lineage-committed progenitors accurately.

Objective To evaluate the diagnostic value of shoulder MR arthrography for superior labral anterior-posterior (SLAP) lesions.Methods A retrospective study was conducted in 137 cases of shoulder MR arthrography confirmed by subsequent shoulder arthroscopy.Two radiologists analyzed all MR examinations independently and the results were compared with those of arthrescopy.The superior labrum was described as normal or torn.In addition, each iabral tear was classified as type Ⅰ-Ⅳ.Type Ⅰ lesions were defined as marked fraying of the articulating surface of the superior labrum; type Ⅱ, avulsion of the labral-bicipital complex from the ghnoid; type Ⅲ, displaced bucket handle tear of the superior labrum; and type Ⅳ, bucket handle tear of the superior labrum with extension into the fibers of the biceps tendon.Sensitivity, specificity, and accuracy were calculated.Kappa values were calculated to quantify the level, of inter-observer agreement.Results SLAP lesions were arthroscopically diagnosed in 59 of the 137 patients.Six of the 59 lesions ( 10.2% ) were classified as type Ⅰ , 50 (84.7% ) as type Ⅱ, and 3 (5.1% ) as type Ⅲ.The overall sensitivity, specificity, and accuracy of MR arthrographic detection of SLAP lesions were 86.4% (51/59), 78.2% (61/78), and 81.8% ( 112/137), respectively, for observer A, and 88.1% (52/59), 84.6% (66/78), and 86.1% (118/137), respectively, for observer B.At inter-observer comparison, agreement was very good (Kappa values = 0.796 ).The MR arthrographic classification showed correlation with the arthroscopic classification of SLAP lesions were 83.1% (49/59)and 79.7% (47/59) for two observers, respectively.Conclusion Shoulder MR arthrography is a reliable method for evaluating SLAP lesions.

Objective To assess the diagnostic value of MRI for the long head of the biceps brachii tendon tear,and to compare the diagnostic efficiency between routing MRI and MR arthrography. Methods A retrospective study was conducted in 215 cases with shoulder MR examination (107 with MR arthrography, and 108 with routing MRI) and subsequent shoulder arthrescopy and surgery. Two radiologists analyzed all MR examinations independently, and the results were compared with those of arthroscopy and surgery. Sensitivity, specificity, and accuracy were calculated. Kappa values were used to quantify the interobserver agreement. Results Based on the results of arthroacopy and surgery, 215 patients comprised 7 cases of complete tear of the long head of the biceps brachii tendon, 29 cases of partial tear, and 179 cases without tear. The overall sensitivity, specificity, and accuracy for the diagnosis of tears (complete and partial tear) of the long head of the biceps brachii tendon were 72.2% (26/36), 91.6% (164/179), and 88.4% (190/215) respectively for observer 1, 80.6% (29/36), 93.8% (168/179), and 91.6% (197/215) respectively for observer 2. The interobserver agreement was good (Kappa value=0.681). For the complete tear of the biceps brachii tendon, the sensitivity, specificity, and accuracy were all 100% (7/7), 100% (208/208), and 100% (215/215) for both observers. For the tear of the long head of the biceps brachii tendon, the accuracy of MR arthrography were 93.4% (100/107) for observer 1 and 96.3% (103/107) for observer 2. They were higher than the Accuracy of routing MRI, which were 83.3% (90/108)and 87.0% (94/108) respectively for two observers (P<0.05). Conclusion Shoulder MRI is a moderate reliable method for evaluating the tear of the long head of the biceps brachii tendon, and the accuracy of MR arthrography is found to be superior to that of routine MRI.

OBJECTIVE To investigate the distribution and the resistance variance tendency of the pathogenic bacteria isolated from the blood cultureing specimens collected during the period of 2002-2005.METHODS A retrospective analysis was made to the blood cultureing results during the period of 2002-2005 with WHONET 5.1 software.RESULTS Gram-negative rods were the predominant bacteria which caused sepsicemia,the isolated rates of Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus were the most high during the period of 2002-2004 but the S.epidermidis and S.hominis were also the important pathogenic ones which caused blood stream infection.Vancomycin and the teicoplanin were the most effective to the Gram-positive bacteria,and the imipenem and the cefepime were the most effective to the Gram-negative ones.CONCLUSIONS It′s important to strengthen the blood cultureing for blood stream infection patient.

Objective The aim of this study was to describe the clinical and pathological features of primary biliary cirrhosis(PBC) and their correlation.Methods Liver biopsy specimens were obtained through percutaneous needle puncture from twenty four patients with PBC who had not been diagnosed or treated before.These samples were fixed in formaldehyde and embedded in paraffin for routine histological examination.Pathologic stages based on Ludwig criteria,fibrosis,portal and periportal inflammation,lymphocytic periportal piecemeal necrosis,ductular proliferation,intralobular hepatocyte necrosis,the degree of ductopenia and relevant laboratory results were recorded.Statistics method used was x2 or t-test,Mann-whitmey U nonperametric test and Pearson's or Spearman's correlation analysis.Results The pathological stages,degree of fibrosis were positively correlated with total bilirubin (TBIL) level,total bile acid (TBA),cholesterol (CHO),IgG levels,and were negatively correlated with serum albumin(ALB) level(r=-0.527,P=0.030; r=-0.503,P=0.039) ,percentage of eosinophilic cells (EOS) ( r=-0.554,P=0.021; r=-0.502,P=0.040).Lymphocytic periportal piecemeal necrosis was positively correlated with alkaline phosp-hatase (ALP),TBIL,DBIL,TBA,and also tumor necrosis factor-αt (TNF-αα) levels(r=0.617,P=0.006).Conclusion TBIL,DBIL,TBA,CHO,IgG and ALB,EOS are good surrogate markers for disease sever ity and reversibility of PBC,while ALP,TNF-Cα,TBIL,DBlL,TBA can be used as markers for disease activity.

Objective: To observe the accuracy and repeatability of Revolution CT energy spectrum imaging for measuring bone mineral density (BMD) of lumbar vertebra phantom. Methods: Revolution CT was used with different tube current and different tube rotation speed combinations, a total of 20 sets of scanning conditions, and the European spine phantom (ESP) were scanned repeatedly for 10 times. The Hydroxyapatite (HAP) value of L1, L2, and L3 vertebral bodies were measured by energy spectral material decomposition technique, and the measured HAP values were compared with actual values. At the same time, the volume CT dose index (CTDIvol) of each scanning condition were recorded and compared. Then the repeatability of measurements with CT machines was observed. Results: Under 20 groups of conditions, the measured HAP values of L1, L2 and L3 intervertebral bodies were statistically significant (all P<0.001). With tube current 230 mA and tube rotating speed 0.8 s/rot or tube current 315 mA and tube rotating speed 1.0 s/rot, no significant difference was found between measured HAP values and the actual values of L1, L2 and L3 vertebral body, nor between measured HAP values obtained with 2 CT machines (all P>0.05), and CTDIvol was 9.09 mG and 15.46 mGy, respectively. Conclusion: Revolution CT scan is accurate in measuring BMD of ESP, especially with tube rotation speed 0.8 s/rot and tube current 230 mA, and the radiation dose is low. The repeatability between different CT machines of same model is good.

Biopsy ; Histological Techniques ; instrumentation ; methods ; Humans ; Indicators and Reagents ; Paraffin Embedding ; Ultrasonics

Objective To explore the value of endoscopic ultrasound (EUS) in differential diagnosis of ectopic pancreas and stromal tumor in stomach.Methods The clinical data and endoscopic ultrasound findings of 40 patients with ectopic pancrea and 141 patients with stromal tumor were retrospectively analyzed,including the location,size,growth pattern,layer of origin,internal echo pattern and so on.All patients were diagnosed pathologically.Results Ectopic pancreas were predominantly located in the antrum (92.5％) and stromal tumor were mainly located in the gastric body (45.4％),the antrum (23.4％) and the fundus (22.0％),there was a significant difference in lesion' s location between two diseases (P ＜0.001).There was no statistical difference in the ratio of longest/shortest diameter of the lesion size(P =0.057).But there was statistical difference in lesion size between ectopic pancrease and stromal tumor [(19.98 ± 12.80)mm vs (11.25 ± 3.61)mm].Mural growth pattern was most common in ectopic pancrease (82.5％) and mural growth pattern (37.6％),extraluminal growth pattern (24.8％) and intraluminal growth pattern (22.7％) in stromal tumor (P ＜0.001).The third layer (75.0％) was predominant in ectopic pancrease while the fourth (54.6％) and the second layers (34.0％) in stromal tumor (P ＜0.001).With regard to internal echo pattern,hypoechoic (32.5％),intermediate (27.5％) and heterogeneous (27.5％) was predominant in ectopic pancrease and homogeneous hypoechoic lesion (72.3％) in the stromal tumor (P ＜ 0.001).Conclusions There were statistical differences between ectopic pancrease and stromal tumor in the location,size,layer of origin,growth pattern and internal echo pattern under EUS.EUS plays an important role in identification of ectopic pancrease and stromal tumor.

ObjectiveTo report the preliminary results and surgical technique of Stoppa approach used in treatment of acetabular fracture.MethodsFrom May 2005 to May 2010,23 patients with acetabular fracture were treated using modified Stoppa approach.The mean age was 37 years old(range,21-71years old).According to Letournel classification,there were 7 cases in anterior column fracture,6 cases in anterior column with posterior hemitransverse fracture,6 cases in transverse fracture,4 cases in associated with both column fractures.All patients in the study were operated under general anesthesia on a radiolucent table in a supine position and underwent Stoppa approach.Fracture reduction was evaluated by Matta's score system.The clinical outcome was judged by modified Merle d' Aubigne and Postel score system.Four cases of associated both column fractures,4 cases of anterior column with posterior hemitransverse fracture required the use of the lateral window.ResultsThe mean surgical time was 166 min (range,110-320 min).The mean blood lose was 647 ml (range,300-2500 ml).Blood transfusion was 3.3 unites (0-12 unites).All the factures healed in 3 months.The fracture reduction was evaluated according to the Matta's score system:an excellent reduction was obtained in 15 patients(65％),a good reduction was obtained in 5 patients (22％),and three(13％) were considered poor.Clinical results were excellent in 11 patients(48％),good in 7 patients (30％),fair in 3 patient (13％),and poor in 2 patients (9％).Superficial wound infection happened in 1 case.It healed after debridment.One patient noted to have significant weakness of the hip adductors (obturator nerve palsy) after surgery.It reached grade Ⅳone year later.No sciatic nerve,femoral nerve and vascular injury happened in this study.ConclusionFor the selected acetabualar fracture,Stoppa approach can get satisfied exposure and fixation of the fracture,especially in the patient with central dislocation of the femoral head as well as medial displacement of quadrilateral plate.