Objective To investigate the effect of different end-tidal PCO2 (PETCO2) on the quantitative electro-encephalogram (qEEG) and auditory evoked potential index (AAI) in patient undergoing elective general surgery under inhalation anesthesia. Methods Thirty-eight ASA Ⅰ-Ⅱ patients aged 22-48 yrs weighing 49-79 kg undergoing elective general surgery under inhalation anesthesia were studied. The intra-operative blood-loss was expected to be

Objective To evaluate the effect of the interlocking nail for extremity fractures. Methods This study reviews 1224 cases of extremity fractures treated with locking intramedullary nail fixation from October 1996 to June 2004, including 92 cases humeral shaft fracture; 210 cases intertrochanteric fractures; 488 cases femoral shaft fractures; 92 cases supracondylar femoral fractures; 342 cases tibia and fibular fractures. According to the AO classification there were 642 type A, 364 type B and 218 type C. There were 986 cases (72.4%) high-energy injury; 405 cases were multiple injury. There is 778 male and 446 female with mean age 39 years (range 16-92 years). Duration from injury to operation was 8 days(3 hour-30 days). Close reduction was 1203 cases and open reduction were 21 cases. Results Mean follow-up period is 24 months(6-70 month), mean operation time was 90 minutes(40-480 minutes). Union was in 1204 cases, union rate was 98.2%, mean union time was 5 months (3-12 months) on average, there were nonunion in 22 patients: 4 in humeral shaft, 8 in femoral shaft, 4 in supracondylar femur, 6 in tibia shaft, the nonunion rate is 1.8%. Late deep infection occurred in 3 patients: 1 in femoral shaft, 1 in supracondylar femur, 1 in intertrochanteric femur, the infection rate is 0.2%. There were 16 split in intraoperation: 4 in humeral nail, 4 in Gamma nail, 9 in supracondylar nail. Iatrogenic nerve palsy occurred in 6 patients: 2 in radial nerve, 2 in sciatic nerve, 2 in common peroneal nerve, the occurrence is 0.4%. One femoral nail was broken, locking screw were broken in 9 patients (0.6%), femoral shaft fracture of distal nail end occurred in 3 cases: 1 in Gamma nail, two in supracondylar nail. 53 patient complained uncomfortable in entry point (8 shoulders; 9 hips; 36 knees). Conclusion The result is satisfactory in bone healing low infection reduced blood loss and rapid recovery of the joint and body with the close interlocking nailing to be treatment of fresh extremity shaft fracture. It is a perfect method, however the complication should be pay more attention.

Objective To develop a reliable and reproducible modei of hyperalgesia arising from chronic compression of dorsal root ganglion (DRG) and investigate the contribution of spinal cord dorsal horn calcitonin gene-related peptide (CGRP) to the clinical manifestation of sciatica.Methods Sixty healthy Wistar rats of either sex weighing 200-300 g were randomly divided into three groups: group A control ( n = 12) ; group B sham operation (n = 24) and group C chronic compression of DRG ( n = 24) . In group B and C the animals were anesthetized with intraperitoneal 1.25% thiopental sodium (50mg?kg-1) . The animals were then placed in prone position and the left L4 and L5 intervertebral foramina were exposed. In group C a 4 mm long 1-0 chromic catgut was inserted into the intervertebral foramen. Motor function of the hind limbs was assessed by gait disturbance scores (GDS) , and paw-withdrawal threshold (PWT) was measured with modified Randall algometer 3, 5, 7, 10, 14, 17, 21 and 28 days after operation. In group B and C 12 animals were decapitated on the 5th and 28th days after operation respectively and lumbar section of spinal cord was removed for determination of dorsal horn CGRP content (by radio-immunoassay) and microscopic examination of DRG. Results In chronic compression group (C) significant hyperalgesia occurred after operation and reached a peak one week after operation then gradually decreased but didn't return to normai on the 28th day, while in sham operation group (B) postoperative hyperalgesia quickly decreased and returned to normai on the 7th day. In group C dorsal horn CGRP content on the compressed side significantly increased on the 5th and 28th day after operation as compared with that on the contralateral side in the sham operation and control group. Microscopic examination of DRG showed significant edema of endoneurium and neurons which persisted on the 28th day but significantly attenuated. Conclusion This animal model reliably produces a disorder resembling low back pain. It is easy to perform less traumatic and produces significant hyperalgesia. The dorsal horn CGRP content on the compressed side significantly increases, which is consistent with chronic pain.

Objective:To study assessment value of brachial‐ankle pulse wave velocity (baPWV) for severity of coro‐nary disease in patients with coronary heart disease (CHD) .Methods :According to SYNTAX score of coronary an‐giography ,a total of 206 CHD patients from our hospital were divided into mild group (n=74 ,SYNTAX score <23 scores) ,medium group (n= 72 ,SYNTAX score 23~32 scores) and severe group (n= 60 ,SYNTAX score > 32 scores) .Another 80 healthy subjects undergoing physical examinations were selected as healthy control group during the same period .BaPWV ,ankle brachial index (ABI) and carotid -femoral pulse wave velocity (cfPWV) were measured and compared among all groups .Pearson correlation analysis was used to analyze the correlation among baPWV ,cfPWV ,ABI and SYNTAX score in CHD patients ;multi -factor Logistic regression model was used to analyze whether baPWV ,cfPWV and ABI were risk factors for SYNTAX scores .Results:Compared with healthy control group ,there were significant rise in baPWV [ (1.2 ± 0.3) m/s vs .(1.5 ± 0.4) m/s vs .(1.8 ± 0.6) m/s vs . (2.0±0.7)m/s]andcfPWV [ (1.3±0.5)m/svs.(2.5±0.7)m/svs.(2.9±0.8)m/svs.(3.4±0.7)m/s]in mild group ,medium group and severe group (P<0.05 or <0.01) ,and that of severe group was more than that of medium group ,and>mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all);significant reduction in ABI [ (1.02 ± 0.32) vs .(0.82 ± 0.24) vs .(0.73 ± 0.16) vs .(0.56 ± 0.09)] in mild group , medium group and severe group ,and that of severe group was < medium group ,and < mild group in turn ,there was significant difference by pairwise comparisons ( P<0.05 all) .Pearson correlation analysis indicated that baPWV and cfPWV were positively correlated with SYNTAX score ( r= 0.613 , P= 0.007;r=0.528 , P=0.023) ,while ABI had no correlation with SYNTAX score .Multi-factor Logistic regression analysis indicated that diabetes melli‐tus ,hypertension ,baPWV and cfPWV were risk factors for SYNTAX score (OR=4.016~5.809 , P<0.05 or <0.01) .Conclusion:The baPWV can effectively assess severity of coronary disease in CHD patients .

Objective To explore the intervention effect of active fraction of Angelica Sinensis Radix in mice under high altitude hypoxia condition. Methods Totally 72 healthy SPF mice were randomly divided into control group (K), model group (M), Rhodiola rosea group, and active fraction of Angelica Sinensis Radix groups (B, C, X). The mice were administerted corresponding treatment by gavage for 21 days. Control mice were given normal saline in same volume. From the 8th day, all mice excepted control mice were exposed to high altitude hypoxia cabin after 0.5 hour gavage treament. On the 22nd day, after got out of the cabin and their body weight were measured, mice were put to death through eyeball blood sampling to prepare splenic lymphocyte suspension. The proliferation and transformation capacities of lymphocyte cell and killing activity of NK cells were detected by MTT. The content of IL-2 in the serum of mice in each group were detected by ELISA. Results Compared with the control group, the body weight of mice, the proliferation and transformation capacities of lymphocyte cell, the killing activity of NK cells, and the content of IL-2 were all significantly decreased (P<0.05, P<0.01). Experiment tests showed that the proliferation and transformation abilities of lymphocyte cell and the killing activity of NK cells were all increased in the mice of group B, C, and X compared with those of the model group (P<0.05, P<0.01). The stimulate index of lymphocyte cell was raised after X intervention compared with those of the model group (P<0.05). The content of IL-2 in the serum was enhanced after intervention of active fraction C and X of Angelica Sinensis Radix compared with those of the model group (P<0.05, P<0.01). Conclusion Active fraction of Angelica Sinensis Radix shows increasing immunological function of mice exposed to hypoxia.

Objective To explore the application value of endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group .Methods The clinical data of 130 patients which treated by thyroidectomy without transection ante‐rior cervical muscle group were analyzed ,retrospectively .There were 68 cases treated by endoscopic thyroidectomy via breast ap‐proach and 62 cases treated by conventional thyroidectomy .Results 68 patients underwent endoscopic thyroidectomy ,the mean time of operation was(127 .66 ± 29 .56)min ,which was longer than that in conventional group (89 .06 ± 24 .25)min(P<0 .01) ,but blood loss was significantly less in endoscopy group than that in conventional group(19 .13 ± 7 .37)mL vs .(50 .17 ± 29 .28)mL . (P<0 .01) .The patients treated by endoscopic thyroidectomy with neck pain induration were less than that in conventional group (1 case vs .7 case) ,P<0 .01 ,and the nerve dysfunction were (4 case vs .3 case) ,P>0 .05 ,the nerve dysfunction had no significant difference .Conclusion Endoscopic thyroidectomy via breast approach without transection anterior cervical muscle group has less blood loss ,lower neck pain induration rate ,hidden incisions and excellent cosmetic benefits .The method is safe and feasible .

Objective To evaluate the clinical value of tomography ultrasonic imaging (TUI) in staging carcinomas of the cervix.Methods Eighty-seven patients with biopsy proven cervical cancer who underwent transvaginal TUI examination were enrolled.Clinical and ultrasonic staging were based on the FIGO staging system.Surgical-pathological or MR results was taken as golden standard.Ultrasonic staging were compared with clinical staging.Tumor sizes of 38 cases of cervical cancers measured by TUI were recorded and compared with the pathological results.Results The overall accuracy of preoperative TUI staging was higher than that of preoperative clinical staging (91.95 ％ vs 81.60 ％,P ＜0.01).Mean size of the 38 malignant tumors was 2.5 cm×2.1 cm×2.2 cm by TUI and 2.6 cm×2.1 cm×2.3 cm by pathological samples (P ＞ 0.05).Conclusions TUI technology may be useful in the noninvasive examination of preoperative staging of carcinoma cervix.

AIM:To study the effect of Hand2 (one of basic helix-loop-helix proteins’ transcription factors) expression on the development of the cardiac tissues in the fetal rats from gestational diabetes mellitus ( GDM) parents, and to investigate the potential pathogenesis of GDM-induced congenital cardiac defects in rats.METHODS: The adult Spra-gue-Dawley female rats were randomly divided into blank control group (n=24), GDM group (n=30), negative control group ( n=30) and insulin intervened group ( n=30) .The GDM model was established by intraperitoneal injection of 2%streptozotocin (STZ, 40 mg/kg body weight) to the pregnant rats on the successive day.The rats in insulin intervened group were injected with intermediate-acting insulin in order to keep the fasting blood glucose in the normal range.The rats in negative control group were injected with citric acid-sodium citrate buffer solution in the same position.Blood glucose and body weight were examined every day 72 h after STZ injection.On E12, E15 and E19, the rats were anesthetized and the embryonic cardiac tissues were collected after caesarean section.The histopathological changes of the cardiac tissues were observed under microscope with HE staining.The expression of Hand2 was analyzed by the method of immunohisto-chemistry.The expression of Hand2 in the cardiac tissues at mRNA and protein levels was determined by real-time fluores-cence quantitative PCR and Western blotting.RESULTS:During the development of embryonic heart, the protein expres-sion of Hand2 in the cardiac tissues was showed dynamic changes.Observed on E12, obviously increased on E15, and at the highest level on E19.Compared with the other 3 groups, the protein and mRNA expression of Hand2 in GDM group was decreased at the time points of E12 and E15.CONCLUSION:The morbidity of fetal cardiac malformation is significantly increased in GDM group, suggesting that Hand2 may be involved in the development of cardiac malformation in GDM.

Objective:To investigate the diagnostic value of the promoter methylation of plasma RNF180 gene and its protein ex-pression for the detection of gastric cancer. Methods:Methylation-specific polymerase-chain reaction (MSP) and enzyme-linked immu-no-sorbent assay (ELISA) were performed to detect DNA methylation and protein expression of the RNF180 gene, respectively. The correlations of DNA methylation and protein expression of the RNF180 gene with the clinico-pathological parameters of gastric carcino-ma were then separately analyzed. Results:MSP showed that the methylation rates of the RNF180 gene were 62.75%and 21.88%in the plasma of patients with gastric carcinoma and healthy volunteers, respectively;this result indicated that the two groups significantly differed (P<0.01). The methylation of the RNF180 gene was associated with tumor size, clinical stage, tumor differentiation, lymph node metastasis, and distant metastasis (P<0.05). ELISA results showed that the protein expression of the RNF180 gene [(23.22 ± 1.36)μg/mL] was significantly lower (P<0.01) in the plasma of patients with gastric carcinoma than in the plasma of healthy volunteers [(34.25 ± 2.44)μg/mL]. However, the protein expression of the RNF180 gene was not associated with clinicopathological parameters (P>0.05). Conclusion:The RNF180 gene is expressed at a hypermethylation rate, and the corresponding protein expression level is de-creased in the plasma of individuals with gastric carcinoma. Therefore, RNF180 gene methylation in plasma could be applied to detect microinvasion for the clinical diagnosis of gastric cancer.