Hypoxemia is the most frequent respiratory abnormality in craniocerebral injuries. we present here the results of a retrospective study of the post-operative changes in arterial oxygenation in 65 cases of craniocerebral injuries. Thirty cases of non-neuro-surgical operations were used as controls.It was found that the PaO2 values in the craniocerebral injury group were significantly lower than those in the controls and often accompanied by obvious hypocapnia and respiratory alkalosis. Seventy-two per cent of the 65 cases had PaO2 values below 80mmHg and 20% below 60mmHg. Obvious hy-poxemia occurred most often in patients with brain stem injuries, extensive cerebral contusions and subdural hematomas. The PaO2 values usually decreased to the lowest level during the period of 24 to 48 hours after operation. There was no mortality in patients whose PaO2 values were above 80mmHg. In contrast, 61% of patients with PaO2 below 60mmHg showed poor prognosis.ICP mornitoring performed in 5 cases of craniocerbral injuries suggested that increased ICP was, in some way, associated with lower PaO2 .Nine dogs, anesthetized with sodium pentobarbital and under controlled ventilation, were studied for changes of arterial blood gases after ICP had been increased by epidu-ral balloon inflation to 50 and 100 mmHg for 30 minutes. All the animals consistently showed a decrease of PaO2 accompanied by a slight increase of PaCO and decrease of pH values after elevaion of ICP.The extent of these changes was greater when ICP was 100mmHg than when it was 50mmHg.Hyperventilation at ICP of 100mmHg could not restore PaO2 to baseline in most animals although their PaCO2 was decreased below baseline. These results indicate that acutely increased ICP has a direct effect on lungs, which is responsible for venous admixture and hypoxemia.The mechanisms,by which hypoxemia is caused after craniocerebral injuries, are discussed, ventilation-perfusion imbalance is considered to be a main factor for hypoxemia.we conclude that instant examination of arterial oxygenation is helpful to the recognition of the status of the patient's respiratory function, to the guidance of medical care and to the assessment of patient's prognois.It is suggested that effective control of increased ICP in head injuries can prevnt further deterioration of the respiratory function.

The clinical diagnosis of cerebral small vessel disease (CSVD) is largely dependent on neuroimaging. Features seen on neuroimaging of CSVD include white matter hyperintensities, lacunes and lacunar stroke, microbleeds, and perivascular spaces, suggesting brain tissue injury secondary to microvascular changes. Additionally, with the rapid development of neuroimaging method, several new methods from magnetic resonance imaging (MRI), functional MRI and positron emission computed tomography are applied in the clinical diagnosis of CSVD. Therefore, unified understanding of terminology and de?nitions for imaging features of CSVD, and of protocols for image acquisition and assessment, makes a significant meaning in clinical diagnosis and research of CSVD.

Objective:To compare the effects of a single dose of dexrazoxane or cAMP and their combined use on anthracycline cardiotoxicity in the multiple treatment course of patients with hematological malignancies to explore better alternatives for reducing an-thracycline cardiotoxicity. Methods: In the study, 80 patients were randomly divided into 4 groups with 20 cases each. Group A ( cAMP group) received cAMP 20 ml·d-1 for a week before every treatment course. Group B was treated with dexrazoxane and adria-mycin at a dosage ratio of 10∶1 via a fast intravenous drip 30 min before the application of anthracycline chemotherapy, and the 20 ml cAMP was given once a week before the chemotherapy session. Group C only received dexrazoxane. Anthracyclines was administered 30 min before each chemotherapy session. Groups A, B, and C were the experimental groups, and group D was designed as the blank control group. All groups received four complete cycles of chemotherapy. The ECG changes, echocardiography ( left ventricular ejection fraction, LVEF) and B-type brain natriuretic peptide ( BNP) values of all the groups were observed before and after the chemotherapy. Results:As for the ECG changes, group B and C had lower incidence rate of abnormal ECG than group A and D(P<0. 008 3). Sig-nificantly decreased LVEF and increased BNP values were observed in group A, B and C compared with those in the control group ( P<0. 05), and group B showed the most significant effect. Conclusion:All of the studied treatments can effectively reduce anthracy-cline chemotherapy-induced cardiotoxicity in cancer patients, and the combination of cAMP and dexrazoxane exhibits the best effect. Dexrazoxane has better protective effect on myocardial cells than cAMP.

Objective To evaluate the value of CT and ultrasonography in the diagnosis of originative malignant tumors of the female internal genitals.Methods 147 cases of originative malignant tumors comfirmed pathology in the female internal genitals were restropectively analyzed.Among them,73 cases were examined by CT.The CT findings were analyzed and compared with ultrasonography.Results Ultrasonography was proved to be slightly superior in the rate of definite diagnosis and also the cost was lower than CT.Conclusion The authors recommend that ultrasonography examination may be used as screening method for the orignative malignant tumors of the female internal genitals,and CT may be used as a important complementary method.

Objective To investigate the value of CT and mammography for diagnosing breast masses.Methods 61 cases with breast mass confirmed pathologically were studied comparatively. The diagnostic accuracy was compared between the two mentioned diagnostic methods.Results The qualitative accuracy of CT in diagnosis of breast cancer, galactocele, lipoma, fibroadenoma, gynecomastia, breast hyperplasia was 80%(8/10), 100%(2/2), 100%(1/1), 100%(27/27), 100%(7/7), 100%(14/14), respectively. The qualitative accuracy of mammography in diagnosis of the above lesions was 70%(7/10), 50%(1/2), 0%(0/1), 81%(22/27), 43%(3/7), 71%(10/14), respectively. In the cases of breast cancer, mammography could detect clustered microcalcification foci in 4 of the 10 cases(40%). But CT could detect none of them. Mammography was superior to CT in demonstrating cluster microcalcifications which are important basis for diagnosing breast cancer. The overall accuracy of CT and mammography for diagnosing breast masses were 97% and 71%.Conclusion CT has a higher accuracy than mammography in determining the nature of breast mass. The synthetic application of both the two methods may raise the diagnostic level for early stage breast cancer.

Objective To compare the predictive values of the classification of clinical symptoms(OCSP classification), brain images and artery abnormalities on prognosis of cerebral infarction. Methods Totally 116 acute ischemic stroke patients were divided into 4 subtypes based on the OCSP clinical classification. Lesion distributions were classified into cortical infarction, basal ganglion infarction, centrum ovale infarction and posterior infarction according to brain MRI image. Artery abnormalities were grouped into large artery disease and small artery disease according to the results of transcranial doppler, brain MRA, carotid duplex sonography or cerebral angiograph. The neurological function of patients 1 year after onset was evaluated by Barthel index and Rankin scale. Kaplan-Meier survival curves were graphed, and log-rank testing was performed to investigate the differences among stroke subtypes. Results OCSP clinical classification and brain image classification predicted the neurological function recovery 1 year after stroke onset, but it might be based on the size of the lesion whether it caused a dominant factor or not. Patients with small artery disease were found having a lower recurrence and mortality rate, as compared those with large artery diseases(0 vs 17.9%, Log-rank test, P=0.03). Conclusions There might be differences in predictive value among these 3 classification methods upon the prognosis of cerebral infarction.

Objective: : T o study the microanatomy of the facial nerve in the cerebellopontine angle (CPA) a nd the internal auditory meatus (IAM) for the preservation of the facial nerve i n the acoustic neurinomas surgery. Methods: Forty sides of CPA f acial nerve of 20 adult cadaver heads were examined. Results: In the pontomedullary sulcus the facial nerve (1.98? 0.10) mm anterior to the vestibulocochlear nerve,(8.76?1.42) mm lateral to the abducent nerve at the points where the nerves join the brain stem at the lateral end of the sulcu s, (8.15?2.18) mm above the junction of the Ⅸ nerve with the medulla. There were 62 nutritious artery supplying the facial nerve in the CPA, mainly from the anterior inferior cerebellaris artery (AICA) and its branches; and 17 in the IA M were mostly from the internal auditory arteria (IAA). Conclusion: To be familiar with the microanatomy of the facial nerve in CPA and IAM is h elpful for localizing the facial nerve and improve its preservation in acoustic neuroma surgery.

Objective To clarify the role of hypothalamic IL-6 in gastric mucosal blood flow, gastric juice pH value and gastric mucosal injury. Method Model of gastric stress ulcer was established by fluid percussion to make craniocerebral trauma. Twenty male SD rats fed for one week in the experiment room were randomly(random number) divided into control group, one hour group, six hours group and 12 hours group after injury. The levels and distribution of IL-6 in hypothalamus were detected by using immunohistochemistry and Western blot. Simultaneously, gastric pH value, gastric mucosal blood flow and gastric mucosal injury index of rats in each group were measured, and the histology of gastric mucosa was observed. Results IL-6 immunoreactive cells were widely distributed in neuronal cells of hypothalamus of the stressed rats especially in the para-ventricular nucleus (PVN).One hour after injury, the pH value rapidly declined, and the lowest point appeared 6 hours later. One hour after injury, the injury of gastric mucosa was found, and the injury became worse and worse as time got longer and longer. The ulcer index (UI) was increased. One hour after injury, there was a brief increase in blood flow to the peak in gastric mucosa, and then the blood flow declined until 6 hours elapsed and got stable. The experiment prompted the gastric stress ulcer appeared. Conclusions In the SD rats with gastric stress ulcer induced by craniocerebral injury incurred by hydraulic percussion, the hypothalamic IL-6 may activate neuronendocrine metabolism mediated through the activation of PVN, inducing gastric mucosal injury.

To explore the application of Problem-Based Learning( PBL) method in the clinical teaching of dermatology,we discuss the specificity in teaching and problems in application of dermatology and venereology from the relations between dermatology and venereology and other subjects,between summary and each chapters,and the relationships between each diseases.

Objective To explore the correlation between membrane targeting of rodent Muc3 C-terminal domain and proteolytic cleavage blockage within its SEA module and N-linked oligosaccharides inhibition.Methods COS-1 cells were transfected with three different expression vectors containing rodent Muc3 C-terminal domain,namely p20,p20t and p20s/a by lipofectAMINE reagent.Inhibition of N-glycosylation of the expressed protein was performed by using tunicamycin.The transfected COS-1 cells(fixed or unfixed) were detected by immunolocalization experiments(anti-V5 and anti-Myc antibody) for the protein expression.Results In fixed COS-1 cells,the expressed product of p20 transfectant detected using both anti-Myc and anti-V5 antibodies was found to localize in perinuclear position and on the plasma membrane.While in the unfixed cells,immunostaining was only confined on cell surface using anti-V5 antibody.The expressed product of p20t transfectant was detected by anti-V5 antibody to localize only in perinuclear region,as observed in a few fixed cells.The distribution of p20s/a fluorescence resembled that of p20 transfectant.Plasma membrane targeting of the non-glycosylated products due to tunicamycin treatment still occurred in transfected COS-1 cells and resembled the glycosylated products.Conclusions The blockage of proteolytic cleavage within C-terminal domain of rodent Muc3 and its inhibition of N-linked oligosaccharides in SEA module cannot affect its membrane targeting.The only apparent requirement for membrane targeting is the transmembrane and/or cytoplasmic tail segments which exist in the C-terminal domains of rMuc3.