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 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 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 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: : 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 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 observe the curative effect of Qingkailing Injection in treating diabetic foot with ischemic gangrene in early stage and investigate it′s therapeutic mechanism.Methods 40 patients were divided into Qingkailing treatment group (treatment group) and Xuesetong treatment group (controlled group),4 weeks in a treatment course.The foot skin color,skin temperature,degree of tumefaction,rage of gangrene,ability of walking,degree of pain were observed and C-reactive protein (CRP),fibrinogen (Fib) in plasma were detected before and after the treatment respectively.Results After 4 weeks treatment by Qingkailing Injection,the various standards mentioned above in treatment group were improved obviously,Compared with treatment group (except Fib),There was remarkable significance by statistics (P

Objective To review the features of diagnosis and treatment of craniocerebral firearm wounds in peacetime. Methods A total of 86 cases with various kinds of firearm wounds were retrospectively analyzed for discussing the characteristics of diagnoses and treatment of firearm wounds so as to provide the best treatment methods for firearm wounds of the brain. Results Of all, 80 cases (93%) won full recovery and four (5%) partial recovery but two (2%) were died of massive vascular damage and severe cerebral injuries within 24 hours after operation. Conclusions Craniocerebral firearm wounds are among the most devastating causes for morbidity and mortality in the civilian population. It is important to remove all foreign bodies, especially broken bones and necrotic tissues, and turn the open injury to the close injury. Stereotactic technique, localization of foreign bodies, culture of foreign body bacteria, drug allergy test and correct use of antibiotic and antiepileptic drugs are also critical for eliminating mortality and complications of craniocerebral firearm wounds.

Objective To investigate the effect of acute high intracranial pressure on the static pressure-volume curve of dogs' total respiratory system in order to evaluate the relationship between brain injury and respiratory insufficiency.Methods Fourteen dogs were divided into two groups.Animals were anesthetized,paralyzed and mechanical ventilated.The intracranial hypertension in experimental group(n=8)was induced by injecting blood-clots into the right frontal lobe.The other six dogs served as control.The intracranial pressure was monitored by an optical fiber transmitter inserted into the left cerebral hemisphere.The pressure-volume curves of the respiratory system were measured before and after induction of high intracranial pressure by a self-made apparatus consisting of two sealed bottles and a U shaped glass tube.The curves were also measured correspondingly in control group.The static compliance was calculated by equation C=?V/?P.The volume of intracerebral hematoma was calculated.The histopathology of lung was studied under microscope.Results The intracerebral hematoma was located in the right frontal lobe with volume from 4.8-11.5ml(average 8.48ml).The intracranial pressure was elevated from 18.13?5.96mmHg to 46.88?16.42mmHg,which induced a shift of pressure-volume curve to the right in experimental group,while no obvious change was found in control group.Compared to pre-injection,the static compliance of total respiratory system decreased significantly(P