Objective: To evaluate the electron beam computed tomography(EBCT) three-dimensional reconstruction in the diagnosis of bowel obstruction.Methods: Seventy-eight patients suspected of bowel obstruction underwent EBCT with two-phase enhancement scanning and 32 of them were re-established by corona-MPR and sagittal-MPR.All the EBCT results were analyzed and compared with the clinical findings.Results: Seventy-three of the cases were diagnosed as bowel obstruction by EBCT,which were all confirmed by surgery or follow-up,with an accuracy rate of 100% for location diagnosis and 86.3% for etiology.Conclusion: EBCT 3D-reconstruction has great advantages in determining the location,etiology and blood-supply of bowel obstruction.

Objective To investigate the effect of ropivacaine combined with dexanmethasone sprayed intratracheally in patients with resistant tubes and postoperative sore throat.Methods Eighty patients ASA Ⅰ-Ⅱ grade undergoing laparoscopic cholecystectomy were randomly divided into four groups by random digits tabel method,20 patients in each.2 ml of 0.75％ ropivacaine combined with 1 ml dexamethasone (group A) ; 2 ml of 0.75％ ropivacaine combined with 1 ml 0.9％ sodium (group B) ; 3 ml of 1％ tetracaine (group C); 3 ml of 0.9％ sodium (group D) were immediately intratracheal sprayed before intubation.The resistant tubes and degree of postoperative 24 h sore throat [by visual analog scale (VAS) scores],comfort [by Bruggrmann comfort scale (BCS) scores] and the incidence of sore throat were recorded.Results The resistant tubes appraised rate in group A,B and C was higher than that in group D [65.0％ (13/20),60.0％ (12/20),70.0％ (14/20) vs.5.0％ (1/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The incidence of sore throat at 24 h after surgery in group A,B and C was lower than that in group D [20.0％(4/20),25.0％ (5/20),25.0％ (5/20) vs.90.0％ (18/20)] (P ＜ 0.05),but there was no significant difference among group A,B and C (P＞ 0.05).The VAS and BCS scores in group A were better than those in group B,C and D [(0.52 ± 1.14) scores vs.(1.68 ± 1.42),(1.59 ± 1.33),(4.22 ± 1.95) scores,(2.80 ± 1.54) scores vs.(1.60 ± 1.19),(1.80 ± 1.20) and (0.45 ± 0.81) scores] (P ＜ 0.05),but there were no significant differences between group B and group C (P ＞ 0.05).Conclusion Ropivacaine combined with dexamethasone sprayedintratracheally can significantly increase the degree of postoperative resistant tubes,decrease the rate of sore throat after general anesthesia,and increase patient' s comfort.

Objective To study the effect of moxonidine (Mox) on the His bundle electrogram (HBE) of normal rabbits. Methods A total of 24 healthy rabbits were randomly divided into four groups: control group, small dose of Mox (0.1 mg?kg -1), medium dose of Mox (0.3 mg?kg -1) and large dose of Mox (0.9 mg?kg -1). The electrode catheter was inserted from the right carotid artery to record the HBE. The HBE and the synchronism surface ECG were recorded before and after intravenous injection. Results In normal rabbits, the R-R interphase, P-R interphase of the ECG and the H-V interphase of the HBE were prolonged in a dose-dependent manner after intravenous injection of Mox. Mox exerted no significant influence on the A-H interphase. Conclusion ① Mox decreases the heart rate of rabbits in a dose-dependent manner in vivo. ② Mox dose-dependently prolongs the P-R interphase of the surface ECG and the H-V interphase of HBE. This indicates that Mox mainly acts on the intraventricular conducting system.

To realize temperature real-time control in microwave heat treatment, this paper presents a new type of thermal dosimeter on hyperthermia. The sign of temperature is extracted by mini-thermal-electronic-couple transducer, amplification circuit and main magnifier. The bond of temperature controlling and thermal therapy is achieved, the experimental prototype of thermal dosimeter equipment is developed and clinical experiment scheme is designed. The whole system is simple in structure, high in efficiency and reliability.

Objective To evaluate the effect of remifentanil pretreatment on myoclonus after etomidate injection.Methods Sixty patients undergoing scheduled for intestinal endoscopy under general anesthesia were divided into remifentanil group and control group by random digits table method with 30 cases each.Before 0.3 mg/kg etomidate was given,the patients in remifentanil group and control group were pretreated with remifentanil 0.5 μ g/kg or amount of 0.9％ sodium chloride.Myoclonus was observed and recorded.Nausea,pruritis and apnea were observed after procedures.Results The incidence of myoclonus was 73.3％(22/30) in control group,mild in 11 cases,moderate in 10 cases and severe in 1 case.The incidence of myoclonus was 6.7％(2/30) in remifentanil group and mild in 2 cases.There was significant difference in the incidence of myoclonus between two groups (P ＜ 0.01).In control group,the ratio of myoclonus was 14/16 in males and 8/14 in females.In remifentanil group,male and female each had 1 case of myoclonus.There was no nausea,pruritis and apnea in remifentanil group.Conclusion Pretreatment with 0.5 μ g/kg remifentanil reduces myoclonus after etomidate injection,male patients are more associated with the incidence of myoclonus than female patients.

BACKGROUND: It is proposed that elevated serum homocysteine is an important independent risk factor for ischemic stroke (IS), and 5, 10-methylenetetrahydrofolate reductase (MTHFR) is the key enzyme for homocysteine metabolism. The relationship between genetic mutation of MTHFR and IS remains controversial.OBJECTIVE: To examine the association of hyperhomocysteinemia and two MTHFR gene polymorphisms with IS in Northwest Chinese population.DESIGN: Case-control study.SETTING: Department of Neurology, First Hospital Affiliated to Jilin University, and Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA.PARTICIPANTS: Ninety-seven consecutive patients with ischemic stroke (71 males and 26 females) treated between November 2001 and May 2002were recruited, who were diagnosed by CT scan or MRI in the Department of Neurology, Xijing Hospital, Fourth Military Medical University of Chinese PLA. The control group consisted of 94 subjects (58 males and 36 females) without history of ischemic stroke. All the subjects were free of intracranial hemorrhage, cancer, renal dysfunction, and none used multivitamins or estrogen.METHODS: Serum homocysteine was measured by fluorescence polarization immunoassay. Polymerase chain reaction-restriction length polymorphism (PCR-RFLP) method was employed to detect the genotype at the two sites of C677T and A1298C in MTHFR gene.MAIN OUTCOME MEASURES: Serum homocysteine levels and the genotypic frequency frequencies of the two mutations of MTHFR.RESULTS: The 677T allele frequency was 59.3% in IS patients and 44.7% in the controls, showing significant differences (P=0.006), but no difference in 1298C allele frequency was detected between the two groups (22.7% vs 19.7%, P ＞ 0.05). Homozygous 677TT genotype was closely associated with hyperhomocysteinemie (P ＜ 0.01). In multivariate logistic regression analysis,677T gene mutation and hyperhomocysteinemie were all associated with the IS, with an OR of 1.870 and 1.031 (P＜ 0.05), respectively.CONCLUSION: Hyperhomocysteinemie is a risk factor of IS, and C677T mutation significantly increases homocysteine levels, and serves also as an independent genetic risk factor of IS.

Objective To evaluate the value of CEUS in dynamicly assessing the blood perfusion of hepatic alveolar echinococcosis (HAE) in rats.Methods The experimentally induced secondary HAE in totally 70 rats were studied at different time periods (gth week,28th week,and 50th week) with CEUS,and compared to pathology results.Results At the 9th week,55 HAE lesions (55/70,78.57％) presented hyperechoic and the rest of 15 HAE lesions (15/70,21.43％)presented mixed echogenicity.The single or multiple vesicular structures were found as pathological feature.At later stages (28th week and 50th week),the size of lesions increased compared to 9th week with more solid structures and the calcifications found in HAE lesions.Microscopically,the fibrous tissues surrounding the lesions gradually thickened and the microvascular accumulation were visible around the lesions.The HAE lesions at the 9th week showed the ring enhancement and central septa enhancement in CEUS.The HAE lesions at the 28th week and 50th week showed combinations of no enhancement,ring enhancement,and central septa enhancement in CEUS.The ratio of edge enhancement to maximum diameter of lesions decreased with the progression (P=0.02).Conclusion The ultrasonographic features in HAE lesions become more complicated with increasing calcifications and enlarged necrosis areas with the progression.The CEUS can reveal the dynamics of blood perfusion of HAE lesions at different stages.

BACKGROUND:The traditional orthopedic fixation by C-arm positioning surface is completed, but the large C-arm injury on the human body and the long fixed time increase the suffering of patients. OBJECTIVE:To investigate the X-ray fixed in position within the orthopedic implants, navigation and effect. METHODS:Twenty-six New Zealand white rabbits were randomly divided into C-arm machine group and X-ray group, with 13 in each group. Rabbits in both groups were used to simulate soft tissue foreign body localization, intramedul ary nail implantation at distal fracture end and spinal pedicle screw entry point position. In the C-arm machine group, positioning navigation was conducted with C-arm machine. In the X-ray group, X-ray positioning navigation was used. The positioning and navigation effects were compared between the two groups. RESULTS AND CONCLUSION:(1) Compared with the C-arm machine group, the time required for navigation in the X-ray group targeting soft tissue foreign body localization, fracture distal locking intramedul ary nail implantation and pedicle screw spinal needle point location was significantly shorter (P<0.05);navigation displacement and deviation produced were significantly less (P<0.05). (2) These findings suggested that the X-ray positioning for orthopedic fixation method is relatively simple, with high availability, and can obtain a high performance-price ratio. Meanwhile, the X-ray localization can improve accuracy and shorten the fixed time.

10.3969/j.issn.1000-8179.2013.12.010

Objective To explore the prognosis and related factors of brain glioma .Methods 133 patients who have been con-firmed pathology with brain glioma from Jan .2001 to Dec .2010 were retrospectively analyzed .The factors such as sex ,age ,func-tional status ,histological character ,the longest diameter of tumor ,surgical excision of part or all of the tumor ,whether or not being radiotherapy after surgical excision were selected to evaluate by single factor and multiple factors analysis .Results The median fol-low-up time was 36 months ,The follow-up rate was 93% .73 cases were followed up for 3 years ,the 1- ,2- and 3- year survival rate was 93% ,82% and 70% ,respectively ,the median survival time was 62 .7 months .Multiple factors regression analysis showed that histological character ,the longest diameter of tumor and whether or not being radiotherapy after surgical excision were related to prognosis .Conclusion High-grade of histological character ,the longest diameter of tumor≥6 cm predict poor prognosis ,postop-erative radiotherapy can improve the survival of glioma .