Diagnostic Errors ; Humans ; Larynx ; Tuberculosis, Laryngeal ; diagnosis

Objective Toinvestigate the effects of carbon dioxide pneumoperitoneum on cardiovascular system by making use of arterial pressure waveform analysis( FloTrac/Vigileo system) to observe the change of heart function of patients undergoing laparoscopy cholecystotomy. Methods Forty patients scheduled for elective laparoscopy cholecystotomy were divided into two groups with 20 cases each by random sampling.Ventilatory capacity was fixed (tidal volume was 10 ml/kg, frequency was 12 times/min) in group A and adjusted to keep arterial carbon dioxide tension (PaCO2) and end expiration carbon dioxide tension(PETCO2)in normal range in group B. The parameters, such as mean arterial pressure (MAP), cardiac output(CO),stroke volume (SV), stroke volume variability (SVV), heart rate(HR), pulse oxygen saturation (SpO2),PETCO2, PaCO2 were recorded and analyzed. Results In group A:HR,MAP,CI,SVV,PaCO2 and PETCO2 were increased at 10,30 min after pneumoperitoneum (P ＜0.05 or ＜0.01),there was no significant difference in SVV between the end of pneumoperitoneum and 5 min after intubation [(8 ±2)% vs. (9 ±3 )%](P＞ 0.05 ) ,but HR, MAP, CI,SVI,PaCO2 and PETCO2 increased significantly (P＜ 0.05 or ＜ 0.01 ). In group B: HR, MAP, CI, SVI, PaCO2 and PETCO2 at 10,30 min after pneumoperitoneum were no changes (P ＞0.05 ), SVV was higher than that at 5 min after intubation (P ＜ 0.01 ), there was no significant difference in SVV between the end of pneumoperitoneum and 5 ain after intubation [(9 ± 2)% vs. ( 10 ± 2)%] (P ＞0.05 ). HR, CI, SVI, PaCO2, PETCO2 at 30 min after pneumoperitoneum and the end of pneumoperitoneun were significantly higher in group A than those in group B (P ＜ 0.05 or ＜ 0.01 ). Conclusions During carbon dioxide pneumoperitoneum, hypercapnia can increase MAP, HR, CO,SV significantly, and intra abdominal pressure can decrease preload by hindering the reflow of inferior vena cava and abdominal viscera veins. Arterial pressure waveform analysis can promptly reflect the effects of carbon dioxide pneumoperitoneum on cardiovascular system and be in favour of adjusting the respiration parameters and managing transfusion in laparoscopic surgery.

The present study was to examine the effect of stellate ganglion block (SGB) on bilateral regional cerebral oxygen saturation (rSO2) and postoperative cognitive function. Eighty patients undergoing selective coronary artery bypass graft with cardiopulmonary bypass (CPB) were randomly and equally divided into two groups. The patients in group S were given right SGB with ropivacaine, while the patients in group C were injected with normal saline. We compared the bilateral rSO2 after SGB. Minimum Mental State Examination (MMSE), Visual Verbal Learning Test (VVLT), and Digital Span Test (DST) were applied to observe the effect on cognitive function. We found that the incidence of postoperative cognitive dysfunction (POCD) 7 days after surgery in group S was lower than that in group C. The level of blocked side rSO₂ of S group were significantly higher before CPB time of rewarming than that before SGB (P < 0.05), much higher than corresponding non-blocked side rSO₂ before CPB (P < 0.05), and much higher than rSO₂ level in group C before CPB and after CPB (P < 0.05). The non-blocked side rSO₂ in group S before anesthesia were much lower than basic levels and those in group C (P < 0.05). It could be concluded from the above results that there was significant increase in the blocked-side rSO₂ compared to the non-blocked side and there was significant decrease in the incidence of POCD compared to the control group after SGB.
Autonomic Nerve Block ; adverse effects ; Cardiopulmonary Bypass ; adverse effects ; Cerebrum ; physiology ; Cognition ; Cognition Disorders ; Coronary Artery Bypass ; adverse effects ; Humans ; Incidence ; Oxygen ; physiology ; Oxygen Consumption ; Postoperative Complications ; Stellate Ganglion

Objective To study the mRNA expression of myelin basic protein (MBP) and myelin oligodendregha glyeoprotein (MOG) in hippocampus of rats following global brain ischemia.Method The four- vessel occlusion animal model in the Sprague-Dawley rats was used in this study.The mRNA expression levels of MBP and MOG in the hippocampus of rats were analyzed by reverse transcription polymerase chain reaction (RT- PCR) at day 2,4,7,14 and 28 days after global brain ischemia.There were eight rats at each time-point and sham operated group.Results The mRNA expression of both MBP and MOG in hippocampus of rats decreased at 2 days after global brain ischemia.The gene expression of myelin gene decreased significantly at 7 days and it reached to the lowest level at 28 days.Compared with sham operated group,the gene expression of MBP and MOG in hippocampus of rats decreased significantly at 7,14 and 28 days after global brain ischemia (P

The points stimulated by output pulse of the electroacupuncture instrument are fixed, and this stimulation model makes Deqi sense of the distal point unable to reach the affected parts, only limiting around the point for most patients, so the therapeutic effects are influenced to a certain extent. From design, usage and other aspects, it is described that joint the output conducting wires to the acupuncture needles from the distal point to the proximal point in turn. When the output ports of the electroacupuncture instrument export the pulse wave one port by one port, the sense of Deqi of the patient propagates towards the affected area one point by one point. Finally, the sense of Deqi of the patient propagates and reaches to the affected area. The along-meridian treatment instrument overcomes the shortcomings of the existing electroacupuncture instrument, and obviously increases therapeutic effects.
Electroacupuncture ; instrumentation ; methods ; Equipment Design ; Humans ; Meridians ; Treatment Outcome

Objective To study the feasibility of percutaneous pedicle screw fixation in treatment of thoraco-lumbar fractures.Methods Twenty-two patients with thoraeo-lumbar fractures were treated with the posterior percutaneous or open pedicle screw fixation respectively.Operation time,the bleeding volume,the height of the anterior border,the cobb angles of seoliosis,the late loss of correction,and complications were compared.Results All patients were followed up for mean 19 months(13 to 22 months).In percutaneous group,the mean time of operation was 102 minutes,the anterior height of compressed vertebral bodies was restored from 52% to 95% of the normal height,and the Cobb angle was corrected from 16?to 6.3?,the mean late loss of correction was 13% in percutaneous group,and there were no significant differences between the two groups(P＞0.05).The mean bleeding volume in the percutaneous group and open group was 102 ml and 290 ml respectively,which showed significant difference(P＜0.05).Conclusion Posterior percutaneous pedicle screw fixation in treatment of thoracolumar fractures,which didn't need vertebral canal decompression,was a perfect and effective method.Compared with open method,it had such strongpoints as quicker recovery and less invasive.

Objective To explore the value of 18F-FDG PET/CT on the assessment of chemotherapy response in patients with diffuse large B-cell lymphoma (DLBCL). Methods 18F-FDG PET/CT was performed before and after 4 cycles of chemotherapy( R-CHOP or CHOP protocol) in 53 patients with DLBCL. The patients were divided into 3 groups: complete response group, partial response group and no response group. The therapeutic response was assessed by comparing post-treatment 18F-FDG PET/CT with pre-treatment PET/CT. Complete remission (CR) rate at the end of chemotherapy was calculated. χ2 test was performed with software SPSS 13.0. Results CR rates of complete response group, partially response group and no response group were 88.5% (23/26), 73.3% (11/15) and 8.3% (1/12), respectively (χ2=23.548, P=0.000). CR rates of the complete and partially response groups were significantly higher than those of no response group (χ2=22.656, P=0.000; χ2=11.407, P=0.001). Conclusion 18F-FDG PET/CT may be useful for the assessment of chemotherapy response in DLBCL.

Objective To investigate the influence of low-dose ketamine and dexmedetomidine on cardiovascular response during. sedative amnesia fiberoptic nasotracheal intubation. Methods Ninety ASA Ⅰ or Ⅱ patients scheduled to recerve general anesthesia were evenly random-ized to dexmedetomidine and ketamine (group DK),dexmedetomidine and propofol (group DP)and dexmedetomidine and remifentanil (group DR).Ten minutes before intubation,the patients in group DK received intravenously dexmedetomidine 1.0 μg/kg plus ketamine 0.5 mg·kg-1 ·h-1 ;those in group DP received intravenously dexmedetomidine 1.0 μg/kg plus propofol 2.0 mg · kg-1 · h-1 ;those in group DR received intravenously dexmedetomidine 1.0 μg/kg plus remifentanil 5.0μg·kg-1 ·h-1 .Nasotracheal intubation was performed with fiberoptic bronchoscopy after dexemeto-midine injection and complete topical anesthesia.HR,MAP,SpO 2 and Ramsay sedation score were re-corded before anesthesia (T0 ,baseline),before intubation (T1 ),immediately intubated (T2 )and five minutes after intubation (T3 ).Side effects such as restlessness,bucking,respiratory depression and cardiovascular event during intubation and awareness of intubation were also recorded.Results All pa-tients in three groups were performed successfully.HR and MAP were significantly decreased in groups DP and DR at T1 (P <0.05),SpO 2 was significantly decreased in group DP at T1 (P <0.05);MAP in group DR were higher than those in group DP,HR in groups DP and DR were significantly increased than those in group DK at T3 (P < 0.05 );Ramsay score were significantly decreased in groups DP and DR at T2 ,significantly lower in group DR at T3 than those in groups DK and DP (P<0.05).The incidences of bradycardia and respriatory depression were significantly higher in group DP than those in group DK,and bucking,restlessness,tachycardia incidence rate in group DR were significantly higher than those in groups DK and DP (P <0.05).Conclusion Dexmedetomidine com-bined with low dose ketamine together with topical anesthesia is an ideal method for sedative amnesia fiberoptic nasotracheal intubation with slighter cardiovascular response and less side effects.

To observe the effects of ultrasound-guided stellate ganglion block (SGB) on cerebral oxygen metabolism and postoperative cognitive dysfunction (POCD) of elderly patients, we collected 80 elderly patients undergoing selective coronary artery bypass graft under cardiopulmonary bypass. The Mini Mental State Examination (MMSE) was applied to test the cognitive function. The SjvO2, Da-jvO2 and CEO2 were used for the analysis of the cerebral oxygen metabolism. We found that POCD was related to disequilibrium of cerebral oxygen metabolism. Ultrasound-guided SGB before surgery reduced the incidence of POCD because of the improvement of cerebral oxygen metabolism.
Aged ; Autonomic Nerve Block ; Cardiopulmonary Bypass ; Cognition Disorders ; prevention & control ; Coronary Artery Bypass ; Humans ; Neuropsychological Tests ; Oxygen Consumption ; Postoperative Complications ; Stellate Ganglion ; diagnostic imaging ; Ultrasonography

Humans ; Infant ; Neuroaxonal Dystrophies ; diagnosis