Objective: To study amnesia and EEG changes caused by midazolam during epidural and spinal anesthesia. Method: Forty cases with epiduraI anesthesia were divided randomly into 4 groups in double-blind method. 0.15mg/kg and 0.10mg/kg midazolam,0.20mg/kg diazepam and 2ml normal saline were administered respectively and intramuscularly 30 min before anesthesia. The changes of EEG before and after the administration,sedation degree,the amnesia rate and degree for the procedures of anesthesia and the psychological state after operation were observed synchronously. Result: The sedation degree was in accordance with amnesia effect after intramuscular midazolam. The amnesia rate caused by 0.10mg/kg midazolam was 70%,but 90% of them was part amnesia. 0.15mg/kg midazolam produced 100% total amnesia. In midazolam groups,the ? and ? relative powers were increased,but the 6 and ? relative powers were decreased greatly. There were no obvious changes on the Pa and Nb waves in four groups. Conclusion: Intramuscular midazolam can completely prevent the patient from recalling for the process of anesthesia in dose-dependent way. The effective site of anterograde amnesia of midazolam is not located at cortical hut at the hippocampus and thalamus. This kind of amnesia belong to axis amnesia

Objective Evaluate the influence of medical monochrome liquid crystal display (LCD) with different resolutions on the detection of pulmonary nodules.Methods Ninety-three direct digital radiography (DR) chest images were selected on-line from picture archiving and communication system (PACS),including 38 positive,32 suspected and 23 normal cases.All of the images were confirmed by CT.These positive images were divided into group A and B according to the diameter of nodules.Three experienced radiologists blindly read the 93 images using three types of displays with different resolutions.Regarding the presence of nodule,five-point confidence system was used:definitely absent,probably absent,indefinite,probably present and definitely present.All observers marked their confidence levels of each image according to the presence of pulmonary nodule on different displays.Software SPSS 13.0 was employed for statistical analysis.Results In the group-A cases,the areas under ROC curves were 0.643,0.686 and 0.739,and in the group-B cases,those were 0.813,0.832 and 0.846 respectively.There was no difference in the detection efficacy among different radiodiagnostic systems.Conclusion Regardless of post-processing tools,it was equivalent to detect pulmonary nodules with different diameters of Group A or B among medical monochrome LCDs with different resolutions.

Objective To study the effect of labeling esophageal carcinoma with sliver clips on two sides by esophagoscopy in mapping the target for conformal radiotherapy (CRT). Methods Eighty patients with esophageal carcinoma (28 patients in early stage, 52 patients in late stage), who were eligible for CRT, were collected and the tumor volume was detected by three methods: CT (A),CT combined with X-ray (B) and CT combined with sliver clip labeling by esophagoscopy (C). The differences of the tumor length and position in head-foot site (Y-axsis) among three methods were compared. Results The comparison of average length of tumor in early stage patients showed significant difference among three methods in all types of tumor (F= 4.07 ～ 7.43, P＜0.05 ) except papillary type (F= 1. 71, P＞0. 05). There was difference (ranged from 0. 5 cm to 2. 0 cm) in detection of position in head-foot site between A and B methods and C method. Significant difference was found in determining the displacement on head-foot site among three methods (F = 34. 36 ～193.50,P ＜0.01). The comparison of average length of tumor in middle or terminal stage patients showed significant difference among three methods in all types of tumor (F=4. 07～30.10 ,P＜0.05) except mushroom type (F = 2.44, P＞ 0. 05). Significant difference was found in determining the displacement on head-foot site among three methods (F= 12.00 ～ 21.16, P ＜ 0. 01 ). Conclusion These findings indicate that C method is more sensitive and correct in mapping the target for CRT in comparison with other two methods.

Larvae of Schistosoma japonicum could be blocked in Oncomelania hupensis with pre-infection by larval Exorchis trematodes (Tang et al., 2008, 2009). The present manuscript reports the result of comparison between the two different developments of larval S.japonicum in O.hupensis snails with and without pre-infection by larval Exorchis trematodes. Of 300 (invader rate 26.74%) abnormal larvae of S.japonicum for 4-82 days old were found from 28 (73.7%) O.hupensis snails which were pre-infected with Exorchis eggs, their body structure were unusual and developed astray at early mother sporocyst stage. From 25 (69.4%) O.hupensis snails without pre- infection by larval Exorchis, 67 (invader rate 13.96%) normal mother sporocysts of S.japonicum for 5-61 days old in different development stages and many early or middle stage daughter sporocysts were found, in the 75th day after infection many mature daughter sporocysts and cercariae of S.japonicum were found. Different increase of lymphocyte in body tissues of snails were found from the two experimental O.hupensis snail groups.

Objective To investigate the capillary blood volume (BV) changes in acute ischemic denervated hindlimb of rabbits and the value of 256-slice detector computed tomography (CT) perfusion imaging in evaluation.Methods A total of 40 healthy, adult white rabbits underwent either right hindlimb femoral artery excision combined femoral nerve denervation (combined modeling group, n = 10), simple femoral artery excision (iachemia group, n = 10), simple femoral nerve denervation (denervation group,n = 10), or simple femoral artery separation (sham-surgery group, n = 10).At 1,7, 14, 21, and 28 days following surgery, CT perfusion scanning (Philips Brilliance 256-row) was performed and CT perfusion images were processed using maximum-slope method with Function CT software on EBW workstation.The ratio of BV (rBV) in muscle tissue between right and left hindlimbs was calculated in each group.At 14 and 28 days, following sacrifice, rabbit bilateral adductor was harvested for immunohistochemical staining.The ratio of microvessei density (rMVD) in muscle tissue between right and left hindlimbs was calculated.The significance of the difference of rBV at each time point was assessed using analysis of variance of factorial design (2 ×2).Pearson correlation analysis was used to study the relationship between rBV and rMVD.Results After surgery, the 1st day rBV of combined modeling group, combined modeling group,denervation group and sham-surgery group is 0.31 ± 0.15 ( n = 6), 0.29 ± 0.12 (n = 6), 0.98 ± 0.08 ( n =6), 0.98 ± 0.07 ( n = 6) respectively.The 7th day following surgery rBV is 1.69 ± 0.45 ( n = 5 ), 1.63 ±0.43(n=6), 0.99 ±0.07(n =6), 1.00 ±0.08(n =6).The 14th day is respectively 1.58 ±0.18(n=5), 1.49 ±0.25(n =6), 0.94 ±0.08(n =6), 1.01 ±0.05(n =6).The 21th day is 1.42 ±0.41 (n=4),1.43 ±0.31(n=4), 0.94 ±0.05(n =5), 1.02 ±0.05(n =5),and the 28th day is 1.00 ±0.25(n=4),0.99 ±0.08(n=4), 0.92 ±0.09(n =5), 1.02 ±0.13(n=5).At each time point with exception of postoperative 28 days(F(A) =0.214,P>0.05), ischemia produced main effects on rBV(F(A) =274.268,30.044,65.787,18.886 ,P < 0.01 ), while simple denervation did not show main effects on each time point.Ischemia and denervation did not yield interaction effects on each time point, rMVD from each group supported above-mentioned changes.The correlation coefficient of rBV to rMVD was r = 0.862 ( P < 0.01 ).Conclusions BV in acute ischemic denervated hindlimb of rabbits shows a dynamic change, and denervation does not obviously influence this process.256-slice detector CT perfusion imaging can be used to noninvasively and semi-quantitatively evaluate the dynamic changes of capillary bed in acute ischemie denervated hindlimb of rabbits.

OBJECTIVETo explore the clinical effects of Dynesys system for the treatment of multiple segment lumbar degenerative disease.

METHODSA total of 28 patients with lumbar degenerative disc disease treated with Dynesys system from December 2008 to May 2011 were retrospectively reviewed. There were 16 males and 12 females, aged from 27 to 75 years old with an average of 49.1 years. Thirteen patients with multiple segmental lumbar intervertebral disc protrusion, including L3-L5 in 7 cases, L2-L4 in 1 case and L4-S1 in 5 cases. Fifteen patients with multiple segmental lumbar spinal stenosis, including L3-L5 in 10 cases, L4-L5 in 4 cases and L2-S1 in 1 case. The symptoms of lumbago and (or) intermittent claudication in all patients were treated with conservative treatments for more than 6 months and these methods did not work. Visual analogue scale (VAS) was used to analyze the lumbar and leg pain, imaging data were used to measure the intervertebral space height and intervertebral motion of fixed segment and upper adjacent segment, Oswestry Disability Index (ODI) was used to evaluate the clinical effect.

RESULTSAll operations were successful and the patients were followed up from 38 to 65 months with an average 50.6 months. At final follow-up, ODI and VAS of the low back pain and leg pain were (25.10±6.52)%, (1.25±0.70) points and (1.29±0.89) points, respectively and were decreased compared with preoperative (P<0.05). Postoperative intervertebral space heights were increased and intervertebral motions were decreased in fixed segment compared with preoperative (P<0.05). There were no significant differences in intervertebral space heights and intervertebral motions of upper adjacent segment between preoperative and postoperative (P>0.05).

CONCLUSIONDynesys system may obtain long-term clinical curative effect in treating multiple lumbar degenerative disease. It can partially preserve the intervertebral motions of the fixed segments, have little effect on adjacent segments. The long-term clinical effect of Dynesys still need longer time follow-up observation.

Adult ; Aged ; Female ; Follow-Up Studies ; Humans ; Intervertebral Disc Degeneration ; pathology ; surgery ; Joint Instability ; Lumbar Vertebrae ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Visual Analog Scale

OBJECTIVETo evaluate the clinical effects of dynamic neutralization system (K-Rod) in treating multisegmental lumbar degenerative disease.

METHODSFrom October 2011 to October 2013, 20 patients with multisegmental lumbar degenerative disease were treated with dynamic neutralization system (K-Rod). There were 8 males and 12 females with an average age of 45.4 years old (ranged from 31 to 65) and an average course of 3.8 years (ranged from 9 months to 6.25 years). All patients had the history of low back and legs pain. Among them, 10 cases were far lateral lumbar disc herniation, 7 cases were lumbar spinal stenosis, 3 cases were lumbar spondylolisthesis (degree I in 2 cases and degree II in 1 case). Every patient had only one responsible segment which causing the symptom would have to be rigidly fixed during operations, and the adjacent intervertebral disc of the responsible segments at least 1 segment has already obvious degenerated. All patients underwent the operation to relieve compressed nerves and reconstruct spinal stability with K-Rod system (the responsible segments were fixed with interbody fusion, and the adjacent segments were fixed with dynamic stabilization). Visual analogue scale (VAS), Japanese Orthopaedic Association Scores (JOA) and Oswestry Disability Index (ODI) were used to evaluate the clinical effects. Imaging data were used to analyze the range of motion (ROM), intervertebral disc height and intervertebral disc signal (according to modified Pfirrmann grading system) in degenerative adjacent segment.

RESULTSAll patients were followed up for more than 1 year, and preoperative symptoms obviously relieved. There were significant differences in VAS, JOA, ODI between preoperative and postoperative (postoperative at 1 week and 1 year) (P<0.05). Radiological examination showed that all responsible segments had already fused, and no looseness, displacement and breakage of internal fixations were found. Postoperative at 1 year, the ROM of adjacent segments were decreased (P<0.05). There was no significant difference in intervertebral disc height between preoperative and postoperative at 1 year (P>0.05). According to modified Pfirrmann grading system to classification for the 25 disks of adjacent segment, 8 disks (32%) got improvement, 15 disks (60%) got no change and 2 disks (8%) got aggravation at 1 year after operation.

CONCLUSIONDynamic neutralization system (K-Rod) combined with interbody fusion could obtain short-term clinical effects in the treatment of multisegmental lumbar degenerative disease.

Adult ; Aged ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Lumbar Vertebrae ; surgery ; Male ; Middle Aged ; Range of Motion, Articular ; Spinal Diseases ; surgery ; Spinal Fusion ; methods ; Spinal Stenosis ; surgery ; Spondylolisthesis ; surgery

Objective To investigate the operative technique and outcome of the expanded flap to repair the full thickness defects of nose and upper lip simultaneously.Methods Three kinds of ex panded flaps were chosen to reconstruct the full thickness defects of nose and upper lip.They were designed according to the location and the size of the defects,and also the circumstances of the donor site.Treatment effectiveness were observed by long-term follow-up.Results 7 patients were treated with the expanded flap.All cases received satisfactory results with no complications such as flap necrosis.And for male patients,the frontal expanded flap could reconstruct upper lip and beard simultaneously that reached better shape.Conclusions It is an ideal approach of repairing nasal-lip defects by the tissue expanded flap.

Objective We examined the in vivo effect of the antisense or/and decoy oligonucleotide of nuclear factor-?appa B (NF-?B) on balloon-injured smooth muscle cell proliferation and MMP-9 in the carotid artery of rats. Methods Sprague-Dawley rats underwent balloon-dilation injury of the left carotid artery. Rats were divided into 7 groups(n=18) and each group included 6 time points (6 h and 1,3,5,7,14 d)(n=3). Results The mean intima/media ratio increased significantly in sense group、scramble group and model group and reached the maximum at 7 d after rat injured carotid artery, compared with normal group, antisense group, decoy group and decoy plus antisense group(P

0.05).However,there was no significant difference in the AMPAR-mediated basal synaptic transmission on hippocampal CA1 between those at the later period(6 weeks) of epilepsy induced by pilocarpine and controls,while LTP was inhibited(P