Objective: The relationship between intracranial pressure (ICP) and visual evoked potential (VEP) or brainstem auditory evoked potential(BAEP)was investigated. Method:An acute intracranial hypertension animal model was established in ten anesthetized rabbits. The changes of VEP and BAEP were observed by an AXON Systems Sentinel-4 Neurologid monitor at different levels of ICP,which were monitored with a fiberoptic transducer being inserted into the epidural space through a burrhole. Result:Both latencies of waves P_1 and N_2 of VEP was positively correlated with the ICP(r=0.62,r=0.60,P

Objective To summarize imaging features of Kallmann syndrome (KS) in children and to improve diagnostic level of the disease.Methods The imaging manifestations of 13 patients with clinically proved KS were retrospectively studied.MRI of rhinencephalon and left wrist X-ray examinations were performed in all the 13 children.Ultrasound of abdomen and pelvis was implemented in the 8 of 13 patients.Results All the patients had abnormalities of olfactory system.Bilateral olfactory bulbs and tracts were absent in 9 patients.Unilateral olfactory bulbs and tracts were absent in 4 patients,in which contralateral olfactory bulbs and tracts were hypoplastic.These patients presented 2 aplastic,17 hypoplastic and 7 normal olfactory sulci.Anterior pituitary was hypoplastic in 3 patients.Bone age showed retardation in 6 of 13 patients.Bilateral testicles were small in all the 8 cases by ultrasound.Conclusions Aplastic or hypoplastic olfactory bulbs and tracts and sulci are seen in children with KS.Anterior pituitary dysplasia is present in part of patients and bone age backward happens in approximate half of the children.

Objective To evaluate the correlation between Narcotrend index (NI) and the depth of anesthesia during inhalation anesthesia with sevoflurane and compare NI with BIS values in patients.Methods Sixtytwo ASA physical status Ⅰ or Ⅱ patients,aged 25-60 yr,weighing 44-100kg,scheduled for elective surgeries under general anesthesia,were enrolled in the study.Sevoflurane inhalation was started at 5 min after endotracheal intubation.When the end-tidal concentration of sevoflurane (ETsevo) reached 0.6％,0.9％,1.3％,1.6％,2.1％,2.4％,2.9％,3.2％,3.8％ and 4.2％,NI and BIS values were recorded simultaneously.Results The correlation coefficients between ETsevo and NI and BIS values were-0.627 (r1) and-0.669 (r2) respectively when ETsevo ＜ 2.9％,and-0.608 (r3) and-0.230 (r4) respectively when 2.9％ ≤ ETsevo ≤4.2％ (P ＜ 0.01).Comparison of the absolute value of correlation coefficients:no significant difference was found between r1,r2 and r3 (P ＞ 0.05) ; r1,r2 and r3 were significantly greater than r4 (P ＜ 0.01).Conclusion When ETsevo 4.2％,NI values can accurately reflect the depth of anesthesia; when 2.9％ ≤ ETsevo ≤4.2％,the accuracy of NI values in monitoring the depth of anesthesia is superior to that of BIS values.

Objective To evaluate the clinical application value of multislice spiral CT (MSCT) in diagnosis andclinical treatment of the chronic suppurative otitis media(CSOM). Methods Multislice spiral CT with direct axial plane and saggitalmultiplanar reformation(MPR) were performed in 61 cases including 76 ears.The results from those images were comparedwith that of operations. Results The sagittal MPR images preferably could delineate the anatomical details of the temporal bone and theadjacent relationship,and could display the tympanicand mastoid segment of the facial nerve,sigmoid sinus plate and the glomusjugular better.On the sagittal MPR images,the disruption of the ossicular chain and bony erosion in the tympanic cavity and antrum weredisplayed in 38 ears.The destruction of the facial nerve canal was severe in the type of cholesteatoma compared with the type of granuloma of chronic suppurative otitis media.The congenital abnormities were showed in 8 ears of the sigmoid sinus plate and 2 ears of the glomus jugular.Conclusion CT sagittal MPR images are of significant clinical value in showing the degree and location of destruction of the canal of facial nerve , and the relation between around structures in chronic suppurative otitis media.

To detect the expression of p16 protein and Ki-67 antigen in gastric mucosa-associated lymphoid tissue lymphoma(MALTL)and normal gastric mucosa and to investigate the clinical significance of their expression in the occurrence and development of gastric MALTL.Methods 47 samples of gastric MALTL diagnosed pathologically in the department of pathology of the PLA General Hospital from March 1993 to June 2005 were collected.By using immunohistochemial methods,the expression of p16 protein and Ki-67 antigen was detected in 20 samples of normal gastric tissue and the 47 samples of gastric MALTL.Results The positive rate of p16 protein Was 21.3%(10/47)and 90.0% in gastric MALTL and normal gastric tissue respectively.The positive rate of p16 protein in gastric MALTL was lower than that in normal gastric tissue(P<0.05).The expression of p16 was related to the degree of lymph node metastasis.The positive rate of Ki-67 labelling index(LI)in gnstric MALTL was hiigher than that in normal gastric tissue.A negative correlation was found between the expression of p16 protein and Ki-67 LI(P<0.05). Conclusions Detection p16 and Ki-67 may help to predict the possibility of lymph node metastasis and prognosis in gastric MALTL.

Objective To investigate the effects of propofol and sevoflurane on oxidative stess response induced by short period pure oxygen inhalation during general anesthesia.Methods Sixty ASA Ⅰ or Ⅱ patients aged 20-60 yr weighing 50-85 kg undergoing elective abdominal surgery under general anesthesia were randomly divided into 2 groups (n=30 each):group propofol (group P) and group sevoflurane (group S).Each group was further divided into 2 subgroups inhaling 40% O2 (P0.4,S0.4) and 100%O2(P1.0,S1.0) respectively during operation.Anesthesia was induced with propofol 1-2 mg/kg,midazolan 0.02 mg/kg and sufentanil 0.1-0.2 mg/kg.Tracheal intobation was facilitated with rocuronium 0.6-0.8 mg/kg.The patients were mechanically ventilated(VT 8 ml/kg,RR 12 bpm).PET CO2 was maintained at 35-40 mmHg.Anesthesia was maintained with in both groups.BIS was maintained at 40-60.Arterial blood samples were collected immediately before induction of anesthesia (baseline),at 2,4,6h after tracheal intubation(T1-3) and 24h after operation(T4) for determination of PaO2,serum 8-iso-PGF2α and MDA concentrations and SOD activity.PaO2/FiO2 was calculated.Results In subgroup S1.0 the serum 8-iso-PGF2α and MDA concentrations were significantly increased while serum SOD activity was significanfly decreased at T1-3 as compared with the baseline.Serum 8-iso-PGF2α and MDA concentrations were significantly higher while serum SOD activity and PaO2/FiO2 were significantly lower at T1-3 in subgroup S1.0 than in stress response induced by≤6h pure O2 inhalation but inhalation of 1.5%-3.0% sevoflurane can not.

Objective To evaluate the blood-saving effect of combination of hemocoagulase artox for injection and tranexamic acid (TXA) in patients undergoing off-pump coronary artery bypass grafting (OPCABG).Methods Eighty ASA Ⅱ patients (NYHA Ⅰ or Ⅱ),aged 50-70 yr,weighing 50-100 kg,scheduled for elective OPCABG,were randomly divided into 4 groups (n =20 each):control group (group C),hemocoagulase atrox for injection group (group H,n =20),TXA group (group T) and hemocoagulase atrox for injection + ·TXA group (group HT).Hemocoagulase atrox 0.04 U/kg (the highest dose 4 U) was injected at 20 min before skin incision,and additional hemocoagulase atrox 2 U was given every 2 h starting from 15 min after administration of protamine until the end of operation in group H.TXA 20 mg/kg was injected intravenously at skin incision,followed by a continuous infusion of TXA at 10 mg· kg-1 · h-1 until the end of operation in group T.Hemocoagulase atrox and TXA were given as the method described in groups H and T.Venous blood samples were taken from the central vein before operation,at the end of operation,and 24 h after operation to determine the plasma D-Dimer concentration.The amount of blood loss,allogeneic red blood cells and plasma infused during operation,volume of drainage during 0-6 and 6-24 h after operation,total volume of drainage and volume of allogeneic blood transfused during operation were recorded.The deep vein thrombosis was recorded.Results Compared with group C,the amount of blood loss during operation was significantly decreased in groups T and HT,and the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in groups H,T and HT (P ＜ 0.05).Compared with groups H and T,the allogeneic red blood cells and plasma infused during operation,and volume of drainage during 0-6 and 6-24 h after operation,and total volume of drainage were significantly decreased in group HT (P ＜ 0.05).No deep vein thrombosis was observed in the 4 groups.Conclusion The combination of hemocoagulase artox for injection and TXA provides better blood-saving effect than either alone for the patients undergoing OPCABG without increasing the risk for thrombosis.

ObjectiveTo investigate the effects of ederavone on oxidative stress response during one-lung ventilation (OLV).MetihodsThirty ASAⅠ or Ⅱ patients of both sexes aged40-64 yr,weighing50-85 kg undergoing elective esophageal cancer resection were randomly divided into 2 groups ( n =15 each):control group (group C) and edaravone group (group E).In group E edavavone was infused immediately after tracheal intubation at 60.0 mg/h for 30 min.Then the infusion rate was reduced to7.5 mg/h and maintained until the end of operation.In group C equal volume of normal saline was infused instead of edaravone.Arterial and venous blood samplea were taken immediately before skin incision,at 30 min of OLV and 30 min after re-expansion of the collapsed lung for blood gas analysis and determination of serum MDA and 8-iso-PGF2a concentrations.PaO2/FiO2,PA-aDO2 and respiratory index (RI) (RI =PA-aDO2/PaO2 ) were calculated.ResultsPA-a DO2,RI and serum concentrations of MDA and 8-iso-PGF2a were significantly lower at 30 min after re-expansion of the collapsed lung in group E than in group C( P ＜ 0.05).ConclusionEdaravone can attenuate oxidative stress response during OLV.

Objective To investigate the effect of isoflurane anesthesia on the expression of amyloid β protein (Aβ) in hippocampus in aged rats.Methods Sixty-one healthy male SD rats,aged 18-19 months,weighing 400-500 g,were randomly divided into 3 groups:isoflurane group (group Ⅰ,n =31),control group (groupⅡ,n =20),and blank group (group Ⅲ,n =10).Group Ⅰ inhaled 1.4％ isoflurane for 2 h,and cognitive function was assessed at 5 d before and 2 d after anesthesia by Morris water maze.Group Ⅱ received Morris water maze text only.Group Ⅲ received no treatment.Group Ⅰ was divided into 2 subgroups according to whether the cognitive impairment occurred:cognitive impairment group (P subgroup) and no cognitive impairment group (NP subgroup).The animals were sacrificed immediately after the test.The hippocampus was isolated for determination of the levels of Aβ40 and Aβ42,β-secretase (BACE),insulin degrading enzyme (IDE)and neprilysin (NEP).Results There was no significant difference in the results of Morris water maze test before anesthesia among the 3 groups.There was no significant difference in the swimming velocity between group Ⅰ and group Ⅱ.The time of staying at the original platform quadrant was significantly shorter in P subgroup than in NP subgroup and Ⅱ group,and there was no significant difference in the time of staying at the original platform quadrant between NP subgroup and Ⅱ group.There was no significant difference in the levels of Aβ40 and Aβ42,BACE,NEP and IDE among the 5 groups,and between P subgroup and NP subgroup.Conclusion Isoflurane anesthesia has no effect on the expression of Aβ in the hippocampus,indicating that isoflurane-induced cognitive impairment is not related to Aβ pathway in aged rats.

Objective To determine the effects of dose reduction on multi-slice spiral CT(MSCT) of neonatal head and assess the lowest possible radiation for acceptable clinical images.Methods Fifty-seven newborns suspected intracranial hemorrhage were entered into the study and underwent MSCT scans.Original images at three anatomic levels (posterior fossa, basal ganglia, centrum semiovale) were collected and synthetic noise was added so as to simulate dose reductions of 25%, 40%, 50% and 70%, respectively by using the noise addition tool.A total of 855 image data sets were obtained for the 57 patients.Original and simulated dose-reduction scan images were analyzed.Image noise and image quality were assessed by two independent experienced pediatric radiologists using diagnostic acceptability score, subjective image noise score on a 5-peint scale and objective noise index.Image noise was measured by respectively placing region of interest (ROI) at cerebellum, thalamus and corona radiata of 3 different slices.And the noise index and mean value was calculated.The degree of inter-observer concordance was determined by Kappa statistical analysis.The Spearman statistical correlations between the noise index and diagnostic acceptability score were performed.Results On the images of original dose and simulated dose reductions of 25%, 40%, 50% and 70%, the diagnostic acceptability was 4.47±0.51, 3.96±0.33, 3.21±0.45, 2.92±0.32, and 1.85±0.57, respectively,the subjective image scores were 1.62±0.48, 1.99±0.48, 2.76±0.81, 3.19±0.67, and 4.27±0.54, respectively, the noise index were 1.90±0.19, 2.17±0.20.2.44± 0.25, 2.68±0.28, and 3.37±0.39, respectively.The two radiologists had good intembserver agreement for diagnostic acceptability (K=0.860, P=0.017) and for image noise scoff ng (K=0.630, P=0.022).There was significant statistical correlation between image noise index and diagnostic acceptability (r= 0.826,P=0.001).At 40% dose reduction to the standard protocol, the noise index was 2.44 and the image quality score was 3.21 which were considered clinically acceptable.Conclusion The study revealed that acceptable imagos could be obtained with mean noise index of 2.44 and 40% dose reduction.