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 determine the feasibility of using a special auditory intervention to detect intraoperative awareness in children under general anesthesia. Methods Thirty-four ASA Ⅰ or Ⅱ children aged 5-15 yr weighing 16-73 kg undergoing scoliosis were enrolled in this study.Intraoperative wake-up test was performed during operation.Two easily identified animal noises(60 dB,lasting 15 s)were played through head phones before induction of anesthesia and immediately after the intraoperative wake-up test. Children were interviewed on the 1st and 5th-7th days after surgery to assess their awareness of intraoperative wake-up test and special auditory intervention. Results Four children were excluded from the study because of restlessness during the intraoperative wake-up test or their refusal to be interviewed. From the remaining 30 children,4 children were suspected to be aware of intraooperative wake-up test. Awareness was comfirmed in 3 children and suspected in one child.The incidence of awareness of intraoperative wake-up test was 10%.But only one of them could tell the animal sound played during the wake-up test.All the patients in this study had explicit recall of the animal noises played before induction of anesthesia.Conclusion Special auditory intervention can not detect intraoperative awareness in children unnder general anesthesia.

Objective To compare the BIS values in patients under anesthesia with minimum alveolar concentration (MAC) of sevoflurane and median effective concentration (EC50) of propofol at loss of consciousness.Methods Sixty ASA Ⅰ or Ⅱ patients,aged 18-60 yr,undergoing elective surgery under general anesthesia,were equally and randomly divided into 2 groups:inhalational anesthesia with sevoflurane group (group Sev) and intravenous anesthesia with propofol ( group Pro).The end-tidal concentration of sevoflurane was monitored using Aestiva anesthesia machine (Datex Ohmeda) in group Sev.Anesthesia was induced with intravenous injection of etomidate 0.3 mg/kg,rocuronium 1 mg/kg,and remifentanil 0.2 μg/kg.The patients were mechanically ventilated after tracheal intubafion.Sevoflurane inhalation was started 12.5 min after intubation in group Sev.Propofol was given by target-controlled infusion with the target plasma concentration set at 3.8 μg/ml 12.5 min after intubation in group Pro.When the effect-site concentrations of propofol reached EC50 of propofol at loss of consciousness (2.2 μg/ml),1.3 EC50(2.86 μg/ml) and 1.5 EC50 (3.3μg/ml) and when the end-tidal concentrations of sevoflurane reached 1.0,1.3 and 1.5 MAC,BIS value,MAP and HR were recorded.Results HR was significantly higher at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 in group Pro than in group Sev ( P ＜0.05).BIS value was significantly decreased at 1.3 MAC or 1.3 EC50,and at 1.5 MAC or 1.5 EC50 compared with that at 1.0 MAC or EC50(P ＜0.05).There was no significant difference in MAP and BIS value at each time point between the two groups ( P ＞ 0.05).Conclusion No significant change in BIS values is found in patients under anesthesia with 1.0,1.3 and 1.5 MAC of sevoflurane and with 1.0,1.3 and 1.5 EC50 of propofol.

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 To investigate the effects of propofol and inhalation anesthetics on the implicit memory under general anesthesia and determine the critical value of auditory evoked potential index (AEI) at which implicit memory no longer exists. Methods Sixty ASA I-II patients of both sexes scheduled for elective abdominal surgery or surgery on lower limb were enrolled in the study. They averaged (41.25?9.25) years and (63.8?9.57) kg. Patients with psychoneural or memory disorders were excluded. The patients were randomly divided into five groups of 12 patients in each group: isoflurane, sevoflurane, desflurane, propofol and control group. Each inhalation anesthetic group was further divided into two subgroups based on their end-tidal concentration: 0.8 or 1 .0 MAC. Propofol group was divided into two groups based on the infusion rate: 8 mg.kg. h-1 or 10mg.kg.h-1 . In control group operation was performed under epidural anesthesia. The patients were unpremedicated. Anesthesia was induced with propofot 1 .5-2.0 mg.kg and vecuronium 0. 　-0.2mg.kg-1, and maintained with inhalation anesthetic or propofol infusion supplemented with intermittent boluses of fentanyl and vecuronium. AEI was continuously monitored and recorded before anesthesia (T0), when the patient was sleepy (T1 ) and did not respond to verbal command (T2 ), after intubation (T3), after skin incision (T4), when peritoneum was being closed (or 30 min before the surgery) ( T5 ) and during emergence from anesthesia ( T6 ) . Eight hours after surgery muddy identified hearing rate was determined. Hemodynamic parameters were continuously monitored during operation. Results There was significant difference in AEI between the two subgroups before and after induction (P

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 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.

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 movement function of the left ventricular short-axis with parameters (velocity, acceleration and relatively force) measured with improved anatomical M-mode ultrasound. Methods Sixteen patients with myocardial ischemia coronary heart disease who had taken percutaneous transluminal coronary intervention (PCI) were enrolled. All patients were divided into two groups: group A, single major vascular stenosis (n=8);group B, more major vascular stenosis (n=8). M-mode curves of short-axis sections at mitral valve level, papillary level and apical level were recorded, then the peak myocardial velocities, acceleration and force of the systolic phase, early-diastole phase and end-diastole phase were measured at the post processing station. Results The variety ranges of average velocity and acceleration of the three levels during systolic phase were higher than that during diastole phase. The changing rate of velocity and acceleration in group B was higher than that in group A. Conclusion The new parameters that are measured and calculated with anatomical M-mode ultrasound can reflect the movement functions of coronary heart disease patients taken PCI.

Objective To investigate the effects of suramin application in acute angle closure glaucoma surgery patients.Methods A prospective study method was used.From February 2012 to January 2016,178 acute angle closure glaucoma surgeries in our hospital for treatment were selected,and were equally divided into observation and control groups (89 cases in each group) according to the order of admission,and two groups were given filtration surgery.The observation group was treated with suramin adjuvant therapy after surgery.The duration were 1 ～ 14 d after operation.The prognosis of two groups was observed.Results All patients were successfully completed surgery.The intraoperative and postoperative complications were no seriously occurred;the postoperative intraocular pressure in the observation group and the control group were (11.52 ± 3.24) mmHg and (16.98 ± 5.33) mmHg that compared preoperative [(31.98 ± 5.22) mmHg,(31.87 ± 5.11) mmHg] with significantly different (P ＜ 0.05),while the observation group was significantly lower than that of the control group (P ＜ 0.05).The postoperative peak systolic velocity (PSV) and end diastolic velocity (EDV) values of the central retinal artery of the observation group and the control group were significantly higher than that of preoperation (P ＜ 0.05),and the postoperative PSV and EDV values of the central retinal artery of the observation group were significantly higher than that in the control group (P ＜ 0.05).The postoperative ratios of functional filtering bleb in the observation group and control group were 80.9％ and 60.7％,respectively.The observation group was significantly higher than that of the control group (P ＜ 0.05).Conclusions The application of suramin in acute close angle glaucoma filtration surgery can promote the function of filtering bleb and intraocular pressure reduction,and improve the ocular blood flow speed that has good application effects.