Objective To evaluate the non-invasive cardiac output measurements by electric impedance in critically illpatients. Methods Cardiac output measurements by impedance and Doppler ultrasonography were performed in 38 pa-tients in ICU. Results There was a significant correlation (r =0. 908 ) between impedance and ultrasonography for car-dio output measurement. Conclusion There is close agreement between electric impedance and ultrasonography in themeasurement of cardiac output in the patients. The electric impedance measurement is a noninvasive,feasible, handy, con-tinuous and cheap measurement of cardiac output.

Objective To investigate the difference of the protein expression in serum of rats with acute edematous pancreatitis (AEP) and acute necrotizing pancreatitis (ANP),and to investigate serum marker for acute pancreatitis severity.Methods The model of AEP and ANP was induced by retrograde injection of 4％ or 5％ sodium taurocholate into the biliopancreatic duct.Weak cation exchange (WCX2) and surface enhanced laser desorption/ionization time of flight mass spectrometry ( SELDI TOF MS) was used to investigate the difference of the protein expression in serum of rats with AEP and ANP.Results Thirty-eight spectral peak clusters which had significantly different signal intensities between AEP and ANP sera at mass charge ratio between 1000-50 000(P ＜0.05) were detected.The peak clusters at 9500 and 9700 in the sera of AEP were higher than that in ANP rata.Conclusions Serum analysis with SELDI-TOF MS can detect the difference of the protein expression in rats with AEP and ANP.The decreased expression of the protein of molecular weight of 9500 and 9700 may be a signal of AEP transition into ANP.

Objective To observe the brain regions activated during calculation in patients with left temporal lobe epilepsy (TLE) and in normal subjects.Methods Functional magnetic resonance imaging (fMRI) was applied.Sixteen right-handed persons with left TLE were selected as the left TLE group,and sixteen healthy volunteers were recruited as a control group.The fMRI data was collected as each subject performed simple additions,subtractions and abdication subtractions.Statistical parametric mapping was used to compare the activated brain regions between the two groups.Results The error rate in the calculations was significantly higher in the left TLE group,and their average reaction time was significantly longer.There were aslo significant differences between the two groups in terms of brain activation patterns.Compared with the control group,the left TLE group exhibited hypo-activity in regions such as the left paracentral lobule,the posterior central gyrus,the bilateral inferior parietal lobule,the left angular gyrus,the bilateral supramarginal gyrus,the left middle frontal gyrus,the left superior gyrus,and also in the bilateral posterior cingulate,insular lobule,superior and inferior temporal gyrus,right hippocampus,parahippocampal gyrus,thalamus and cerebellum.The TLE subjects exhibited hyper-activity in the bilateral superior parietal lobule,the bilateral anterior cingulate,as well as in the right,middle and inferior frontal gyrus.Conclusion Our results support a significant functional reorganization of calculation-related neuronal networks within and between the hemispheres in TLE patients.The frontal and parietal lobes may play a compensatory role in the reorganization of the calculation function.Task-related fMRI technology can provide useful information for non-invasive assessment of mathematical computing and cognitive function in TLE patients.

Objective To explore the consistency and significance of optical coherence tomography (OCT) and clinical and histopathological findings in adoptively transferred uveitis in mice.Methods The adoptively transferred experimental autoimmune uveitis (EAU) model was established by intraperitoneal injection of antigen-specific T cells in C57BL/6 mice.Since 9 days after transferred,inflammation of eyes was observed by indirect ophthalmoscope with +90D lens and record clinical scores every 3 days.The disease was divided into 6 phases including onset phase,early phase,pre-peak phase,peak phase,resolution phase and late phase of EAU,which respectively corresponding to clinical score 0.5,1.0,1.5-2.0,2.5-3.0,1.0-2.0 and less than 1.0.Since 9 days after transferred,the retina and retinal thickness (RT) was measured by spectralis OCT about 1 disc from the disc edge in 10 time points including 9,11,16,21,25,30,35,40,50 and 60 days after transferred.The OCT score was recorded as from 0.0 to 4.0.After transferred 9,21 and 60 days,the mice were killed and eye balls were examined in histology.OCT score,clinical score and histology in the mouse were compared and analyzed.Results The disease was divided into onset phase,early phase,pre-peak phase and peak phase of EAU,which respectively corresponding to 9,16,21 and 26 days after transferred.In four phases,OCT score were 0.5,1.0,2.0 and 4.0 respectively.After transferred 30 days,which was in resolution phase of EAU,the inflammation cells in vitreous were decreased and OCT score was 3.0.After transferred 60 days,which was in late phase of EAU,inflammation cells in vitreous were disappeared and retina was atrophic topically.The histology showed the vitreous has slight inflammation cells and retinal structure was normal at onset of EAU.The vitreous has massive inflammation cells and retina structure was disorder at pre-peak of EAU.And in resolution phase of EAU,the inflammation cells in vitreous were slightly and retina was atrophic and thinned.The data in this study demonstrated that OCT score was well correlated with clinical score in EAU (r=0.957 9,P＜0.000 1).Conclusion OCT and clinical and histopathological findings in adoptively transferred uveitis in mice were consistency and OCT is contribute to evaluate the disease dynamically and quantifiably.

ObjectiveTo introduce the application of slender narrow subcutaneous fascia pedicle flap in repairing the cavity of conchs wound in microtia plasty,and to investigate its survival mechanism.MethodsThe all 6 congenital microtia cases were repaired with the concha compound flap up rotation.The all microtia concha wounds were repaired with the slender narrow pedicle.The lateral maxillocevicai fasciotaneous flap with its slender subcutaneous fascia pedlcle located in front of auricle.The size of the flaps ranged from 3.0 cm × 3.0 cm to 4.0 cm × 4.5 cm,The width and length of the pedicle ranged 1.0-1.5 cm and 3.5-4.5 cm.Results6 cases of the slender narrow subcutaneous fascia pedlcle flaps all survived,with primary wound healing and ideal appearance.ConclusionsThis slender narrow subcutaneous fascia pedlcle flap does not contain any major blood vessel,which is dissected easily in the operation.Due to its slender narrow pedicle,the flap rotation is also easy and its coverage area is large,without cat ears.The postoperative appearance (color,lexture,cosmetic aspect)is satisfactory.The slender narrow flap is an extraordinary new design and is ideal for the cavity of concha wound repair in the microtia plasty.

Objective To systematically evaluate the study of animal surgery course among medical students with different majors and languages so as to provide evidences for further improve-ment education quality. Methods Ten majors and two kinds of international medical students (in total of 1 105 students;2009 grade)of Southern Medical University were subdivided into five groups ac-cording to the relationship with clinical operative manipulation. Quality of experimental animal surgery education was tested respectively. Then SPSS 13.0 was used to statistically evaluate and analyze the data. Measurement data between two groups were compared by t-test,multi-group analysis of variance between groups was conducted using one-way ANOVA. Ranked data between groups were compared using non-parametric Mann-Whitney U rank sum test. Merits and demerits of the curriculum were dis-cussed by combing statistical results with in-class condition to provide evidences for further improve-ment. Results There was no significant difference between clinical group and clinical professional group in aseptic technique and operation skills (P=0.739),but scores of the two groups were signifi-cant higher than that of associate group (P=0.004). Moreover,scores of international students who passed Chinese TOEFL were significant higher than the others (P=0.001). Differences between groups existed predominantly in the animal surgical practice rather than in basic theory or knot and sterilized methods. Conclusions For students with different majors and languages,different teaching key points should be paid attention to. Basic surgery techniques might be emphasized on for students with associ-ate clinical major and foreign students with poor Chinese language.

Objective To investigate the value of the new method with bilateral lip mueosa flaps for central defect reconstruction of upper-lip vermilion. Methods On both sides of the central defect of upper lip vermilion, reverse triangular flaps was designed below the junction between vermilion and mucosal. These two flaps had the common pedicle of vermilion depression site. Incisions of "(λ)" shape were de-signed below the defect area and the flaps included mucosa and submucous tissue. This mueosa flaps were raised and orbicularis otis muscles under the flaps were free moderately. Bilateral orbicularis oris muscles were sutured under the common pedicle of the two mucosa flaps. Then the bilateral mucosa flaps were ro-tated down 90° and inserted into the " (λ)" shape incisions to increase the tissue volume of the middle upper lip and deepen the labiogingival sulcus. The common pediele of the bilateral mucosa flaps was formed to the vermilion tubercle and then the incisions were sutured layer by layer. Results The technique was per-formed on 26 patients including 18 cases of upper-lip vermilion defect after repair of bilateral cleft lip,4 ca-ses of upper-lip vermilion defect after repair of unilateral cleft lip and 4 cases of congenital malformation. All the lip mucosa flaps survived completely without any complications. The vermilion, tubercle and shape of the lips were satisfactory after all cases were repaired and all incision scars were concealed. Con-clusions Using the lip mucosa flaps transfer to repair vermilion defect with the same tissue can obtain satisfactory appearance. The lip mucosa flaps are ideal for repairing of the lip vermilion defect and recove-ring of the profile of labial arch and vermilion tubercle. It can be used widely in any cases with the central defect of upper lip vermilion.

Objective To reveal the relationship between a certain ratio of the length to width of a slender narrow pedicle and random flap in survival area with an experimental study. Methods 25 pigs were randomly divided into 5 groups. The ratio of length to width of slender narrow pedicle in 5 groups was different and every ratio's slender narrow pedicle was carrying 5 different sizes of random flaps. In each group, these 5 flaps were created randomly in each pigs' bilateral back. The flaps were evaluated with the general observation, fluorescence examination, blood flow ECT test, and computerized analysis of survival area. Results When the ratio of the length to width of the slender narrow pedicle was constant, along with the flap area increased, the flap survival area also increased, but when the flap reached a certain area, the distal flap would develop necrosis, the flap survival area would not reduce; when the flap size remained unchanged, along with the ratio of the length to width of the slender narrow pedicle increased, the flap survival area was not affected, but, when the ratio of the length to width of the slender narrow pedicle increased to a certain limit, distal flap would lead to necrosis, and the flap survival area would reduce. Conclusion The slender narrow pedicle flap is a new and practical random flap. The pedicle of random flap can be designed as slender shape, and the ratio of pedicle width to flap length is far less than traditional ratio. Increasing the flap size or ratio of the length to width of a slender narrow pedicle in a certain extent will not lead to flap necrosis.

Objective To explore the feasibility for the tissue dispersion quantitative analysis software of ultrasonic strain elastography in diagnosing benign or malignant of thyroid lesions.Methods Eighty-two patients with 98 lesions were examined by ultrasonic strain elastography.There were 11 parameters of elastography imaging obtained by the tissue dispersion quantitative analysis software,including average relative strain value(MEAN),standard deviation of relative strain value(SD),area ratio of low-strain region (AREA％),complexity(COMP),kurtosis(KURT),skewness (SKEW),contrast (CONT),entropy(ENT),inverse different moment (IDM),angular second moment (ASM),correlation (CORR).The receiver operating characteristic (ROC) curve was constructed if there were statistically significant differences between benign and malignant lesions,and the areas under the ROC curve were got.Results All parameters except CORR had statistically significant between the groups of benign and malignant thyroid lesions (P ＜0.05).The AREA％ and IDM were the best valuable parameters,the areas under the curve(AUC) of which were 0.965 and 0.908,respectively.Their cut-off point were 81.96％ and 0.42,the sensitivity and specificitywere 98.4％ and 89.2％,91.8％ and 86.5％,respectively.Conclusions The tissue dispersion quantitative analysis software is helpful in the evaluation of benign ormalignant of thyroid lesions,parameters of AREA％ and IDM has the highest relationship with pathology and good diagnostic value.

Objective To analyze the ultrasonic features of interrupted inferior vena cava (IVC) and its relationship with related deformities so as to improve the prenatal diagnosis of isomerism.Methods Pregnant women who received prenatal care in Peking University People's Hospital or who were referred to our hospital for suspected malformation of fetus between January 2010 and December 2013 were enrolled in this study.Fetal echocardiography and abdominal transverse section were performed routinely.Spatio-temporal image correlation technology was used to further clarify interrupted IVC if azygos vein was broadened or IVC disappeared in the fetal abdominal transverse sections.Based on the presence of cardiac structural abnormalities,interrupted IVC was divided into isolated IVC interruption and complex IVC interruption.Neonatal echocardiography was performed in women with continued pregnancies.In women with terminated pregnancy,fetus was autopsied after induced labor.Results In total,12 cases of interrupted IVC were diagnosed,including 5 cases of isolated IVC interruption with full-term delivery and 7 cases of complex IVC interruption.Neonatal echocardiography,abdominal ultrasound were all normal in the 5 cases of isolated IVC interruption except for 3 cases complicated with sistus inversus viscerum.All the 7 cases of complex IVC interruption had induced labor because of some congenital cardiac abnormalities.Autopsy showed that 6 cases had left isomerism,and 1 case had right isomerism.Conclusions Interrupted IVC can be easily identified in prenatal diagnosis due to the typical ultrasonic features.Complication with some congenital cardiac abnormalities often indicates isomerism,especially left isomerism.