ObjectiveTo establish a mathematical formula for choosing the manner of replacement fluid infusion in continuous renal replacement therapy (CRRT), so as to provide the basis for improving the treatment effect. Methods A mathematical formula for choosing the manner of replacement fluid infusion with continuous veno-venous hemofiltration (CVVH) was taken as an example, and it was compared with the result of standard replacement fluid in order to analyze the effect of different manners of infusion.① Comparison parameters: the plasma volume (Vreturn) and some electrolyte concentration (Creturn) in back way of CRRT (if other thing was solute, filter coefficient should be 1.0).② Research objects: the actual replacement fluid (for example, the most complex should be sorted into A and B type) mode (pre or post) was compared with the standard replacement fluid (the A and B in one).③ Based on the formula of standard replacement, four equations in different conditions were derived: pre-dilution and post-dilution mode; same direction and same ratio; same direction and different ratio; different direction and same ratio; different direction and different ratio.Results The calculated results of Vreturn (except hematocrit) and Creturn were same to the standard only following the rule of same direction and ratio for A and B no matter pre-dilution mode or post-dilution mode, and it was different from the standard in others. In pre-dilution mode and post-dilution mode, it showed:① A and B in same direction and different ratio: Vreturn and Creturn were different from the standard for the alterative ratio of B.② A and B in different direction and same ratio: Vreturn was same to the standard, but Creturn was different from the standard for the completely different and more complex computational formula.③ A and B in different direction and different ratio: both Vreturn and Creturn were different from the standard. The different Vreturn was due to the different ratio of B. The different Creturn was caused by different ratio of B and the completely different computational formula.Conclusions① For parts of replacement fluid which must be separated ( for example, bicarbonate formula ), the result is same to the standard, and is predicted and mastered only following the rule of same direction and ratio. Otherwise, we need to calculate the two parameters over and over again. The result will run out of our judgment. The wrongness of losing water and electrolyte disorders maybe come out.② Accordingly,the formula could be used to analyze the same case like the separated replacement infusion, for example, a large number of citrates as regional anticoagulation were infused only in the front of filter, while the replacement fluid can be done in varied forms.

0.05) and that of GFAP were found(P

Objective To find a new way to promote the regeneration of injured peripheral nerve after surgical repair, and to interpret its application and advantages. Methods Eighty adult male Wistar rats with sciatic transplantation were divided into group A(control group) and group B(exponential curve electric stimulus group). The effect of pace, hair and unfold claw reflex were observed, and the sciatic nerve function index(SFI), nerve conduction velocity, wet weight of triceps surae were measured at different time. The curative effects of two groups were compared statistically. Results The group of exponential curve electric stimulus had positive effect on the recovery of nerve conduction velocity, the slower of the denervated disuse of triceps surae, the recovery of SFI, the acceleration of distal nerve degeneration, at last promote the injured nerve regeneration and the good recovery of function. The group of exponential curve electric stimulus is of significant difference statistically with the control group. Conclusion Exponential curve electric stimulus can promote the injured nerve regeneration.

Objective To investigate the accurancy of somatosensory evoked potential (SSEP) and motor evoked potential (MEP) in estimation of the occurrence of intraoperative cerebral ischemia in patients undergoing carotid endarterectomy (CEA).Methods Ninety patients (71 males, 19 females, aged 18-80 years, ASA physical status grade Ⅱ or Ⅲ) undergoing CEA using general anesthesia were studied.Bilateral SSEP and MEP were monitored during CEA and the intraoperative changes of SSEP and MEP amplitude and latency were analyzed before, during and after ICA cross-clamping until CEA ended.Neurological dysfunction was investigated within 5 days after operation and the gold standard of cerebral ischemia was defined as the occurrence of neurological dysfunction.Results Fourteen cases (15.6%) were diagnosed as post-operative neurological dysfunction.The sensitivity, specificity of SSEP in detecting the occurrence of intraoperative brain ischemia were 79%, 92%, respectively.The sensitivity, specificity of MEP was 86%, 89% respectively.The sensitivity, specificity, of SSEP+MEP was 79%, 99% respectively.Conclusion During the carotid endarter ectomy,SSEP predicts the occurrence of cerebral ischemia with a high specificity.MEP has a high sensitivity.The combination monitoring of SSEP+MEP can improve the specificity, make up for the shortcomings of single monitoring.

Objective To compare the effects of nerve block using diprospan, triamcinolone and lysinipirium on cervicogenic headache (CEH).Methods Sixty CEH patients were randomly divided into three groups (20 cases in each group), treated by occipital nerve block and C2 neural blockade with diprospan, triamcinolone and lysinipirium respectively, combined with a mixture of 0.4% lidocaine. All patients in three groups were evaluated by numeric rating scales (NRS) for pain degree and range of motion of the neck (ROM) before and after the nerve block.Results The scores of NRS decreased significantly and ROM improved in all groups after treatment ( P<0.01). There were no significant differences between diprospan group and triamcinolone group, but these two groups had a better effect than lysinipirium group ( P<0.01).Conclusion Nerve block using diprospan and triamcinolone can obtain a significant effect in the treatment of CEH.

Up to now,the researches of postoperative headache have been focused on the pain of the incision of scalp,however,other kinds of headache have not been thought highly of.To find and determine the reasons of postoperative headache and treat depending on the pathogenesis of the pain are the main goal in the future.The authors investigated and reviewed the pathogenesis of cervicogenic headache after craniotomy and proposed the therapeutic strategy in this article.

Objective To evaluate the efficacy of pregabalin combined with nerve block on postherpetic neuralgia (PHN). Methods 60patients were assigned into group A (n=30), who received pregabalin orally, and group B (n=30), who received nerve block (trigeminalnerve, intercostal nerve, lumbar nerve block) in addition. They were assessed with visual analogue scale (VAS) of pain, sleep score fromHamilton Rating Scale for Depression before and 3 d, 1 week, 2 weeks, 3 weeks, 4 weeks, 5 weeks, 6 weeks, 7 weeks, and 8 weeks aftertreatment. The incidence of pain decreased >50% and >30% were compared. Results The scores of VAS and sleep significantly reduced inboth groups 1~8 weeks after treatment (P<0.01), and decreased significantly 3 d after treatment in group B than in group A (P<0.05). The incidenceof pain decreased >50% and >30% were more in group B than in group A (P<0.05). Conclusion Nerve block combined with oralpregabalin is more effective on PHN.

Objective To explore the feasibility and safety of dexmedetomidine sedation in interventional neuroradiology operations.Methods Eighty-five cases ASA grade Ⅱ-Ⅲ grade patients undergoing cerebral angiography according to age divided into two groups:old group(more than 60 years old,35 cases) and young group (18-59 years old,50 cases).The loading dose of dexmedetomidine were dexmedetomidine 0.5 μ g/kg in old group and 1.0 μ g/kg in young group,respectively.The loading dose was administered for 10 min followed by continuous infusion dexmedetomidine 0.5 μ g/ (kg· h).Blood pressure,heart rate (HR),peripheral oxygen saturation (SpO2) and respiratory rate (RR),Ramsay score and bispectral index(BIS) were monitored and recorded during the study.Results The BIS,Ramsay score after administration 10,15,30,45 min in two groups was significantly longer than that before administration [old group:84 ±22,83 ±22,85 ± 15,75 ±23 vs.94 ±5; (2.0 ±0.4),(2.3 ±0.6),(2.8 ±0.7),(3.0 ±0.7)scores vs.(1.7 ± 0.5) scores; young group:91 ± 8,89 ± 11,86 ± 12,81 ± 13 vs.96 ± 2; (1.9 ± 0.6),(2.3 ±0.7),(2.7 ± 0.9),(3.0 ± 0.9) scores vs.(1.6 ± 0.5) scores,P ＜ 0.05].The systolic blood pressure,diastolic blood pressure,mean arterial pressure (MAP) after administration 10,15,30,45 min in two groups was significantly longer than that before administration [old group:(152 ± 23),(144 ± 23),(140 ± 21),(135 ±21) mm Hg(1 mm Hg =0.133 kPa) vs.(165 ± 25) mm Hg; (87 ± 11),(83 ± 11),(78 ± 8),(75 ± 8) mm Hg vs.(89± 13)mm Hg;(106±14),(100±13),(99±12),(95±12)mm Hg vs.(113±16)mm Hg;young group:(131 ± 24),(127 ± 23),(124 ± 25),(124 ± 26) mm Hg vs.(142 ± 23) mm Hg; (81 ± 13),(79±13),(77±13),(76±13)mmHgvs.(86± 14) mmHg;(97±16),(94±16),(91±19),(92±20) mm Hg vs.(104 ± 19) mm Hg,P ＜0.05],but the decreases in blood pressure were ＜20％ from baseline.The HR,RR and SpO2 was no significant difference (P ＞ 0.05).Conclusions Continuous infusion of dexmedetomidine sedation during cerebral angiography has little effect on hemodynamics,no significant respiratory depression,is safe and effective.

0.05). HL activity in liver tissue in AS group was significantly lower than control group (P

AIM: To investigate the effect of insulin on ox-LDL transferring the THP-1 cells to foam cells and influencing the LPL mRNA expression in THP-1 cells. METHODS: THP-1 cells were incubated with 50 mg/L ox-LDL and insulin at concentrations of 10 mU/L,100 mU/L,1 000 mU/L and 10 000 mU/L, respectively. The expression of LPL mRNA in cells was detected by RT-PCR. Lipoprotein lipase of THP-1 cells was presented by no-specific lipase staining. THP-1 cells were stained with oil red O. Accumulation of total cholesterol (TC) in THP-1 cells was determined with oxidase assay. RESULTS: In 100 mU/L?1 000 mU/L?10 000 mU/L insulin groups, LPL mRNA expression increased 2 times, the average cell perilength was longer, the percentage of positive oil red O staining cells was significant higher, the content of cholesterol in THP-1 cells was higher than in ox-LDL control ( P