Objective To observe the evolution process of cerebral blood flow spectrum in brain death by transcranial doppler ultrasound.Methods To detect the blood flow of bilateral middle cerebral artery in brain dead patients by transcranial doppler ultrasound.Results Twenty brain dead patients were collected in the study.The blood flow velocity of middle cerebral artery ranged s from 6 to 37cm/s,and the mean velocity was (12.13 ± 3.15)cm/s.There were three characteristic spectrums which include oscillatory wave (reverse wave in diastolic),nails wave (tip small wave in systolic),no blood flow sign,and they appeared in turn accoerding to worsen of the disease.The heartbeat irreversibly stopped within 8 days after the appearing of oscillatory wave,and ninty percent of the cases had the regular blood flow spectrums of oscillatory wave-nails wave-no blood flow sign.Conclusion The three regularly characteristic transcranial doppler ultrasound blood flow spectrums,which include oscillatory wave,nails wave and no blood flow sign could facilitate the diagnosis of brain death.

Objective To assess the predictive value of cerebral arteriosclerosis to acute cerebral infarction evaluated by transcranial doppler ultrasound .Methods 170 cases suspected cerebral arteriosclerosis consecutively enrolled were given transcranial doppler ultrasound and were followed up for 6 months,then we assessed the correla-tion between the levels of cerebral arteriosclerosis and acute cerebral infarction within 6 months.Results By Spearman rank correlation analysis ,there was positive correlation between the severity of cerebral arteriosclerosis de-tected by transcranial doppler ultrasound and acute cerebral infarction within 6 months,the correlation coefficient was 0.575(P<0.05).Conclusion Through the detection of transcranial doppler ultrasound ,the higher levels of cere-bral arteriosclerosis,the greater probability of acute cerebral infarction within 6 months.

Objective To observe the effect of Tongsaimai Tablets on the leptomeningeal collateral circulation established after acute cerebral infarction by TCD.Methods 50 patients with acute cerebral infarction were randomly divided into control group (received conventional treatment) and treatment group (received Tongsainai Tablets three times a day,1.75g each time,on the basis of conventional treatment).The leptomeningeal collateral circulation of the two groups were observed after 6 months.Results The factors which may affect the leptomeningeal collateral circulation,such as age,the prevalence of hypertension and hyperlipidemia,original compensatory status of cerebral artery between the two groups had no statistically significant differences.The open rate of leptomeningeal collateral circulation in the treatment group was 64.00％,which was significantly higher than that of the control group(32.00％)(P =0.024).Conclusion Tongsaimai Tablets can promote the formation of leptomeningeal collateral circulation in patients with acute cerebral infarction.

Objective To observe the influence of Gastrodia data capsule on cerebral blood flow in the treatment of patients with hypertension.Methods A total of 69 patients with hypertension were divided into the treatment group(36 cases) and the control group(33 cases).The treatment group received treatment of Gastrodia clara capsule combined with antihypertensive drug,the control group received treatment of antihypertensive drug only.Two groups received TCD test before and 20 days after treatment,and the changes of blood flow of intracranial vessels before and after treatment were assessed.Results The total effective rate in treatment group was 97.2％,12 cases cured,15 cases of tangible effectiveness,8 cases of effectiveness,1 case of invalidity.The total effective rate in control group was 75.8％,7 cases cured,12 cases of tangible effectiveness,6 cases of effectiveness,8 case of invalidity,The difference of clinical efficacy between the two groups was statistically significant ( Z =2.240,P ＜ 0.05 ).The mean velocity of MCA,ACA,PCA,BA,VA of control group 20 days after treatment was not statistically different compared to those before treatment.The mean velocity of MCA,ACA,PCA,BA,VA of treatment group 20 days after treatment was lower than those before treatment(t =-2.65,-2.44,-3.92,-3.31,-4.68,all P＜0.05).Conclusion The treatment of Gastrodia elata capsule conbined with antihypertensive drug can significantly improve curative effect of patients with hypertension and improve the condition of cerebral blood flow.

Objective To investigate the morphological characteristics of the autophagic structures in macrophages after phagocytosis of apoptotic lymphocytes and to explore the effects of autophagy on clearance of the apoptotic cells by macrophages. Methods Apoptosis of lymphocytes was induced with cyclophosphamide.The morphological changes of macrophages phagocytizing the apoptotic cells were viewed with a scanning electron microscope.The structural features of the autophagosome precursors,autophagosomes and autophagolysosomes in macrophages were examined with a transmission electron microscope,and the cross-section areas of the autophagic structures were measured with an image analyzer.The autophagosomes of macrophages were labeled with monodansylcaolaverine(MDC) staining and quantitated using laser scanning confocal microscopy.Results Macrophages actively phagocytized the apoptotic lymphocytes,apoptotic nuclei,apoptotic bodies and other cell debris to form heterophagosomes.When compared with the control group,numbers of autophagic cells and autophagosomes in these cells increase in the group of macrophages that engulfed the apoptotic cells.In addition,the ratios of the cross-sectional areas of the autophagic structures to that of the cytoplasm of the macrophages were greater.There were also apoptotic bodies or other cell debris in many the autophagosomes,and these autophagosomes were large and near the cell membrane.Autophagosomes containing the whole apoptotic cell or apoptotic nucleus were not observed.Conclusion The autophagic abilities of macrophages were significantly enhanced when the cells removed the apoptotic lymphocytes.Autophagy also plays an important direct or indirect roles in clearance of the apoptotic lymphocytes by macrophages.

Objective To investigate the effects of intravenous penehyclidine hydrochloride or doxofylline on respiratory mechanics during non-thoracotomy in patients with chronic obstructive pulmonary disease (COPD).Methods One hundred and thirty-five ASA Ⅱ or Ⅲ patients with COPD, aged 55-86 yr, weighing 44-78 kg,scheduled for elective non-thoracotomy under general anesthesia, were randomly divided into 3 groups ( n = 45 each): control group (group C), penehyclidine hydrochloride group (group P) and doxofylline group (group D).Anesthesia was induced with fentanyl 4 μg/kg, propofol 1.5 rg/kg and cis-atracurium 0.2 mg/kg. The patients were tracheal intubated and mechanically ventilated. PETCO2 was maintained at 40 mm Hg. At 5 rin after tracheal intubation, penehyclidine hydrochloride 0.01 mg/kg was injected intravenously in group P, and doxofylline 4 mg/kg was injected intravenously in group D. The equal volume of normal saline was injected intravenously in group C. Anesthesia was maintained with propofol 5 mg· kg- 1 · h- 1, eis-atracurium 0.2 mg· kg- 1 · h- 1, and intermittent iv boluses of fentsnyl. The auditory evoked potential index was maintained at 15-20 during operation. The peak airway pressure, airway plateau pressure, lung compliance and airway resistance were recorded immediately before administration, and at 30, 45 and 60 rin after administration. Results Compared with group C, the peak airway pressure, airway plateau pressure and airway resistance were significantly decreased, while the lung compliance was significantly increased at each time point after administration in groups P and D ( P ＜ 0.05 ). There was no significant difference in the parameters of respiratory mechanics at each time point between group P and group D ( P ＞ 0.05). Conclusion Both intravenous penehyclidine hydrochloride and doxofylline can improve respiratory mechanics during non-thoracotomy in patients with COPD.

OBJECTIVE:To probe into the reasons for drug repercussion in ward area and find a solution.METHODS:The reasons for drug repercussion,the kinds of the returned drugs and the proportion of these drugs in the total in terms of amount of money between Oct.to Dec.in 2006 were analyzed and compared with the amount of money of returned drugs between 2005 and 2006 in our hospital.RESULTS:There were 2 674 cases of drug repercussion between Oct.to Dec.in 2006 in our hospital;the returned drugs totaled 192 kinds,and the drug repercussion was mainly due to patients' discharge,alteration of medical orders and input error.The rate of drug repercussion was 4.67%.CONCLUSION:There were drug repercussion cases in all the departments of our hospital,and the amount of the returned drugs were large,which resulted in increased difficulty of drug quality management and serious hidden dangers for medication safety,therefore,standard administration on which is much needed.

OBJECTIVE To evaluate the clinical effects and toxicity of netilmicin with different administrations by de?termining its serum concentration in the treatment of lower respiratory tract infection.METHODS:22cases of lower respi?ratory tract infection were randomly divided into two groups.The drug serum concentrations were determined by TDx system.Clinical effects were compared;renal function and hearing ability were monitored.RESULTS:On the condition of the same total daily dosage,the peak concentrations in once-daily group(group QD)were significantly higher than those in twice-daily group(group BD)(P

AIM:To investigate the changes of autophagy of macrophages after phagocytizing dust particles and explore the mechanisms of dust particle-induced autophagy of the cells.METHODS:The bronchopulmonary lymph nodes were collected from patients with lung operation.The paraffin sections were prepared and then stained with Wilder's method.The tissue structures were viewed.Peritoneal macrophages were harvested from rats and then treated with carbon particles.Influences of carbon particles in autophagic activities of macrophages were examined.The ultrathin sections of the lymph nodes and the cells phagocytized carbon particles were prepared.The structures and distribution of phagosomes,autophagosomes and lysosomes were viewed.The apoptotic cells in the dust cells of the lymph nodes and the cells having phagocytized carbon particles were examined using transmission electron microscope and TUNEL staining.RESULTS:In adult lymph nodes,dust particles were deposited significantly in macrophages,collagen fibres and density of microvessels increased.There were autophagosome precursors,autophagosomes,autophagolysosomes as well as phagosomes in the dust cells and the cells phagocytized carbon particles.In autophagosomes,mitochondrion,dust particle or carbon particle were usually observed.There were positive cells by TUNEL staining in the dust cells and the cells phagocytized carbon particles.Nuclear condensation or apoptotic body in the apoptotic cells were observed under transmission electron microscope.CONCLUSION:Deposition of dust particles induces enhancement of autophagic activities and apoptosis of macrophages.Autophagy plays an important role in cleaning dust particles and the injured mitochondria.

Objective To compare the value of automatic breast volume scanner (ABVS) with enhanced magnetic resonance imaging(MRI) in the diagnosis of breast masses.Methods Seventy-four patients with 80 breast masses underwent preoperative ultrasound examinations including ABVS and MRI.The values of ABVS and MRI in the diagnosis of breast masses were comparatively analyzed.Results Among the 80 breast masses that were surgically removed,37 masses were benign and 43 masses were malignant.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value of ABVSin the diagnosis of breast malignant masses were 94.6％,79.1％,86.3％,79.5％ and 94.4％,respectively,those of MRI were 94.6 ％,86.0 ％,90.0 ％,85.4 ％ and 94.9 ％,respectively,and those of the combination of ABVS and MRI were 94.6％,93.0％,93.8％,92.1％,and 95.2％,respectively.The sensitivity and specificity were not significant difference between ABVS and MRI in the diagnosis of breast malignant masses(P ＞0.05).The specificity of the combination ABVS and MRI in the diagnosis of breast malignant masses were significantly higher than that of ABVS (x2 =4.17,P =0.04).The sensitivity,specificity and accuracy of convergence sign in the diagnosis of breast malignant masses were 64.9 ％,97.7 ％ and 82.5 ％,respectively.Conclusions ABVS and MRI are both valuable in the diagnosis of breast masses,and the combination of ABVS and MRI is the most valuable due to high specificity.