Computed radiography(CR) is a relatively new concept. The main advantage is the significant reduction of defect of radiography. It provides a more complete anatomic definition and display images to assist the radiologist. The technique can improve target definition and characterization. Such systems allow projection radiology to have the advantages of other digital techniques, including electronic storage, electronic retrieval, transmission over digital networks, and digital image processing. The CR technique, when implemented for multiple room use, can be an economical way to implement digital radiography on a large scale. This represents a potential advantage of CR. We believe that use of CR may be a practical and valuable tool for improving imaging quality where financial resources are limited, and CR is likely to supplant screen-film radiography at many medical imaging centers over the next decade.

Objective To investigate the cerebral protective effect of intracarotid infusion of propofol in patients undergoing resection of cerebral gliomas. Methods Sixty ASA Ⅰ- Ⅲ patients with cerebral glioma aged 40-64 yr weighing 48-73 kg were enrolled in this study. Forty patients undergoing resection of glioma under general anesthesia were randomly divided into 2 groups ( n = 20 each): intracarotid propofol group (group IA ) and intravenous propofol group (group Ⅳ). Twenty patients undergoing biopsy of glioma under local infiltration anesthesia with 2% lidocaine 15-20 md served as control group (group C). In IA and Ⅳ groups anesthesia was induced with TCI of propofol and remifentanil. Tracheal intubation was facilitated with rocuronium 0.6 mg/kg. The patients were mechanically ventilated. PErCO2 was maintained at 35-45 mm Hg. Anesthesia was maintained with TCI of propofol and remifentanil and intermittent iv boluses of rocuronium. In group IA internal carotid artery was cannulated after induction of anesthesia and propofol was administered by TCI via carotid artery while remifentanil was administered by TCI via peripheral vein. BIS was maintained at 40-60 during operation. ECG, MAP, HR, SpO2, PETCO2 and BIS were continuously monitored. MAP and HR were recorded before induction of anesthesia (T1) ,during skin incision (T2 ), at the end of operation (T3), during extubation ( T4 ). The glioma specimens were obtained for microscopic examination and determination of aquaporin 1 and aquaporin 4 ( AQP1, AQP4) expression by immunohistochemistry. Results MAP and HR were significantly decreased at T2 and T3 as compared with the baseline at T1 in group Ⅳ ( P ＜ 0.05), while there was no significant change in MAP and HR after induction of anesthesia in group IA ( P ＞ 0.05). The expression of AQP1 and AQP4 was down-regulated in IA and Ⅳ groups compared with group C (P ＜0.05). The propofol consumption during anesthesia was significantly less in group IA than in group Ⅳ (P ＜0.05). There was no significant diffe-rence in AQP1 and AQP4 expression, the amount of remifentanil and recuronium consumed and duration of operation betweenIA and Ⅳ groups ( P ＞ 0.05). Concltsion Intracarotid propofol can decrease the amount of propofol needed for maintenance of anesthesia as compared with intravenous administration and attenuate brain edema,indicating cerebral protective effect.

Recent studies show that vitamin D plays a role in lung development and regulation of lung maturation in the fetus. The AAP and the Institute of Medicine( IOM) both define vitamin D insufficiency as ser-um 25-OH-D concentrations <50 nmol/L in the pediatric population. The surveys in our country show the prev-alence of vitamin D insufficiency is higher according to the criteria defined by AAP. Evidence from animal study suggests that vitamin D may increase alveolar count,alveolar septal thickness,lung volume and decrease airway resistance,immune cell aggregation leading to the maturation of lung. The cohort studies suggest low 25-OH-D level in infants at birth is associated with greater need for assisted ventilation,increased rate of ARDS,increased duration of oxygen requirement.

Objective To investigate the effects of propofol on cultured primary neurons isolated from fetal Wistar rats against anoxic-reoxygenated injury and its neuro-protective mechanisms at cellular level. Methods Neuronal cells were isolated from brains of fetal Wistar rats and cultured for 12 days. The cultured neuronal cells were randomly divided into 4 groups : (Ⅰ) control group; (Ⅱ) anoxic-reoxygenated group in which neurons were exposed to 95% N2 + 5% CO2 at 37?for 3O min; (Ⅲ) propofol pretreatmenl group in which propofol was added to the culture medium (the final concentrations of propofol were 14 ?mol?L-1) 1 h before exposure to anoxia. (Ⅳ) propofol pretreatment group (the final concentrations of propofol were 56 ?mol?L-1) . Neuronal activity was detected by MTT analysis and NO output was assayed with nitrate reductase method at 1, 2, 4, 6 and 24 h after reoxygenation. The synthesis of heat shock protein (Hsp)70 mRNA was measured by in situ hybridization technique and the synthesis of Hsp70 was measured by immuno-histochemical technique at 1, 3, 8, 24, 48 h and 72 h after reoxygenation.Results (1) 30-min anoxia decreased neuronal activity, increased NO output and significantly increased the synthesis of Hsp70 mRNA and Hsp70. The expression of Hsp70 mRNA reached its peak at 24 h after reoxygenation and that of Hsp70 at 48 h after reoxygenation. (2) Propofol pretreatment significantly increased neuronal activity at 1, 2, 4, 6 and 24 h after reoxygenation and decreased NO output at 1, 2 and 4 h after reoxygenation compared with those in anoxia-reoxygenated group. (3) The synthesis of Hsp70 mRNA was significantly increased and accelerated by pretreatment with both concentrations of propofol but the synthesis of Hsp70 was significantly increased and accelerated by pretreatment with 56?mol?L-1 propofol only. Conclusion Propofol pretreatment can inhibit anoxia-reoxygenation injury to neurons by decreasing NO output and increasing expression of Hsp70 through inducing the synthesis of Hsp70 at both transcription and translation levels.

Objective To explore the feasibility of Video-Assisted Thoracic Surgery(VATS)in the treatment of mediastinal diseases. Methods 39 patients underwent VATS for mediastinal diseases from May 1994 to February 2002.There were 20 males and 19 females with a mean age of 44.9 years(range 25～75 years).13 patients with thymoma,2 patient with invasive thymoma,10 patients with neurogenic benign tumor,3 patients with esophagus cyst,3patients with bronchus cyst,2 patient with pericardial cyst,1 patient with teratoma and 5 patients with other conditions were included in the study.General anesthesia,double lumen endotracheal tube placement and single lung ventilation were used.The patients were placed in the lateral decubitus position with 15? slope forward for posterior mediastinal mass or with 15?～30? slope backward for anterior mediastinal mass.The camera port was placed in the sixth or the seventh intercostal space between the anterior anxillary line and posterior anxillary line.Two or three ports placed according to the site of the tumor permitted an adequate working distance that maximized the range of dissection within the chest.Mini-invasive thoracotomy combined with VATS were performed for some patients when the solid tumor was more then 5 cm in diameter or when it was closely adhesire to surrounding organs Results All patients recovered uneventfully.36 patients underwent tumor removal by VATS alone and 3 patients received mini-invasive thoracotomy combined with VATS performance.The overall incidence of postoperative complication and mortality rate were 0. Conclusions VATS is a safe and effictive technique in the selective patients with mediastinal masses.

Actinomycosis ; pathology ; Adult ; Diagnosis, Differential ; Female ; Humans ; Mycoses ; pathology ; Staphylococcal Skin Infections ; microbiology ; pathology ; surgery ; Staphylococcus aureus ; isolation & purification ; Young Adult

OBJECTIVETo study the effect of Morinda officinalis (MO) extract on cytoxan (CTX) -impaired spermatogenesis of adult male SD rats.

METHODSWe randomly divided 56 adult male SD rats into seven groups of equal number: blank control, CTX model, CTX + NS, CTX + 10 g/kg MO, CTX + 20 g/kg MO, CTX + 30 g/kg MO, and CTX + 40 g/kg MO. We made the models of impaired spermatogenesis in the SD rats by intraperitoneal injection of CTX and treated the animal models by intragastric administration of MO at the concentrations of 10, 20, 30, and 40 g per kg per d, respectively. After two weeks of medication, we observed the changes in the body weight, testicular and epididymal indexes, and microstructure of the testis tissue, measured the mean seminiferous tubule diameter (MSTD) , and obtained testicular biopsy scores (TBS) in different groups, followed by comparative analyses.

RESULTSAfter treatment, the CTX + NS group showed no remarkable differences in the body weight ([234.83 ± 28.77] g) and epididymal index (2.71 ± 0.34) from those of the four CTX + MO groups, but exhibited a significantly lower testicular index ([12.15 ± 1.04] g) than those in the CTX + 20 g/kg MO ([13.71 ± 0.97] g), CTX + 30 g/kg MO, ([13.30 ± 0.29] g), and CTX + 40 g/kg MO group ([13.48 ± 0.51] g) (P < 0.05). Light microscopy revealed obvious pathological changes of the testis tissue in the CTX + NS group and significantly ameliorated structures of the seminiferous tubules in the CTX + MO 10, 20, 30, and 40 g/kg groups, with the MSTD of (204.78 ± 11.03), (216.55 ± 10.93), (218.03 ± 11.23), and (218.59 ± 14.06) μm, respectively, and the TBS of 9.03 ± 0.39, 9.69 ± 0.26, 9.83 ± 0.18, and 9.89 ± 0.11, respectively, all significantly higher than (189.74 ± 8.55) μm and 5.95 ± 1.21 in the CTX + NS group (P < 0.05). The efficacy of MO extract was increased in a concentration-dependent manner.

CONCLUSIONMorinda officinalis extract can repair cytoxan-induced damage to rat spermatogenesis, with may achieve the best effect at the concentrations of 30 and 40 g per kg per d.

Animals ; Body Weight ; drug effects ; Cyclophosphamide ; toxicity ; Epididymis ; drug effects ; Male ; Morinda ; chemistry ; Mutagens ; toxicity ; Plant Extracts ; administration & dosage ; pharmacology ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Seminiferous Tubules ; drug effects ; pathology ; Spermatogenesis ; drug effects ; Testis ; drug effects ; ultrastructure

Humans ; Male ; Middle Aged ; Parathyroid Neoplasms

Objective To establish a HPLC method for the simultaneous determination of campanulin, paeoniflorin and hydrox-ysafflor yellow A in Buyang Huanwu Decoction. Methods A Kromasil C18(4. 6 mm × 250 mm, 5 μm) column was adopted. The mobile phase consisited of methanol and acetonitrile(26 : 2) (A), and 0. 7 % phosphoric acid solution(B), in gradient e-lution (0～10 min, 25 % →35 % A; 10～25 min, 35 %→40 % A). The flow rate was at 1.0 mL·min-1. The column tem-perature was 35 ℃;, and the detection wavelengths were set at 260nm for campanulin, 230 nm for paeoniflorin and 403 nm for hydroxysamor yellow A. Results The linear ranges of campanuliu, paconiflorin and hydroxysafflor yellow A were 0. 0539～1. 078 μg (r=0. 999 5), O. 4160～8. 320μg (r=0. 999 8), and 0. 0418～0. 8352 μg (r=0. 999 5) respectively; the av-erage recovery was 99. 4 % (RSD=1.5 %), 100. 6 % (RSD=1.7 %), and 101.0 % (RSD=1.9 %) respectively. Conclu-sion The method is simple, feasible and reproducible, and can be used for the quality control of Buyang Huanwu Decoction.

Objective To improve the recognition in clinical features,diagnosis and treatment of POEMS syndrome.Method Twenty-one cases of POEMS syndrome were analyzed retrospectively.Results The major clinical features were shown as follows: 21 cases of polyneuropathy, organomegaly, edema and skin changes, 13 cases of monoclonal plasma proliferative disorder, 19 cases of endocrinopathy, 1 case of sclerotic bone lesions, 1 case of Castleman disease,5 cases of papilledema.Conclusions POEMS syndrome is a rare multi-system damage disease.Screening for POEMS syndrome with serum protein electrophoresis, immunofixation electrophoresis,electromyogram and radionuclide bone scanning are essential for all patients with unexplained peripheral neuropathy or multi-system damage.If the index of suspicion is high enough, bone marrow cytomorphologic examination or biopsy with immunohistochemical staining may be required,in order to make an early diagnosis and try to avoid misdiagnosis and mistherapy.