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Liu X.-M.,Navy General Hospital | Fu Q.,Hainan Branch of General Hospital of PLA | Mi W.-D.,Chinese PLA General Hospital
Medical Journal of Chinese People's Liberation Army | Year: 2014

Objective: To explore the value of stroke volume variation (SVV), pulse pressure variation (PPV) and pleth variability index (PVI) in evaluating the volume status under pneumoperitoneum and their correlation. Methods: Twenty-six patients with stomach cancer receiving laparoscopy-assisted radical gastrectomy under general anesthesia were involved in this study. The indexes of SVV, PPV and PVI were monitored continuously after general anesthesia. A volume loading test was performed after pneumoperitoneum, and the hemodynamic parameters were determined before and after fluid infusion (6% HES, 7ml/kg), and the patients were divided into response group (n=16) and non-response group (n=10) according to whether the increase in stroke volume index (ΔSVI) was ≥15% or not. The receiver operator characteristic (ROC) curves of SVV, PPV and PVI were drawn to evaluate the value of SVV, PPV and PVI in evaluating volume status under artificial pneumoper itoneum and the correlation between them. Results: The analysis of ROC curves showed that SVV, PPV and PVI could all be used to estimate the volume status effectively, the area under the curve (AUC) of them was 0.978, 0.963 and 0.928 respectively, and there was a significant correlation between the three parameters (SVV and PPV: r=0.921, P<0.01; SVV and PVI: r=0.686, P<0.01; PPV and PVI: r=0.577, P<0.01). Conclusion: SVV, PPV and PVI could be used to accurately evaluate the volume status under artificial pneumoperitoneum, and there is a good correlation between them. Source


Tan Q.-C.,Chinese PLA General Hospital | Zhang J.-T.,Chinese PLA General Hospital | Xing X.-W.,Hainan Branch of General Hospital of PLA | Tian C.-L.,Chinese PLA General Hospital | And 2 more authors.
Medical Journal of Chinese People's Liberation Army | Year: 2014

Objective To evaluate the significance of the chloride contents both in cerebrospinal fluid (CSF) and plasma, and the ratio of two chloride contents in early diagnosis and differential diagnosis of central nervous system infections. Methods The chloride contents in CSF and plasma were detected from Jan. 2003 to Dec. 2003 in patients diagnosed as viral meningitis (n=223), tuberculous meningitis (n=132) and cryptococcal meningitis (n=47), and the results were compared with those of patients with non-central nervous system infections (n=359). The baseline data and results of chloride contents of CSF and plasma of all the subjects were collected and recorded. The chloride contents in sample of CSF and plasma of disease group and the change in ratio of the two chloride contents were observed, and the ROC curves were generated according to the results, in order to analyze the statistical significance in early diagnosis and differential diagnosis of central nervous system infections. Results The chloride contents of CSF and plasma sample and the ratio of CSF to plasma chlorides decreased in tuberculous meningitis group (<102.150mmol/L, <101.75mmol/L and <1.164, respectively), and the results supported the diagnosis of tuberculous meningitis. Combination of the chloride content in CSF and the ratio of CSF to plasma chlorides could elevate the diagnostic sensitivity to 0.970 or specificity to 0.876. When the chloride content in CSF <121.70mmol/L, plasma chlorides >101.45mmol/L and the ratio of CSF to plasma chlorides >1.200 may be suggestive to make a diagnosis of cryptococcal meningitis, and a combination of the result of chloride content in CSF and the ratio of CSF to plasma chloride has a diagnostic sensitivity of 0.942 or specificity of 0.916. The chloride contents in CSF and plasma and the ratio of CSF chloride to that of plasma showed no diagnostic significance for viral meningitis. The chloride content in CSF was significantly lower in tuberculous meningitis and cryptococcal meningitis patients than in viral meningitis patients. The chloride contents in plasma declined more markedly in cryptococcal meningitis patients than in those with tuberculous meningitis and viral meningitis. The ratio of CSF to plasma chlorides declined in tuberculous meningitis patients, whereas elevated in cryptococcal meningitis patients. Conclusion The determination of the chloride contents in CSF and plasma and their ratio may be helpful in increasing the sensitivity and specificity in the early diagnosis and differential diagnosis of central nervous system infections. Source


Zhang Y.-X.,Hainan Branch of General Hospital of PLA | Huang H.-B.,Chinese PLA General Hospital | Wei S.-H.,Chinese PLA General Hospital
Experimental and Therapeutic Medicine | Year: 2014

Pathological optic disc cupping (ODC) is predominantly referred to as glaucoma; however, it is not only glaucoma that leads to pathological optic disc excavation. A number of other nonglaucomatous diseases also result in optic atrophy and excavation of the optic disc. Therefore, in the present study, the etiology of nonglaucomatous optic disc cupping (NGODC) was analyzed and differentiated from glaucomatous optic disc cupping (GODC). The morphology and clinical data of 19 eyes, from 12 patients exhibiting NGODC, were analyzed. Of the 12 cases, none were diagnosed with glaucoma, four presented with optic neuritis, one with Devic's disease, one with Leber's hereditary optic neuropathy, two with pituitary adenoma, one with basal ganglia cerebral hemorrhage, one with cilioretinal artery occlusion associated with central retinal vein occlusion, one with central retinal artery occlusion and the remaining patient exhibited optic nerve injuries. The key features that differentiated NGODC from GODC were the color of the optic disc rim and the correlation between visual field defects and the disc appearance. The focally notched disc also aided in distinguishing between the two disorders. The results of the present study indicated that it is critical to acknowledge that nonglaucomatous diseases also lead to ODC and that distinguishing between them is necessary. Source


Huang H.-B.,Chinese PLA General Hospital | Zhang Y.-X.,Hainan Branch of General Hospital of PLA
Experimental and Therapeutic Medicine | Year: 2014

Pigmented paravenous retinochoroidal atrophy (PPRCA) is an uncommon disease characterized by perivenous aggregations of pigment clumps associated with peripapillary and radial zones of retinochoroidal atrophy that are distributed along the retinal veins. Patients are usually asymptomatic and the disease process is non-progressive or slow and subtly progressive. It is commonly bilateral and symmetric. The cause of the condition may be unknown or idiopathic, although a dysgenetic, degenerative, hereditary etiology or even an inflammatory cause has been hypothesized. A non-inflammatory cause is referred to as primary, while inflammation-associated PPRCA is referred to as secondary or pseudo PPRCA. The present study reviewed and summarized the features of PPRCA. Source


Huang H.-B.,Hainan Branch of General Hospital of PLA | Zhang Y.-X.,Hainan Branch of General Hospital of PLA | Zhang S.-H.,The Second Affiliated Hospital of Haerbin Medical University | Ma Z.-Z.,Peking University
Neurological Research | Year: 2015

Objectives: To calibrate and standardise an animal model of graded optic nerve injury (ONI) in rats to facilitate future inter-laboratory data comparisons, focussing on quantification of injury intensity, injury severity, and the correlation between them. Methods: A pair of cross-action forceps or a pair of artery clips was used to induce optic nerve (ON) crush injuries. A lever principle and a simplified method were used to measure the crushing force. The simplified method directly measured weights as an external force exerted on the tip of the forceps or clips, which was just sufficient to maintain a gap and was equivalent to the closing (crush) force. The impulse and averaged impulse were explored as physical quantities to compare injury intensities. Graded ONIs were made by crushing the ON for 3, 6, 12, 30 or 60 seconds by the cross-action forceps, or 5, 10 or 15 seconds by the artery clips. The injury severity was evaluated by counting surviving retinal ganglion cell (RGC) through applied FluoroGold to the superior colliculus and lateral geniculate body before ON crush, intact RGC counting by applied FluoroGold after ON crush, and ON axon counting. Results: Similar results were obtained by the lever principle method and the simplified method. The crushing force of the cross-action forceps and the artery clips was 148.0 gram force (gf) and 32.4 gf, respectively. The graded ONI animal models were successfully created in rats without retinal ischaemia post-trauma. The averaged impulse produced by the artery clips for 15 seconds was equal to that produced by a 3-second crush of the cross-action forceps. The correlation between injury intensity and injury severity was fitted for a power function. Discussion: Our results provide a simplified and effective means to quantify and analyse data from ON crush studies compared with previously reported animal models. © W. S. Maney and Son Ltd 2015. Source

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