ABSTRACT
Objective To study the applicability of unilateral and bilateral antegrade cerebral perfusion during deep hy-potbermia circulatory arrest (DHCT) surgery and to determine a better method of brain protection. Methods 60 patients un-derwent aortic arch surgery were random divided into either unilateral cerebral perfusion group with a cannula in the innominate artery (n = 30 ) , or bilateral cerebral peffusion gToup with an additional cannula in the left carotid artery ( n = 30 ). S-100β,neuron specific enolase (NSE) were assayed at the following time points: the beginning of cardiopulmonary bypass (T_1), the beginning of circulatory arrcst( T_2 ), antegradc cerebral perfusion (ACP) 25 min( T_3 ), the end of ACP( T_4 ), the end of car-diopulmonary bypass ( T_5 ) , 1h( T_6 ) , 6h ( T_7 ) and 24h( T_8 ) after operation. Neurological deficit incidence and mortality were also obtained. Results There is no statistical significance for S-100β and NSE plasma concentration among time points of T_1、T_2 and T_3. But every time point among T_4、T_5、T_6、T_7 ,Ts do have statistical significances. The incidence of central nervous system dysfunction in group unilateral ACP was higher than that in group bilateral ACP ( 33.33% vs. 10.00%, P = 0.028 ).But there is no significant difference between the two groups in mortality( 3.33% vs. 6.66% ,P = 1. 000 ). Conclusion There is no significant difference between unilateral ACP and bilateral ACP in 25 min during DHCA. But as the DHCA time extends, the effect of bilateral ACP will be better.
ABSTRACT
Objective To explore the clinical value of the combination of three methods including 99mTc-MIBI imaging, multi-slice spiral CT and tumor markers [carcinoembryonic antigen(CEA),cytokeretin19 fragment(CYFRA21-1), neuron-specific enolase(NSE)] measurement for diagnosis of lung cancer. Methods 350 patients were performed 99mTc-MIBl imaging, multi-slice spiral CT and measurements of tumor markers apart within one week. 200 patients were proved by pathology lung cancer in all 350 patients. Results The sensitivity, specificity and accuracy obtained with the three methods and combination of three methods were 74.5 %(149/200), 68.7 %(103/150), 72.0 %(252/350);97.5 %(195/200), 42.7 %(64/150), 74.0 %(259/350);62.5 %(125/200), 28.7 %(43/150), 48.0 %(168/350) and 99.5 %(199/200), 82.0 %(123/150), 92.0 %(322/350),respectively. Conclusion The results imply that three methods has its distinct important clinical value in diagnosis of lung cancer respectively. The diagnostic efficacy of the combination of three methods is superior to any single one at present situation.