简介：Objective:Toidentifyandseparatetheventralrootfromdorsalroot,whichisthekeyforsuccessoftheartificialsomatic-autonomicreflexpathwayprocedureforneurogenicbladderafterspinalcordinjury(SCI).Herewereporttheresultsofintra-operatingroommonitoringwith10paralyzedpatients.Methods:TenmalevolunteerswithcompletesuprasacralSCIunderwenttheartificialsomatic-autonomicprocedureundergeneralanesthesia.Vastusmedialis,tibialisanticusandgastrocnemiusmedialisoftheleftlowerlimbweremonitoredforelectromyogram(EMG)activitiesresultedfromL4,L5,andS1stimulationrespectivelytodifferentiatetheventralrootfromdorsalroot.ALaborieUrodynamicssystemwasconnectedwithathreechannelurodynamiccatheterinsertedintothebladder.TheL2andL3rootswerestimulatedseparatelywhiletheintravesicalpressurewasmonitoredtoevaluatethefunctionofeachroot.Results:Thethresholdsofstimulationonventralrootwere0.02msduration,0.2-0.4mA,(mean0.3mA±0.07mA),comparedwith0.2-0.4msduration,1.5-3mA(mean2.3mA±0.5mA)fordorsalroot(P<0.01)tocauserevokedpotentialsandEMG.ElectricalstimulationonL4rootsresultedintheEMGbeingrecordedmainlyonvastusmedialis,whilestimulationonL5orS1rootscausedelectricalactivitiesoftibialisanticusorgastrocnemiusmedialisrespectively.Thecontinuousstimulationforabout3-5secondsonS2orS3ventralroot(0.02ms,20Hz,and0.4mA)couldresultedinbladderdetrusorcontraction,butthestrongestbladdercontractionover50cmH2OwasusuallycausedbystimulationonS3ventralrootin7ofthe10patients.Conclusions:Intra-operatingroomelectrophysiologicalmonitoringisofgreathelptoidentifyandseparateventralrootfromdorsalroot,andtoselecttheappropriatesacralventralrootforbestbladderreinnervation.Differentparametersandthresholdsondifferentrootsarethemostimportantfactorstokeepinmindtoavoiddamagingtherootsandtoassurethebestresu

简介：Objective:　Toexploretheregulationofearlybraintissuemetabolicchangingafterbraininjuriesandtheclinicalsignificance.　　Methods:　Therewere17patientswithbraininjuries.EarlydirectmonitoringofPtiO2,PtiCO2,pHandbraintemperature,dynamicobservationoftherelationbetweenvariousparametersandclinicsafterbraininjurieswereperformed.　　Results:　EarlychangesofPtiO2,PtiCO2andpHwerecloselycorrelatedwithoutcome.ThedeathrateobviouslyincreasedwhenPtiO2wascontinuouslylowerthan9mm?Hgwithin24hoursafterinjuries.Secondarybraininjuryprolongedandaggravatedbraintissuemetabolicdisturbance.Whenintracerebralpressurewasover30mm?HgPtiO2begantodecrease.Thebraintemperatureinbraindeathpatientswasevidentlylowerthanaxillarytemperature.　　Conclusions:　ThedirectmonitoringofPtiO2,PtiCO2,pHandbraintemperatureissafeandaccurateandcanfindearlyanoxiadamagetobraintissueandprovidereliablebasisforclinicaltherapy.Ithasaninstructivesignificanceinselectingandstudyinganewtreatmentmethodinbraininjuries.Anditcanbetakenasacriterioninclinicaljudgingbraindeaths.