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[22] B1 The use of Hyperbaric Oxygen in Necrotising Soft Tissue Infections: A Historical Perspective with an Update anno 2008 D. J. Bakker, MD, PhD. Amsterdam, the Netherlands Introduction: Necrotizing soft tissue infections caused by aerobic, anaerobic and mixed bacterial floras are a still increasing problem in surgical and medical practice. They occur with increasing frequency and seriousness, especially in immune-compromised patients. The clinical picture can vary considerably from patient to patient. Treatment is difficult, often irrational and very often "one step behind the facts," because early recognition is difficult and etiology, bacteriology, and the clinical course are sometimes not well understood or expected to evolve in a different and more favourable way. Hyperbaric Oxygen treatment (HBOT) is a highly controversial issue in the literature. Considerable morbidity occurs in these diseases and the mortality can be very high, from 20% up to 70 or 80%. Odstraněno: aetiology History: For a proper understanding it is necessary to give a short review of the history of these infections including the bacteriology and the various forms of treatment that have been advocated and practised. th In this review we will pay attention to the works of Hippocrates from the 5 century BC, Baurienne (1764), Hebler (1848) and Jean Alfred Fournier (1883), a French venereologist, Also the work by the Confederate Army Surgeon Joseph Jones will be mentioned who described a variant of this disease in 1869 and 1870 during the Civil War in the United States. Very relevant are also the works of Meleney and Cullen (1924) en Brewer and Meleney (1926). Meleney reported about his work in the Imperial Hospital In Peking (now Beijing) in China. Extensive reviews on necrotizing soft tissue infections including Fournier’s gangrene have been published and can be found in the literature (Bakker 2002, Bakker 2008). The immense confusion in the nomenclature and the classification of these diseases will be explained. The role of Hyperbaric Oxygen in the treatment of these disease started in 1959 when Boerema and Brummelkamp treated a patient with Gas Gangrene in the Hyperbaric Chamber (HBOT). The first Congress on HBOT was held in Amsterdam in 1963, now 45 years ago. Material and Methods: We will restrict ourselves in this presentation to Clostridial Myonecrosis or Gas Gangrene and Necrotising Fasciitis or Fourniers Gangrene. a. Necrotising Fasciitis (NF) is a progressive, generally rapid spreading, inflammatory process located in the deep fascia with secondary necrosis of subcutaneous tissues and skin. The infection tends to spread very rapidly along the deep fascial planes. There is confusion in the literature about the microorganisms that cause NF. Haemolytic Streptococci play a major role in the onset of the disease. Later on in the disease one can find many more microorganisms, from which their role in the disease is not clear. A rapid diagnosis is essential for treatment and prognosis. Treatment is a combination of proper, early and extensive surgery, antibiotics and adjunctive HBOT. The grade of evidence for using HBOT in the treatment will be shown from the literature data and our own experiences. b. Clostridial Myonecrosis or Gas Gangrene is an acute, rapidly progressive, non-pyogenic, gasforming and necrotising infection of muscles, subcutaneous tissues and skin. The infection is caused by anaerobic spore-forming bacteria of the genus Clostridium. Although the prognosis of the disease is improved by modern antibiotics and intensive care treatment, the mortality and morbidity is still high, especially without HBOT. A rapid diagnosis has to be made, immediately followed by HBOT, not losing any time by performing initial surgery. The patients are too ill for surgery. Treatment consists of immediate HBOT and antibiotics, followed by, if necessary, surgical measures secondarily. This treatment has proven its use in several thousands of patients treated in this way, with constant good results over the years. Here also an update will be give about the best treatment modality anno 2008 and the evidence based reasons for that from the literature and from our own results. c. Evidence based medicine in HBOT (EBHM) is the combination of old and trusted clinical skills completed by and if necessary also corrected by the critically appraised best available scientific research results and the evaluation of care. The idea is to move beyond clinical experience and physiological principles to rigorous evaluations of the consequences of clinical actions. These evaluations are in too many indications in hyperbaric medicine, non-existent. When looking for the evidence of HBOT in infectious diseases several steps have to be taken. First of all the clinical problem has to be appropriately formulated and the correct diagnosis has to be made. Therefore clinical expertise is required. Nothing can Odstraněno: sthese diseases substitute for clinical expertise in determining the specific considerations relevant to the individual patient. Clinical skills are necessary for EBHM plus an understanding of how the patients values affect the balance between advantages and disadvantages of the available treatment options, and the ability to appropriately involve the patient in the decision. Every decision taken on the basis of education and experience should, however, also be based on results of trials and evaluations. In this way we can define HBOT as a primary mode of treatment or as an adjunctive mode. We must be careful not to move the focus of clinical practice away from the care of individuals to the care of populations, lacking than the ability to apply this knowledge back to our individual patient. The Randomised Controlled Clinical Trial (RCT) is nowadays the gold standard in EBHM, but we must not forget that there is more evidence than that, that has to be taken into account when judging HBOT. Conclusion: After a short description of soft tissue infections in the history of medicine, the state of the art in diagnosis and treatment of some special forms of soft tissue infections, eg. necrotising fasciitis and clostridial myonecrosis is shown. Especially the evidence based character of treatment with Hyperbaric oxygen based on own experiences and reports from the literature is described. B2 Role of Tissue Oximetry in Assessment of Problem Wounds Paul J. Sheffield, PhD; International ATMO, Inc, Nix Wound Healing Center, San Antonio, Texas, USA Transcutaneous oximetry (PtcO2) is commonly used to determine treatment options for problem wounds: surgical remedy, adjunctive hyperbaric oxygen (HBO2), or standard wound care. HBO2 wound healing candidates are selected by assessing whether the wound area is hypoxic and if it will respond to respired oxygen. There are five PtcO2 tests commonly used to evaluate wound patients. 1. Evaluate whether wound healing is complicated by severe hypoxia. Test 1: Measure a PtcO2 baseline air value at 1 atm abs. Hypoxia exists if PtcO2 is less than 40 mmHg. The lower the PtcO2 value, the more severe is the hypoxia. 2. Evaluate whether wound healing is complicated by peripheral arterial occlusive disease. Test 2: Elevate the leg (30˚). Disease is present if PtcO2 remains diminished more than 10 mmHg while leg is elevated. 3. Evaluate whether the wound area responds to respired O2. Test 3: Conduct an oxygen challenge at 1 atm abs. Values on respired oxygen should reach at least 35 mmHg and should rise at least 50% above air PtcO2 values. 4. Evaluate whether the wound area responds to respired HBO2. Test 4 (Alternate to Test 3): Conduct an oxygen challenge at 2-2.5 atm abs. Values on HBO2 should be at least 100 mmHg (preferably 200 mmHg). 5. Evaluate whether the wound is to the point where it will heal without further HBO2 treatment. Test 5: Repeat PtcO2 baseline air value at 1 atm abs in 3-4 wk intervals. Normalized baseline values indicate that healing process is in place. PL 1 The Indication of Hyperbaric Oxygen Therapy and for Orthopaedics in Japan Mahito Kawashima, Takashi Yamaguchi Kawashima Orthopaedic Hospital, Japan In Japan, two types of standards of indication of Hyperbaric Oxygen Therapy (HBO) are set. One is established by Japanese Society of Hyperbaric and Undersea Medicine (JSHUM) and another is by the Ministry of Health, Labor and Welfare for public medical insurance. Most cases are treated with the standard of the Ministry of Health, Labor and Welfare, because of the medical serv. system for the whole nation in Japan. This standard, the disease is classified into two types, emergency/non-emergency. The fee for treatment is different between emergency and non-emergency, multiplace chamber and monoplace chambers. In the case of multiplace chamber, the fee for emergency is \60,000 ( US$545) per usage time of HBO. In the case of monoplace chamber, the fee for emergency is \50,000 ( US$454) per usage of HBO. The fee for non-emergency is \2,000 ( US$18) par usage of HBO, in the case of non-emergency the fee is no different, multiplace or monoplace chambers. The standard of indication of HBO by the Ministry of Health, Labor and Welfare is as following. Emergency: Acute carbon monoxide poisoning, Gas poisoning, Air gas embolism, Decompression illness, Acute peripheral vessel trouble, Thermal burns, Frostbite, Crush injury, Peripheral vessel trouble by trauma, Shock, Acute myocardial infarction, Cerebral embolism, Severe head injury, Disturbance of consciousness or brain edema after craniotomy, Hypoxic brain dysfunction, Intestinal atresia, occlusion of retinal artery, Sudden deafness, Acute spinal cord injury. Non emergency: Malignant tumor with carcinostatic or radiation therapy, Refractory ulcer, Skin graft, SMON, Cerebrovascular disorder, Severe head injury, Motor paralysis after craniotomy, sequelae of carbon monoxide poisoning, Spinal nerve disorder, Osteomyelitis, Radiation necrosis. According to the research on March 2008, 51 multiplace chambers and 805 monoplace chambers have been working in 644 facilities in Japan. Kawashima Orthopaedic Hospital specializes in orthopaedic surgery, has 93 beds for admission and two multiplace hyperbaric chambers. The one has worked since 1984 and the other has worked since 1989. Kawashima Clinic is juxtaposition clinic of Kawashima Orthopaedic Hospital. A multiplace hyperbaric chamber has been there since April 2005. The main indications of HBO in orthopaedic surgery are Gas gangrene, Acute spinal cord injury, Crush injury, Osteomyelitis and Refractory ulcer. HBO is expected for these disorders as inhibition and prevention for infection, promotion of recover of damaged cells, promotion of angiogenesis and improvement of edema. The total number of cases is 7,324 cases from 1981 to 2007 in Kawashima Orthopaedic Hospital. In these, Main orthopaedic disorders are 630 osteomyelitis, 183 crush injury, 76 spiral cord injury, 41 gas gangrene and 375 ulcer/necrosis. PL2 The Use of “Deep Stops” In Preventing Precordial Detectable Doppler Bubbles in Recreational Scuba Divers 1 2 3 Frans J. Cronjé, MBChB, MSc , Alessandro Marroni, MD , Peter Bennett, DSc, PhD 1. DAN Southern Africa; 2. DAN Europe; 3. International DAN Decompression illness (DCI) affects some 1500 divers every year. Although DCI is relatively rare, two thirds of these divers develop neurological manifestations. The empirical use of additional deep safety stops by recreational divers has become popular in recent years. However, these arbitrary procedures have not been evaluated for safety and effectiveness. In order to establish appropriate and practical recommendations relevant to typical recreational divers, a series of studies were designed to evaluate the effect of adding deep stops of varying durations (1 to 10 minutes) at half-the-depth of the dive – Half Depth Deep Stops (HDDS) – with or without shallow stops at 5 meters (1 to 10 minutes), in the typical recreational diving range of 18 to 40 MSW. The introduction of a HDDS generally reduced post-dive precordial Doppler detectable venous gas emboli (PPDDVGE), with an overall decrease of High Bubble Grades compared to the same dives without HDDS. The data suggest that the inclusion of a HDDS on dives between 25 and 30 MSW, with Bottom Times of 25 minutes or less (i.e., the typical dive profiles performed by recreational divers) reduces decompression stress as measured by PPDDVGE. The value of HDDS in reducing PPDDVGE was not as evident for shallower (18 – 21 MSW) and deeper dives (40 MSW), when brought to the limit of the respective No-D bottom time according to USN Dive Tables, and showed conflicting results. Further investigation is now being planned to unravel the apparent ambiguity of HDDS at these depths. PL 3 An Overview of Diving and Diving Medicine in China Tao Hengyi, Sun Xuejun, Liu Wenwu, Sun Qiang, Mao Ding Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China This article presents a brief history of diving and diving medicine in China, especially the developmental track of diving and diving medicine, as well as symbolic achievements in this field since the founding of New China. It also provides an overview of research on submarine escape or rescue in the Chinese Navy. 1. A brief history of diving and diving medicine in China Diving is an important means of human fighting against and adapting to Nature. But there is no textual research about when and where diving was started and who pioneered it. According to Shang Shu (the Book of History) published in the st 21 century BC in China, there were already people who used pearls and beads from seabed as tributes to Yu Empire in st ancient China, indicating that the Chinese people started their diving activities as early as in the 21 century BC. Nevertheless, the primitive purpose of human diving was for survival rather than for material contributions. During nearly 50 years from 1900 when China began using modern diving apparatus (Hookah diving apparatus and manual pumps) to the eve the founding of new China, there were only a few diving units with fewer than 100 divers and shabby equipment, much less diving safety operation regulations, and there were few people who had professional knowledge of diving medicine, let alone diving medical supervision systems. The maximum diving depth was about 20 meters. Diving accidents happened frequently, and the incidence of diving disease was high. Once divers were diseased, nobody helped them. Therefore, many divers were handicapped by lifetime diving illnesses, and the case-fatality rate remained at a high level. After the founding of new China, under the attendance and care of the Chinese Communist Party and the people’s government the diving cause in New China has a new lease of life and develops flourishingly. Diving facilities are being built up in succession. Right after the founding of the Chinese Navy, arescue-salvation force was set up, which has been expanded and reinforced increasingly. The Ministry of Communications established marine rescue & salvage bureaus in Shanghai, Guangzhou and Yantai. The Ministry of Petroleum and the Ministry of Railways also established specific diving units. The number of professional divers is on the increase and their diving skills are becoming more sophisticated. Diving technology has now been widely used in economic constructions (such as tapping and exploitation of seabed resources), military activities (such as submarine rescue and underwater reconnaissance), scientific research and sports. Diving medicine has been developing out of nothing and expanding increasingly. In 1954 the Institute of Naval Medicine was inaugurated in China, which includes a research department specialized in diving medicine. In 1960, the Faculty of Naval Medicine was extended in Shanghai Second Military Medical University, which is the only institution of higher learning that can train diving physicians in China. Today diving medicine in China is essentially appropriate to the development of diving technology and the demand of divers’ safety and health. To facilitate academic exchange in diving and diving medicine, in 1980 Shanghai took the lead and established the first Hyperbaric Medicine Society in China. In 1982 the Chinese Navigation Society also established the Diving Rescue & Salvage Committee. As you know, Chinese Society on Hyperbaric Medicine was established in 1992. Before the Cultural Revolution, China carried on a close-door policy and did not know about the world, and the world knew even less about China. Before 1987 when Professor LI Wen-ren and NI Guo-tang, two senior masters in diving th and hyperbaric medicine in China, first attended the 9 International Congress on Hyperbaric Medicine, not a few international scholars in this field even had no idea about whether China had diving operation deeper than 30 meters. So, when Professor Ni presented his MSc thesis at the meeting, a delegate even raised such a question, “Is there diving operation deeper than 30 meters in China?” It is DENG Xiao-ping’s open-to-the-outside-world policy that enables the world to know about China and enables China to know about the world. Today, I’d like to take this opportunity to let the world know more about China, especially about China’s diving and diving medicine. 2. The developmental track of diving and diving medicine in New China The first article about diving decompression sickness (DCS) was officially published in 1955. In 1960 China began using hyperbaric equipment for clinical hyperbaric oxygen treatment. The research and development of the surface decompression table and the underwater stage decompression table of air diving were started in 1961 and ended with success in 1965. They were put to practical use by the Chinese Navy in 1977. Civil diving operations in China also follow these tables. The use of the Navy decompression tables plays an extremely important role in reducing the incidence of DCS and in guaranteeing divers’ safety and health.160-msw deep heliox diving training was first started in 1962 in China. During the construction of Nanjing Changjiang Bridge in 1964, a total of 544 time-person air diving operations were undertaken to a depth of 66 meters, where the technique of surface decompression using oxygen was used without causing a single case of DCS, reaching the world advanced level. The first practical use of deep heliox diving was in 1965 in inspecting the quality of bridge piers, reaching the depth of 83 meters. In 1969, the scuba diving equipment was developed successfully in China. The first experiment of 200-msw heliox simulated diving was undertaken in 1970. In 1973 two divers used air diving into a mud cave equivalent to 92 msw to salvage a lost large drill. Although the attempt failed because of nitrogen narcosis, this was the greatest depth that air diving has been reached in the world. In 1975 deep heliox diving reached 156 mfw in China. In 1976 the first experiment of human simulated air saturation diving was undertaken, the saturation depth being 20 msw. In 1977 the first experiment of human simulated nitrox saturation diving was undertaken, reaching the saturation depth of 20-36.5 msw. During the experiment, air excursion diving successfully reached 50-70 msw in all 181 time-persons. In 1977 a diver, Mr Long, air dived to 64 meters and worked at the bottom for 25 min. But unfortunately, he was out of control and blew up to surface suddenly. As soon as he reached surface, he was paralyzed and comatose. To save this severe DCS diver, Mr. MU Ze-ling, a military diving physician accompanied the patient to the hyperbaric chamber, where the pressure was raised to 11 ATA using compressed air to meet the need of the patient’s condition. They stayed at the maximum pressure for 60 min, and the total duration of decompression was 85 h and 55 min. The patient was saved successfully. This is the maximum air pressure to which humans have been exposed. This practice reverses the previous inference that “human exposed to compressed air ≧ 11 ATA is bound to cause unconsciousness and narcotic coma”. Generally speaking, when the chamber pressure is ≧6-7 ATA, the mixture of heliox should be inhaled to prevent nitrogen narcosis. But as most hyperbaric chambers in China did not have the condition of inhaling heliox at that time, inhalation of 11 ATA compressed air was the last straw to save the patient’s life. This is also a full reflection of how dedicated the Chinese medical workers are in rescuing the wounded and saving the dying. Mr. MU is not only a military diving physician but also a teacher of diving medicine in the Department of Diving Medicne, Faculty of Naval Medicne, Second Military Medical University, Shanghai China. Owing to his selflessness and dedication, Mr. MU was honored as “Model Teacher” in 1978 by the Central Military Committee. In 1979 two experiments of simulated nitrox saturation diving were undertaken in China: the saturation depth of the first experiment was 36.5 msw for 26 days, during which air excursion reached 60-75 msw in 76 time-persons, and the saturation depth of the second experiment was 50 msw for 12 days. Both experiments were successful, taking the lead in the world both in nitrox saturation depth and duration of nitrox saturation exposure. Up to now, no nitrox saturation diving experiment has been reported to exceed the record of 50 msw and 12-day stay. In the same year, an on-the-spot nitrox saturation diving operation was performed, reaching 36.5 msw and staying at saturation depth for 6 days, during which air excursion reached 64 msw in 14 time-persons. Marine in situ practices in China have demonstrated that the results of these simulated nitrox saturation diving experiments are convincing, reliable and practicable. Still, in 1979 the first experiment of simulated helioxsaturation diving was undertaken, reaching the saturation depth of 120 msw and 2-day stay at saturation depth, during which the excursion depth reached 165 msw in 3 time-persons. During 1977-1980, a famous salvage project was completed successfully in salvaging a Japanese sunken ship called “AWAMARU”in a depth of 48-69 msw. The operation used air diving throughout, involving 13604 time-persons. This has been the largest and longest salvage project in China, in which only 80 cases of DCS occurred with an overall incidence of 0.59%. In 1980 three Chinese Navy divers succeeded in locking out from a submarine at a depth of 205 msw during their study in France Navy. In 1980 the first treatment table for air diving DCS was developed in China and has been proved to be therapeutically good. In 1981 an experiment of simulated heliox saturation diving was undertaken, during which three divers stayed at a depth of 302 meters for 43 h, and returned to surface safely and successfully after 12-day decompression. In 1982 the first deep submergence rescue vehicle (DSRV) designed and manufactured by China with self-dominated intellectual property rights cruised its first voyage. In 1989 an experiment of simulated heliox saturation diving was undertaken by the Chinese Navy, in which four divers stayed at the depth of 350 msw for 3 days (72 h and 10 min), and excursion diving reached 370-374 msw in 8 time-persons. After 14-day decompression all four divers returned to surface safely. That was the deepest record of saturation diving in Asia at that time. In 1997 the Chinese Navy conducted a heliox saturation diving training on the sea, the storage depth of which was 120 mswn for 48 h, during which the excursion dive reached 149 msw in 8 time-persons. In 2001 the Chinese Navy conducted two heliox saturation diving trainings. The saturation depth of the first training was 140 msw for 48 h, during which the excursion dive reached 166 msw in 8 time-persons, and that of the second training was 160 msw for 48 h, during which the excursion dive reached 182 msw in 4 time-persons. It was in 2006 that saturation diving was first used for commercial purposes. During October to December 2006, Shanghai Salvage Bureau undertook a commercial heliox saturation diving operation for replacing oil pipes at a depth of 96 msw in South China Sea; the maximum depth of excursion diving was 105 msw. During August to November 2007, Shanghai Salvage Bureau undertook a 115-msw commercial heliox saturation diving operation in the South China Sea Oil Field for clearing, measuring and installing oil pipes; the maximum depth of excursion diving was 124 msw. In April 2008, the same company undertook a 135-msw commercial heliox saturation diving operation for the same tasks as the previous ones; the maximum depth of excursion diving was 153 msw. In these commercial operations, PPO2 at the saturation depth was maintained at 0.4-0.5 ATA; PPCO2 was maintained at <0.0055 ATA; chamber temperature was 28.1-30.5℃; and relative humidity was 56.6-81.1%. During the process of decompression, PPO2 in the chamber was raised to 0.6 ATA. The whole compression was divided into two phases: at first, the pressure was raised to 5 msw using 20/80 He-O2, and the second, the pressure was continued to compress to saturation depth using 2/98 He-O2 at a rate of 1-2 m/min.The saturation decompression rate was controlled at 40-60 min/m. During these commercial saturation diving operations, except two cases of skin infection, no other medical problems occurred because of excellent diving medical supervision. 3. Submarine Escape in China Submarines are among the most important combat weapons for the navy and specially favored by the navy because of their good stealth and strong assaulting ability. But like aeroplanes that may be threatened by air crashes and automobiles that are likely to be involved in road accidents, submarines have their own problems. In exercises or combat operations, submarines may run on collisions and rocks, or have mechanical problems, or lose the floating ability when they are attacked by the enemy. It is roughly estimated that from 1900 to 2001 a total of 434 submarine accidents happened during the peace-time training exercises in American, Russian, British and French armed forces, excluding those that are not reported because of confidential reasons. These accidents involved 176 sunken submarines at least killing 2900 crew members. The most astonishing accident was Russian Kursk submarine due to torpedo explosion on August 12, 2000. The submarine sank to the 108 msw sea floor killing 118 soldiers and officers on the ship. To preserve living strength, timely and effective rescue measures must be taken to help the survivors escape from the wrecks. Therefore, how to help crews escape from the wrecks has long been the focus of attention for navies of all countries. The earliest study on submarine escape techniques and methods in the world was in 1851. As the submarine force in China was established at a relatively late time, the study on submarine escape techniques and methods was started in 1960, but has been progressing quickly. In 1970, type 2-8 submarine escape equipment and the decompression table for submarine escape were developed successfully, by which individual escape in the depth of 120 msw can be effected. Individual escape follewed by mass escape would provide escape from a 200 msw depth. Subsequently, studies on fast ascent and its medical supervision were started. During 1976-1979, simulated 10-310 msw animal experiments were conducted, and in 1980 experiments were performed on humans. In 1983, the human simulated 100 msw fast ascent experiment was accomplished successfully. In 1987, the submarine escape training from the depth of 52 msw through the torpedo tube was accomplished. This is an important creation of the Chinese Navy, because fast ascent from submarine in other countries is implemented through a specific one man escape chamber (OMEC) on the submarine. It has been confirmed by practice that submarine escape from torpedo tube is feasible. In 2002, the study of simulated 153 msw fast ascent was successfully accomplished and created the deepest record of fast ascent for submariners in Asia, thus upgrading China’s research in this field to the world advanced level. PL4 DCS Incidence of Commercial Dive Works In Japan and Evaluation of the Profile on Multi-Level Diving By Integration of Nitrogen Accumulation in Each Body Tissue 1 1 1 1 1 Yoshihiro Mano , Masaharu Shibayama , Masahisa Komiya , Shin-ichiro Togawa , Nobuo Yamami , Kazuyoshi 1 2 Yagishita , and Mahito Kawashima 1. Hyperbaric Center, Tokyo Medical & Dental University Hospital, Japan 2. Kawashima Orthopedics Hospital, Japan Commercial dive work has been strictly controled in Japan, so there were few accident cases recently. According to our data which we have consulted since 1995, the DCS incidence was 0.095 % ( 31 bends per 32,639 dive ) in air dive within 60 m depth and 0.099 % ( 3 bends per 3,038 dive ) in heliox dive works from 30 to 90 m depth. In saturation diving work by heliox within 200 m depth, it has been 0.38 % ( 2 bends in 529 dive ) since 1983. We have used different dive methods like as scuba, air line, bell and saturation. And also deffernt decompression tables like as the Japanese or U.S. Navy standard, surface, and/or our original tables included saturation, however it depends on the dive conditions. This result has been evaluated as considerably better than other commercial dive companies in Japan. However in recrational or fishermen divers, there have been recognized near 40 to 50 diving accidences and 20 to 30 divers have died in each year. And some of them have died by the cause of DCS or AGE. Their diving profiles and the continued decompression methods are obviously risky or self-seeking. So we have developed a new analyzer system to evaluate dive profile through integration of the nitrogen gas accumulation in each body tissue from 5 to 240 min half saturation time. We can calculate the accumulated tisue gas tension during diving activity in each 5 second and can judge whether the diving profile has the risk of DCS or not at the surface by means of compareing it with Workman’s M Value. Japanese standard regulation has now been looking again and it will bocome to better and safer working field in near future. PL5 Traumatic Spinal Cord Injuries – is There a Role for HBO? 1 2 Jochen Freier , MD; Armin Kemmer , MD 1. Consultant für Diving and Hyperbaric Medicine (EDTC), Anaesthesiology and Intensive Care, Vice President of the German Society für Hyperbaric Medicine (GTUEM), Tagesklinik Hofheim, Germany 2. Consultant für Diving and Hyperbaric Medicine (EDTC), Anaesthesiology and Intensive Care, Habach, Germany Spinal cord injuries are still among the conditions, which are extremely difficult to treat. Damage of the nerve strands embedded in the lumen of the spinal cord often results in permanent paraplegia. In addition to direct damage to the spinal cord through ruptures and crushes, the injured tissue suffers from a lack of oxygen in the aftermath of an accident. This causes the cascading release of various tissue hormones like cytokines and prostaglandins, which lead to the swelling of tissue, local inflammation and, ultimately, cell death. These processes cause additional damage to the site of the injury and often result in irreversible damage. The basic principle of surgical therapy for thoracic and lumbar spinal cord injuries relies on decompression, reposition and the subsequent stabilization of the unstable segment. In addition, early administration of methylprednisolone, ideally already at the site of the accident, is recommended. These treatments ultimately aim at improving the tissue’s blood supply and restoring aerobic cell metabolism as quickly as possible. This is the rationale for hyperbaric oxygen therapy. Analogous to the treatment of crush trauma, HBO results in a rapid reoxygenation of tissue, which helps to maintain viability and can thus reduce the loss of function. CNS injuries will cause local changes within a few minutes. These changes not only occur in neurons but also in glia cells. In contrast to CNS neurons, peripheral neurons are able to cover a greater distance downstream of the site of the injury, and there, to form synapses to transfer excitation signals to their target cells. By contrast, CNS neurons stop the process of regeneration immediately once they have reached the site of the injury. The rapidly forming gliatic scar prevents continuing axonal growth (Müller et al. 2005, Stichel et al. 1998). The inhibition of cellular collagen synthesis leads to the permeability of the lesion scar for regrowing axons (Müller et al. 2005). In a study by Murakami (2001), the neurological functions of rabbits with spinal cord ischemia improved when HBO therapy was initiated after 30 minutes. However, no improvement was seen when therapy was started after 6 h. Huang (2003) also observed an improved neurological recovery from spinal trauma in rats when HBO therapy was given. Likewise, Gamache (1980) could demonstrate a more rapid recovery of motor scores in spinal cord trauma after early HBO therapy. In the Trauma Center Murnau, 35 out of 40 patients with acute traumatic paraplegia showed a significant improvement under hyperbaric oxygen therapy. Asamoto et al (2000) could also achieve a significant improvement under hyperbaric conditions. Likewise, Ishihara et al. (1997) observed a positive effect for the application of hyperbaric oxygen therapy. In the Trauma Center Murnau a randomised study design was developed, which is presented herein. The positive effect could be confirmed in several trials. If this effect is solely due to the swell-reducing effect and the improved oxygenation has not been adequately studied. The application of hyperbaric oxygenation after ordinary injuries has shown that its application results in reduced scar formation, i.e. collagen production, which could be another reason for the positive effect of hyperbaric oxygen therapy in spinal cord injuries. Further studies on the possible changes in collagen production under hyperbaric conditions would be desirable. PL6 Hyperbaric Oxygen Therapy in Acute Traumatic Peripheral Ischemic Diseases Wang Gang M.D. Ph.D. Emergency Dept & Hyperbaric Oxygen Dept. First Affiliated Hospital, China Medical University, Shenyang, China HBO can be used as adjunctive therapy for trauma patients with crush injury, compartment syndrome, and other acute traumatic peripheral ischemia (ATPI). The rationale for HBOT is the need to counter the effects of tissue hypoxia arising as a direct consequence of vascular injury and as a secondary consequence of trauma and infection. Physiological and Pharmacological Basis of HBO Therapy for ATPI 1.Hyperoxygenation. 2.Increasing in oxygen diffusion distances. 3.Promoting cellular proliferation, accelerating collagen deposition. 4.Stimulating capillary budding and arborization. 5. Modulating nitric oxide production. 6.Possibly preventing iNOS up-regulation. 7.Enhancing oxygen radical scavengers, reducing neutrophil endothelial adherence, thereby decreasing I/R injury. 8.Vasoconstriction and reduction of edema. 9.Maintenance of cellular function. 10. Accelerating microbial oxidative killing. 11.Improving select antibiotic exchange across menbrances. 12. Interfering with bacterial propagation. Crush injury/ Skeletal muscle-compartment syndromes Crush injury and skeletal muscle-compartment syndrome (SMCS) are two related conditions that arise as a consequence of trauma. Common features include ischemia and hypoxia at the injury site, a gradient of injury, and the potential for self perpetuation of the injury. 1. Etiology 2. Pathophysiology 3. Ischemia 4. Edema 5. Gradient of injury The principles of treatment for crush injury Surgical and orthopedic interventions for crush injury are based on the type of injury and should be independent of the decision whether or not to use HBO. That is, HBO should not be used as an excuse to delay surgery or not do surgery. However, when the decision to use HBO is made, it should be started as soon after the injury as possible. If there are delays in starting surgery, And HBO is available, it should be given while awaiting the availability of the operating room. Scheme of Adjunctive HBO Therapy There is no single ideal protocol for using HBO in crush injury. Treatment schedules are largely a function of clinical judgment and experience. The maintenance of tissue oxygenation is critical in the immediate post injury period. The management of Skeletal-Muscle Compartment Syndrome The diagnosis of compartment syndrome is based on the mnemonic of “five Ps. The monitoring of the pressure in compartment is important for evaluation of the condition and progression of injured tissue. The principle of therapy for SMCS Management of the established SMCS is fasciotomy. This decompresses the muscle and immediately lowers the compartment pressure, thereby restoring perfusion to the contents of the compartment. Convincing laboratory studies and clinical researches show statistically significant reduction, in loss of muscle function, metabolites associated with muscle injury, edema and muscle necrosis with HBO. Scheme of Adjunctive HBO Therapy HBOT in Flap Reconstruction and Skin Grafts Normal skin grafts and flaps with adequate blood supply do not requir HBO. HBO therapy is extremely useful where the skin grafts or flaps suffer from compromised microcirculation or hypoxia. The benefits of HBO on flaps arise from a systemic elevation in oxygen tension rather than a local effect. In addition, HBO therapy prevents neutrophil adherence and subsequent vasoconstriction following ischemia. Compromised Flaps Too frequently, a compromised flap is allowed to progress over the days following surgery until visible signs of necrosis obviate the use of HBO; delayed treatment with HBO cannot revive dead tissue. The resulting disappointment, as well as the associated patient dissatisfaction, can be avoided by rapid diagnosis of the flap problem and early involvement of the hyperbaric physician. Diagnosis of Flap Compromise Compromised tissues are usually hypoxic with oxygen tension of less than 30mmHg. With flaps, the etiology of the flap ischemia and compromise may result from technical causes including improper flap design, closure with tension, pedicle or tissue damage, hematoma, or prolonged operative ischemia. Non-technical causes include arterial vasospasm, flap edema, post-operative infection, and patient deterioration. Special flap problems include low arterial inflow, total arterial occlusion, partial venous congestion, and total venous occlusion. HBO Treatment for Compromised flaps The use of HBO therapy is appropriate only when: 1. The flap problem has been defined 2. There is documented perfusion of flap 3. Appropriate surgical salvage measures have been considered first 4. HBO therapy can be performed in an expedient manner Scheme of HBO therapy for compromised flaps HBO therapy for compromised flaps should be based on the type of flap, classification of ischemia, and effects of treatment of HBO, which decided HBO therapy regimen. HBO Therapy for I/R injury Initially, the focus in acute ischemia caused by trauma should be restoration of blood supply. Replantation should be completed as soon as possible with repair of disrupted arteries and fasciotomies if necessary. Both clinical experience and the previously summarized research experience advocate for HBO treatment in I/R injury and results are positive and often dramatic in our experience. If muscle ischemia time is greater than four to six hours there is a significant risk of severe I/R injury, muscle necrosis, and loss of the affected extremity. Skin is more resistant to I/R injury but it is likely to occur after eight hours of ischemia as in the case of a digital amputation. We, therefore, recommend HBO therapy for all patients with muscle ischemia time greater than four hours and skin ischemia time greater than eight hours. A retrospective controlled review of compromised free flaps and replanted extremities with greater than six hours of primary and any secondary ischemia showed 100% salvage rate when HBO therapy was initiated within 24 hours of injury and 0% salvage rate when HBO therapy was initiated greater than 72 hours after the injury. The major effects of I/R injury are felt to occur within the first 4-7 hours of reperfusion. Since some irreversible tissue damage occurs after this time it is important to take patients to receive HBO therapy immediately postoperatively, even if they are still intubated. Conclusion Are there evidenced-based criteria to justify the use of HBO in crush injuries and SMCS? When the American Heart Association criteria are used, HBO meets the criteria for a Category 1 indication. With the ten-point evidenced-based evaluation systemⅠdevised, crush injuries receive seven points and compartment syndromes five points. A score of five points or more qualifies the intervention as evidenced-base. PL7 The Application of Hyperbaric Oxygen Therapy in Critical Disorders Niu Ko-Chi Department of Medical Research and Department of Hyperbaric Oxygen, Chi Mei Medical Center, Tainan, Taiwan, China Hyperbaric oxygen therapy (HBOT) has been widely applied in severe clinical disorders. However, HBOT is suggested to be hold when body temperature of the patients is higher than 38.5°C and whether HBO may exaggerate oxi dative stress as results of tissue destruction and subsequent ischemia-induced inflammatory response in critical disorders remained to be investigated. MATERIAL AND METHOD: In order to study the effect of HBO on oxidative stress in critical condition, we used the animal model of Heat stroke (HS) in Sprague-Dawley (DS) rats to mimic multiple organ failure and high body temperature. Adult male SD anesthetized rats were exposed to an ambient temperature of 43 °C to induce HS. The mome nt in which mean arterial pressure began to decrease from peak levels was arbitrarily taken as the onset of HS. rats were randomized to several groups and given a) no resuscitation (NBA, normobaric air) after onset of heatstroke; b) HBO (100% O2 at 2.5 ATA for 1 h, 2 h, or cyclic administration); c) hyperbaric air (HBA; air at 2.5 ATA for 1 h); d) normobaric hyperoxia (NBHO; 100% O2 at 1.0 ATA for 1 h); or e) hyperbaric oxygen 8% (HBO 8%; hyperbaric 8% O2 at 2.5 ATA for 1 h). RESULTS: Survival time was 19 ±1, 131 ± 18, 72 ± 14, 68 ± 12, or 45 ± 11 min, (n = 10) respectively for NBA, HBO 1h, HBA, NBHO, or HBO 8% group. The HS-induced arterial hypotension, bradycardia, decreased arterial levels of pH, PaO2, and SO2%, increased arterial levels of TNF-alpha, and increased values of cellular ischemia and damage markers, and neuronal damage scores in the cortex were significantly reduced by HBO resuscitation. The cerebrovascular dysfunctions (evidenced by hypotension, intracranial hypertension, and cerebral hypo-perfusion), hypercoagulable state (evidenced by increased values of activated partial thromboplastin time, prothrombin time and D-dimer in plasma), and tissue ischemia/injury (evidenced by increased levels of creatinine, serum urea nitrogen, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase in plasma, and dihydrobenzoic acid, lipid peroxidation, and oxidized form glutathione/reduced-form glutathione ratio in hypothalamus) that occurred during HS were all suppressed by HBO therapy immediately after the onset of HS. CONCLUSION: We successfully demonstrated that HBO and to some extent, HBA was found beneficial in resuscitating experimental HS. HBO effectively reduced HS-induced arterial hypotension, plasma TNF-alpha overproduction, and cerebral ischemia and damage and improved survival. The current reuaults indicate that HBO may resuscitate rats that had a HS by decreasing multiple organ dysfunction and brain oxidative stress. We report the case of a patient who displayed a classic HS with multiple organ dysfunction and hypercoagulable state resistant to conventional whole body cooling and antipyretic therapy, necessitating the use of HBOT to rescue from death. PL8 Hyperbaric Medicine: an European Perspective Daniel Mathieu Centre Hyperbare, Hôpital Calmette, Centre hospitalier Régional et Universitaire, Lille, France Hyperbaric Medicine has a long history in Europe since the first mention of potential therapeutic application of high ambient pressure for therapeutic purpose goes back to the seventeenth century. Modern application of Hyperbaric Oxygen (HBO) started in the late 1950's in the Netherlands for anaerobic soft tissues infections and in the United Kingdom for carbon monoxide poisoning. Since then, a large number of hyperbaric centers have been implemented throughout Europe, an intense experimental research has been performed and a large clinical work has been done. However, since the mid 1980's and the appearance of the Evidence Based Medicine, European hyperbaric physicians felt the need to improve their organisation and the quality of care delivered by HBO centers. This lead to the development of the "European Committee for Hyperbaric Medicine" (ECHM), which goads are to define commonly accepted indications for HBO, to issue standards for clinical practice, personnel education, technical procedures and safety. There goals were achieved through the organisation of Consensus Conferences, Workshops, reports from ad hoc sub-committees. As a representative body near the European Union, ECHM was successful in promoting an important research program (COST B14) and the issue of a European Norm for therapeutic hyperbaric chambers (EN 14931). Nowadays, even if not similar everywhere, a typical European Hyperbaric Centers is hospital based and implanted in or near an Intensive Care or an Emergency department and is composed by an air-compressed multiplace hyperbaric system, an hospitalization ward and an out patient clinic. Intensive care patients are commonly treated by HBO and considerable efforts are done to closely monitor treatment effects through, for example, oxygen pressure measurements or blood flow at the targeted spot. PL9 The pretective effect of Hyperbaric oxygen preconditioning on ischemic/hyoxia injury Xuejun Sun, Hengyi Tao, Weigang Xu, Runping Li Department of diving medicine, Second Military Medical University. Shanghai, China Hyperbaric oxygen has been widely used as a primary therapy in patients with carbon monoxide poisoning, decompression sickness, and arterial gas embolism, and as an adjunctive therapy for the treatment of various diseases accompanied by impaired oxygen delivery Interestingly, Hyperbaric oxygen has also been tested to produce ischemic tolerance in stroke models and in organs such as spinal cord, heart and liver, suggesting that Hyperbaric oxygen produces a wide scale protective effect, and may be a safer preconditioning stimulus as compared with other stimuli such as hypoxia. Yet the mechanisms underlying its neuroprotective effects remained poorly defined. This paper review the hyperbaric oxygen preconditioning references and our own some experiment results recently. And try give some suggestion for further research in this field. PL 10 Disruption of Viral Pathogenesis Following Patient Exposure to Hyperbaric Environments with Altered Inspired Gas Mixtures Stephen D. Guthrie, MD, PhD and Barbara R. Guthrie, MD Designed Altobaric Research Institute, Livonia, Michigan, USA Introduction There is a broad spectrum of susceptibility to, and virulence of, viral infections. Some of this variance is controlled by the 8,13,25,29,46,50 43,44,50 while some is the consequence of the host’s prior life experiences . This inconsistency host’s genetics in severity of clinical response to the same infecting agent has prompted many inquires into the innate capacities of the 3,4,9,24,51 mammalian cell to resist such infections . Harnessing the power of these inherent anti-viral mechanisms is a compelling therapeutic stratagem. Further, non-pharmacologic interventions avoid the untoward consequences of all drug-based regimens, these being, direct toxicity, drug interactions, and the universal aftereffect of inducing resistant viral mutations. 2,6,8,33 The relative intolerance of the infecting pathogen, compared to the infected host, to marked environmental changes suggests an attractive tactic. Saturation divers, residents of undersea habitats and orbiting space stations, and the participants in conventional hyperbaric therapy routinely experience such changes in their ambient milieu. Environmental manipulations producing direct inhibition of viral pathogenesis, or secondary augmentation of immuno-competence, would be effective clinical instruments. The Food and Drug Administration’s first approval of a controlled clinical trial studying HIV/AIDS patients undergoing hyperbaric chamber treatments is a step towards this goal. Literature Review Relevant publications are categorized either as clinical descriptions of viral infections purposely treated under hyperbaric conditions, or as mechanistic postulations as to how such therapeutic benefits could have occurred. 1. Experimental and Clinical Reports: Using either tissue cultures or experimental animal models, the effects of hyperbaric oxygen exposures on viral 22,38,47 pathogenesis appeared in the literature more than 40 years ago . A wide variety of viral pathogens have been 11,22,44 examined including DNA viruses, RNA viruses, and ones with or without envelopes . Not all types of hyperbaric 28 exposures evoked a positive effect , but consistently the encounter produced some effect on viral penetration, replication, or expression. As early as 1974 experiments were designed to delineate those anti-viral effects caused by the chamber 22,28 pressure versus those induced by the gas composition . In 1997 a 3-year compilation of individual HIV/AIDS patients treated with hyperbaric oxygen exposures for symptomatic indications documented clinical improvements beyond that which could be expected from their concurrent anti-retroviral 41 23 treatments . The current FDA trial on HIV/AIDS patients treated with daily hyperbaric exposures is conducted using air before refinement of the inhaled gas mixtures is introduced. Several individual cases have also been published chronicling improvements in patients with non-retroviral infections such 17 20 as viral encephalitis and viral hepatitis . Treating the latter clinical condition evolved into a limited prospective study 30 with positive results . The completion of a prospective, randomized trial in viral hepatitis will further our knowledge of whether these particular viruses are inhibited by the marked redox imbalance induced by oxygen under high pressures. 2. Mechanistic Proposals: * Direct virocidal effects: With the possible exception of the tantalizing prospect that nitrous oxide (NO) might have a 1,18,49 direct virocidal effect , most of the gases with proven virus-killing capacity would be too toxic for patient 10 administration . It is possible that gases with virostatic potential could trigger the host’s intrinsic mechanisms for defusing 15,44 the lethal viral effects but that is a speculation without any supportive observations. * The “membrane” phenomenon: The observed “membrane” effect of gases under pressure is a general biological 27,48 phenomenon long embraced by hyperbaric medicine . Such effects can be at the cell’s surface or within any membrane-encased intracellular compartment. The ion channel effects of gases, particularly inert gases, have been 42 extensively studied in excitable membranes but those same perturbations would occur at all membranes . Particularly intriguing is the finding that xenon, a very inert noble gas at 1 ATA, actually becomes a general anesthetic agent under 32 hyperbaric conditions . Membrane modeling based on the stereoscopic delineation of anesthetic gas-receptor 8 interaction may help select which gases should be studied under pressure. The latest generation of highly active 36 antiretroviral therapy (HAART) drugs specifically inhibits membrane penetration by the virus . This clearly is another battleground wherein environmental composition could be a valuable addition to the therapeutic armamentarium. * Enhanced immuno-competence: The effects on the immune system of marked alterations in ambient pressure and 12 inhaled gas composition have been known for many years . These particularly have been studied with regard to the 45 reduced immuno-competence observed in long-term occupants of space environments . There are also laboratory 38,47 observations of increased pathogenicity of certain viruses under hyperbaric conditions . Conversely, given the proper 20,21,25 pressure/gas combination, viral pathogenicity can be diminished and immuno-competence can be strengthened . Again, the summary statement here, as with the potential for membrane phenomenon manipulation, is that changes in the host’s ability to address viral infections can be augmented by the ambient conditions. The search must be for that ideal environment, with the supposition that the environment with the greatest viral lethality will likely be determined by the inherent biology of the specific offending virus. * Redox balance manipulation: Another general organism response to hyperbaric environments is imbalance of the redox equilibrium provoked by the reactive oxygen species generated in profusion under such conditions. There are clinical anecdotes documenting viral 17,20,30 hepatitis patients’ improvement following hyperbaric oxygen therapy . Several laboratory models directly implicate 14,25,31 the reactive oxygen species as the anti-viral instrument . These two synchronous lines of investigation have come 6 together as a definitive postulate on disease intervention in the class of enveloped viruses . Further investigation will reveal if the reactive oxygen strategy can be employed in all viruses, or only certain classes, or at only certain vulnerable watershed moments in the course of viral infections. As clinicians, the patient trial processes should be started even as laboratory investigators pursue the intricate mechanisms whereby these beneficial effects occur. * iRNA mechanism(s) The mechanism, or more properly the family of mechanisms, that act to derail, mute, or inactivate the pathologic genetic material introduced by a virus have been formally denominated the “silencing interference RNA” system. Several acronyms exist (siRNA, iRNA, RNAi) all alluding to this same process. The most compelling scientific information from a clinical standpoint derives not from bench-top laboratory experiments or patient 29,35 treatment examples but from descriptions of genetic variances which have resulted in individuals , or whole 13,46,50,51 populations , having the inherent capacity to “ignore” the fatal viral infusion. In a word, those fortunate cells or individuals are capable of “silencing” the fatal genetic instructions. Many of these fortunate adaptations have likely 50 29 evolved over millennia but they may appear spontaneously, and quite suddenly . There are vigorous attempts to harness the siRNA mechanism(s) for immediate clinical utility, and there are sophisticated laboratory tools for quantifying changes in these processes. It should at least be born in mind that accessing changes in the siRNA system(s) could be done contemporaneously with the other clinical trials suggested here. Research Protocol In April of 2005 the Food and Drug Administration approved the submitted protocol for, and issued permission to proceed 23 with, a Phase-II Clinical Trial on the effects of hyperbaric exposures in patients with HIV/AIDS . That regulatory body 40 thus accepted the results of the Phase-I study on healthy volunteers . Further, that approval signaled the FDA’s recognition of the scientific premise that such altered environments would positively influence the progress of this disease based on published laboratory experiments and clinical case reports. The FDA’s assessment of the proposal and protocol allowed them to assign a “Non-Significant-Risk” (NSR) categorization to this trial. This NSR designation obviates inclusion in the study of components assessing sensitivities and allergies, drug interactions, and risks associated with concurrent medical conditions or treatments. The results of this Phase-II study will determine the design and sample size of the Phase-III trials to determine final efficacy. Discussion Any definitive discourse must await the results of the Phase-II Clinical Trial. In the absence of those results any discussion here ought simply to declare, and reinforce, the reasons why this study is proceeding. Vigorous and colorful discussions will undoubtedly follow completion of this trial, discussions regarding the meanings, the mechanisms, and the direction(s) of the next investigational steps. For the moment, the following assertions should be added to the working body of conversation in this discipline: 1 – Ambient pressure changes and altered inspired gas mixtures have a demonstrable effect on the clinical course of patients with viral infections, both through effects on the invading pathogen and on the host’s ability to resist that insult. 2 – Both redox imbalances and inert gas membrane effects can produce such effects. The design of the prescribed gas/pressure blend may depend on the biological characteristics of each individual pathogen. 3 – Such environmental manipulations are spared many of the untoward consequences of drug-based therapeutic regimens. Further, the potential synergy between hyperbaric treatments and administered medicaments could lessen the emergence of resistant strains of the virus that follows use of each drug. It is fortunate that studies on environmental manipulations are not encumbered by the unwelcome physical liabilities linked to pharmacological interventions. Further, it is fortunate that Hyperbaric Medicine has the talent, the intent, and the clear mandate to extend the borders of this therapeutic modality. PL 11 Carbon Monoxide Poisoning Clinical Findings, Common Errors, And Early diagnose 2900 cases Jordi Desola, MD, PhD, Joan Sala, MD. Hyperbaric Therapy Unit of Barcelona, Barcelona, Spain A prospective analysis of Carbon Monoxide Poisoning (CMP) is one of the best documented indications for HBO, where many research has been done, and important experience has been cumulated from all the world. In spite of that, the general opinion of the medical community is not unanimous and it remains confused. Results are really encouraging, but some sceptical attitude about the role of hyperbaric oxygen (HBO) still remains among some hospitals in the area. Many of these attitudes can be explained by a lack of knowledge of the toxicology, pathophysiology and clinical pattern of this frequent inhaled intoxication. The majority of the cases in Catalonia happened within the domestic environment, so the role of primary assistance teams can be essential. However we have observed a large series of common errors, both in the primary assistance medical centres as well in the most important general hospitals, which being so repetitive can not be considered as casual. We have analyzed our series of near to 3000 cases of CMP received in our unit, and we are pointing out the most frequent and relevant errors. 1.DELAYED DIAGNOSIS. Its condition of tasteless, colourless, and odourless, can maintain Carbon Monoxide (CO) hidden once the source is extinguished or simply the windows of the room are open. In such condition, erroneous diagnoses are frequently established in urgency departments and primary assistance cabinets, like Encephalitis, Stroke, Epilepsy, Dysbaric disorder, Tensional Cephalalgia, Occupational conflict, Collective Hysteria, Food poisoning, or Peripheral Vertigo. 2.CONFUSION ASPHYXIA/ POISSONING. CMP is very often a hidden disaster. Only in catastrophic situations, or in cases where coal gas is obviously present, the existence of CO in the environment is presumed. Liquated gases from petroleum (propane, butane, and so on) do not contain CO so they are not toxic. However in case of free escape the inhalation of propane or butane can produce serious asphyxia, but not a poisoning. If the combustion of these gases is incomplete, CO can be formed. In such cases signs and symptoms of asphyxia and CMP will combine and careful attention is needed to associated disorders like smoke inhalation, or Adult Distress Respiratory Syndrome. 3. ERRONEOUS EVALUATION OF CARBOXYHAEMOGLOBIN LEVEL. Even when CMP is almost certain, some doctors only accept this diagnosis if the carboxyhaemoglobin (HbCO) percentage is elevated. And even in these cases, they only consider intoxication as severe if the HbCO elevation is very high. This attitude implies a true ignorance about both the pathophysiology of this intoxication, as well as the physiology of the haemoglobin oxygen transport and the carbon monoxide left deviation of the curve. HbCO only indicates the haemoglobin linked to CO, but nothing is known about the plasmatic CO levels. However, it is well known that in mild cases, patients often have important HbCO elevations, while other patients in deep coma can have low levels. An HbCO elevation only informs that the patient has been exposed to CO at some point during the preceding hours, but neither a correlation with severity nor with prognosis can be established. It is frequently forgotten that the worst toxic role of CO depends on the direct toxic effect over kytochrome-oxydase mitochondrial breathing. 4.ERRONEOUS EVALUATION OF GASOMETRICS AND PULSE-OXIMETRY. Patients poisoned by CO often have nearly normal gasometrical values. A mild hypoxemia may be sometimes observed even in seriously ill patients. Gas blood analytical machines only detect pH, haemoglobin, and arterial pressure of Oxygen and Carbon Dioxide. The other parameters like Bicarbonates, Base Excess, or Oxygen Saturation are calculated -not measured- so when an important quantity of haemoglobin is blocked by CO, the results shown by conventional machines are erroneous. Only Cooxymeters can determine the real oxygen content measuring the actual Oxygen Saturation, but these apparatus are not always available in small hospitals, and almost never in primary assistance medical centres. Pulse-oximetres are really a kind of photocolourimetres and they give erroneous results in case of CMP as well. The recently appeared Pulse-cooximetres can be the most valuable aid in the early diagnose of CMP especially on site for rescuers, first responders, or primary assistance specialists. 5. IMPROPE ESTIMATION OF SIGNS AND SYMPTOMS. Signs and symptoms of CMP are very unspecific. Cephalalgia, Nausea without vomiting, Bradipsyquia, Asthenia, and transitory Consciousness Disturbance are the most common in the not extremely serious cases, which are the most frequent. Some books of internal medicine and on toxicology, explain that one of the most typical symptoms of CMP is the Sherry skin rush, while in our series it has been found in only the 20.3% of the cases. On the contrary, some recent papers consider the Sherry skin rush as a very rare finding. It is obvious that the majority of the patients are not aware of this sign thus they do not report it, and it can remain hidden if it is not actively searched in the emergency department. 6. INNECESSARY CORRECTION OF METABOLIC ACIDOSIS. These patients are usually in real acidotic condition, which may be more related to the severity of the intoxication than the HbCO level. First responders, and urgency physicians in hospitals sometimes try to "correct" this acidosis, and their patients become alkalotic after having received unnecessary doses of bicarbonates. Metabolic acidosis is mainly related to the left deviation of the haemoglobin curve, and it can become a kind of defence against hypoxia trying to achieve a more stable oxygen transference. A moderate acidosis is a positive event and need not to be a concern. Only extreme acidosis in the most severe cases, which can be by itself a cause of major damage, need to be corrected. 7.NON JUSTIFIED ADMINISTRATION OF HYDROXICOBALAMIN. Cyanide (CNH) can be formed in cases of fire in closed environment, very high temperature, and combustion of synthetic and plastic materials. Following the so called “Baud’s criteria” a combined CO plus CNH poisoning can be assumed in some cases of patients rescued from fires. Some experimental laboratory data, not clinically controlled, suggest that very high doses (between 2-5 grams endovenously) of Hydroxicobalamin (HC) can be the antidote of CNH. This overestimated measure has become very popular in some areas and first responders have incorporated HC among their emergency procedures. However HC has no action over the mitochondrial breathing disturbance since only blocks the inhaled CNH, but the patient will persist hypoxic if high quantity of oxygen is not given. Furthermore, HC has no action over CO, so there is no reason to apply in pure cases of CMP in which no criteria of CNH poisoning are estimated, and on the other hand HC is very expensive and it can delay the application of the only etiological treatment with HBO. 8.OVERESTIMATION OF THE UTILITY OF NORMOBARIC OXYGEN. Many patients start to improve from the moment of the rescue from the intoxication site. In fact, they frequently arrive at the hospital in nearly normal status. Applying normobaric oxygen may result in an apparent improvement in the less serious cases, but this amelioration does not correspond to a real healing. High quantities of normobaric oxygen can moderately increase the oxygen concentration in the blood, but the oxygen deliver to the cell will be always done under atmospheric diffusion pressure. Theoretically, the half life of HbCO breathing normobaric oxygen is 80 minutes. But in practice some patients have received normobaric oxygen for several hours in primary hospitals previously to be sent to our unit, and the mean value of HbCO in the moment of the arrival to the emergency room of our hospital is still high. 9.DELAY OR NEGLIGENCE IN APPLYING HYPERBARIC OXYGENATION. The majority of the guidelines or protocols in Emergency department of general hospitals are still conditioning the indication of HBO for CMP patients to HbCO values over 20% or even over 40% what implies a lack of knowledge of the real pathophysiology of CMP and even of the toxicology of CO. Thus physicians from emergency rooms wait for the result of determination of HbCO before deciding whether or not the patient must be sent to the Centre of Hyperbaric Medicine. The delay in our area since the moment that patients arrive to the hospital until they arrive to our unit is near to 7 hours. And many seriously poisoned patients are not sent to Hyperbaric medical centres simply because that at this time the HbCO is already low, in spite of the fact that the patient has suffered a serious poisoning. 10. IGNORANCE OF THE LATE NEUROLOGICAL SYNDROME. Many general practitioners and hospital doctors are unaware of the simple existence of this serious neurological demyelinization syndrome that appears after some days of fully symptomatic remission. Not only practitioners but some hospital neurologists are equally uninformed. Several well known and internationally accepted textbooks on internal medicine, and even some books on toxicology do not mention the risk of late neurological symptom in case of CMP or it is described as a neurological sequella of the acute intoxication.. This was not an exhaustive list of common errors committed by both practitioners from primary assistance as well as doctors from emergency departments in General hospitals. Many of them are based in a lack of information of some aspects that are well described in basic textbooks of respiratory physiology. Some other errors depend on a sceptic attitude proning to accept any drug treatment but at the same time very reluctant against not pharmacologically supported treatments. Data is nowadays relevant. Research is deep and wide. But there are no more serious blinds than those not wishing to see. 投稿发言 Free Paper Abstract OR01 HBO and cytostatic chenotherapy Christtian Heiden German Professional Soc. Hyperb. Chambers Objective: There is a certain amount of reservation for applying HBO to patients who have a history of malignant tumor treated with cytostatic drugs. As hypoxic tumor cells do not react well to treatment wether it is radiotherapy or cytostatic drug there is a ratio for applying HBO as an adjuvant for cytostatics. Method: A survey of the literature on this topic is given in detail, also concerning the different classes of cytostatics. Own experience of the last 5 years is presented. Results: Few publications deal with HBO and cytostatics. There are encouraging papers published. The number of cases treated with HBO after cytostatic tumor therapy and even so as an adjuvant to cytostatics is very limited and far beyond evidence based medicine. In all our own cases the HBO treatment did not cause any problems. Conclusion: The application of HBO after cytostatic treatment is feasable in general. Precautions have to be made concerning special substances. As the experience published is very small the adjunctive application of HBO should be limited to very special cases after all treatment options have failed and the patient would be lost otherwise. Informed consent of the patient for the treatment is indispensable. OR02 Hyperbaric Oxygen: Does it Promote Cancer Recurrence or Metastasis? An Update John Feldmeier University of Toledo Medical Center; Radiation Oncology Department; Toledo Radiation Oncology, USA Objective: To review and update the literature related to cancer growth, recurrence and metastases after hyperbaric oxygen. Methods A comprehensive review of this topic was published by Feldmeier et al in 2003. Since that time several new publications have been added to the body of literature on this topic. The prior review as well and the more recently published literature, found by computer based literature search (Medline), are reviewed. Results: The literature on this topic can be divided into 1) Case reports and case series; 2) Randomized trials designed to investigate hyperbaric oxygen as a radiosensitizer; and 3) Pre-clinical studies designed to address the issue in question and encompassing a broad range of malignancies. Only a rare anecdotal case or small case series reports cancer recurrence or progression after hyperbaric oxygen. Much larger case reports fail to confirm a higher rate of cancer recurrence. The randomized trials from the era of hyperbaric oxygen radiosensitization do not suggest an increased risk for metastases or death due to cancer after hyperbaric oxygen. The vast majority of pre-clinical studies show either a neutral effect or a slight suppression of malignant growth. Conclusions: The preponderance of available evidence fails to demonstrate an enhanced rate of cancer growth, recurrence or metastasis. Hyperbaric oxygen can be given to cancer patients without fear that the treatment will promote cancer recurrence or progression. OR03 Hyperbaric Oxygen for Complications of Oncological Treatment of Paediatric Patients 1 2 2 Michal Hajek , Pavlina Cahova , Jaroslav Sterba , Jiri 3 4 Ruzicka , Pavel Zonca 1. Centre of Hyperbaric Medicine, Municipal Hospital of Ostrava, Czech Republic, 2. Clinic of Paediatric Oncology, Faculty Hospital of Brno, Czech Republic, 3. Faculty Hospital, Charles University of Pilsen, Czech Republic, 4. Centre for Visceral and Mini-invasive Surgery, Krankenhaus Wesseling, Köln am Rhein, Germany Introduction: Use of Hyperbaric Oxygen Treatment (HBO) for children requires special knowledges for indication and treatment. Especially nursing of critically ill patients demands specific equipment inside of hyperbaric chamber. There is a strong need for close cooperation between paediatric and hyperbaric specialists for ensurance of adequate care of sick paediatric patients. HBO for sick oncological patients is very exhausting for nursing staff from psychological, organizing as well as treatment point of view. There is a long tradition of treatment of children within our treatment centre with multiplace hyperbaric chamber equipped with perfect monitoring, ventilation and technical devices, as our hyperbaric center started to work in 1965 and from that time more than 16.000 patients were treated here. Methods and Results: This is retrospective observational study. From 1994-2008 total of 33 children (19 of male sex, 14 of female sex) have been treated for complications of oncological treatment in our hyperbaric unit. In the early period the hepatotoxic influence of cytostatic drugs has been the main reason for HBO treatment (17 patients). Recently hyperbaric oxygen is used due to severe posthypoxic encephalopathy(3 patients), after extensive intracranial surgery for malignant diseases(9 patients) with different grade of brain damage and neurological deficit, complications due to treatment of immunity suppressive drugs (sepsis, critical illness polyneuromyopathy- 3 patients). One children has been treated for radiation injury of urine bladder. Mean age of children were 8 years (1-17 years), 22 patients were treated for blood malignancy, 11 patients for solid tumour. Mean number of HBO sessions were 7,5 (1-20), treatment pressure of 1.9 to 2.5 ATA. Among of them, positive effect has been achieved in 89 to 100 % of cases due to clinical situation, total positive treatment effect was described in 31 from 33 patients(94 %).One patient out of 33 (3%) could not finish his treatment due to ear equillibration problems, in two patients bleeding from tracheostomy as well as nose occured, but without need of interruption of HBO sessions, one patient (3%) failed to achieve positive tendency from treatment. Discussion: This is a pilot study for creating of basal imagine of HBO effects in those clinical situations. It is very important to emphasize that it is a small group of patients, evaluation is provided retrospectively and without use of any standard measurement method and parameters. Most of patients can be evaluated as criticallly ill patients and the complex treatment has been supplied. HBO treatment for those patients is high risk due to infectious diseases, immune suppression therapy, need for isolation of patients inside of hyperbaric facility. We agree with the presence of parents during HBO treatment. ENT examination with paracenthesis, or bilateral tympanostomy with ventilation tubes insertion within general anesthesia are provided before of HBO treatment. For assessment of HBO treatment there have been used standard neurological examination, electromyography(EMG), or creatin kinase levels in blood. Conclusion: Objective evaluation of mechanisms of HBO effects and confirmation of its positive acting will demand next studies, moreover with randomised prospective design. Present results show that HBO can be useful method in treatment of paediatric oncological patients with neurological deficit and other oncological treatment complications. OR04 Hyperbaric Oxygen may accelerate tumour-bearing mice to death Qingle LIU, Chenggang Zheng, Xiaohua Hang Changhai Hospital, the Second Military Medical University, Shanghai, China Objective: To explore the influence of hyperbaric oxygenation (HBO) on life-span in tumour-bearing mice. Method: Male Balb/c mice were randomly divided into celiac-tumour group: inoculating tumour cell into abdominal cavity of the animal, celiac-tumour-HBO group: inoculating tumour cell into abdominal cavity and then exposing to hyperbaric oxygen, back-tumour group: inoculating tumour cell under skin of the back of the animal, back-tumour-HBO group: inoculating tumour cell under skin of the back of the animal and then exposing to hyperbaric oxygen. There are 7 mice in each group. After s-180 tumour cell was translated to mice HBO was given once a day in concerned group. The life-span and skin ulcer were observed. Results: The life-span is 27.57 士 4.4693 days in celiac-tumour-group, 24 士 2.9439 days in celiac-tumour-HBO group, 63.43 士 21.844 days in back-tumour group, and 35.14 士 8.934 days in back-tumour-HBO group. The life-spans in celiac-tumour group and in celiac-tumour-HBO group are different, but P value is 0.133204; the life-spans in back-tumour group and in back-tumour-HBO group are significant and P value, 0.009002. Conclusion: The life-span of mice in back-tumour-HBO group was shorten by exposing HBO, and life-span in celiac-tumour-HBO group is tendency to be shorten by HBO exposure. The ulcer formation is postponed by HBO in back-tumour-HBO group. OR05 Hyperbaric oxygenation (HBO) in mediastinitis treated with an open mediastinum after cardiac surgery 1 1 Jacek Kot , Zdzislaw Sicko , Lech 2 2 Anisimowicz , Wojciech Pawliszak 1. National Center for Hyperbaric Medicine, Medical University, Gdansk, Poland 2. Department of Cardiac Surgery, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland Objective: Postsurgical complications after sternotomy include mediastinal dehiscence and mediastinal wound infection, either superficial or deep. Mediastinitis, as a deep wound infection, is a rare complication after the surgical sternotomy, but it can have high mortality. Several publications show the positive effect of usage of the hyperbaric oxygenation (HBO) in mediastinitis with shorter hospital stay, less morbidity, and cost saving. Methods: In the National Center of Hyperbaric Medicine in Gdynia, Poland, between 2005 and 2008 we treated with HBO thirteen patients (7 males and 6 females) aged between 53 to 74 years (mean 60.5±6.9 [SD] years) with an open mediastinum due to mediastinitis in post-operative period after medial sternotomy for cardiac surgery. In one case there were clinical and microbiological evidences of clostridial mediastinitis. Patients were admitted into the hyperbaric center after initial surgical debridement of wounds and removal of sternal wires. Standard care included: daily change of dressing with wound irrigation and debridement, when necessary; narrow spectrum antibiotics; HBO sessions every 12 hours until resolution of infection; adjunctive treatment as indicated by the clinical status of patients. Results: Median length of stay in the hyperbaric center was 12 days (range 9-38), median number of HBO sessions was 20 (range: 16-54). Median value of C-reactive protein (CRP) titer at admission was 79.8 mg/dl (range: 12.8-260.8) and significantly decreased down to 12.8 mg/dl (range: 7.8-103.1) in all patients (p=0.005; Wilcoxon test). Median value of WBC count at admission was 7470/ml (range: 5100-18670) and it did not change significantly at discharge (7420/ml; range: 2870-10890; p=0.12; Wilcoxon test). In all cases there was improvement in the local and general clinical status and in microbiological results, even if not always there was a bacterial eradication. No major complication occurred during the HBO sessions. Conclusion: Usage of HBO should be considered in mediastinitis as a complication of the cardiac surgery. OR06 Normobaric and hyperbaric oxygen therapy for migraine and cluster headache 1 2 Michael Bennett , Christopher French , Alexander 3 4 3 Schnabel , Jason Wasiak , Peter Kranke 1. Dept. Diving and Hyperbaric Medicine, Prince of Wales Hospital, Australia 2. Dept. Neurology, Prince of Wales Hospital, Australia 3. Dept. Anaesthesiology, University of Wuerzburg, Wuerzburg, Germany 4. Victorian Adult Burns Service, The Alfred Hospital, Melbourne, Australia Background: Migraine and cluster headaches are severe and disabling. Migraine affects up to 18% of women and cluster headaches 0.2% of the population. A number of therapies are available, including both hyperbaric oxygen (HBOT) and normobaric oxygen (NBOT). We assessed the safety and effectiveness of both for treating Odstraněno: ¶ Odstraněno: HBO in Tokyo Medical and Dental University in 2007 and The Effects of HBO on Soft Tissue Injury in Sports Activity¶ Kazuyoshi Yagishita, Nobuo Yamami, Seiichiro Togawa, Yoshihiro Mano¶ Hyperbaric Medical Center, Tokyo Medical and Dental University, Tokyo, Japan¶ ¶ Objective: In our university hospital, multiplace chamber including 3 rooms and the capacity of 16 patients was set up in 2001. In 2007, 7970 times hyperbaric oxygen therapy (HBO) in 958 patients were performed, which is the most patients number in one institute in a year in Japan. The purposes of this study were to report the diseases and the patients performed with HBO in our hospital last year. The effects of HBO on crush injury and compartment syndrome were well documented by many authors, and randomized controlled studies revealed the effects of HBO on reduction of necrosis and edema. We now perform HBO aggressively to soft tissue injury including compartment syndrome, ankle sprain, knee ligament injury, and muscle strain. The purposes of this study were also to investigate the effect of HBO on soft tissue injury in sports activity. Patients and Methods: 7970 times HBO in 958 patients were performed in our hospital in 2007. The number of the patients and HBO times were evaluated. In 180 patients with soft tissue injury in sports activity, visual analog scale (VAS) scores and recovery time to previous sports activity were evaluated. Results: The ... [27] Odstraněno: ¶ and preventing migraine and cluster headaches. Methods: We searched the following in May 2008: CENTRAL, MEDLINE, EMBASE, CINAHL, DORCTIHM and reference lists. Relevant journals were hand searched and researchers contacted. We accepted any randomised trials comparing HBOT or NBOT with any alternative. Three reviewers independently evaluated study quality and extracted data. Results: Nine trials involving 201 participants were included. Pooling of data from three trials suggested HBOT was effective in relieving migraine headaches compared to sham therapy (RR 5.97, 95% CI 1.46 to 24.38, P = 0.01). There was no evidence that HBOT could prevent migraine, or reduce the incidence of nausea/vomiting or the requirement for rescue medication. There was a trend to better outcome in a single trial evaluating HBOT for cluster (RR 11.38, 95% CI 0.77 to 167.85, P = 0.08). NBOT was effective in terminating cluster headache compared to sham in a single small study (RR 7.88, 95% CI 1.13 to 54.66, P = 0.04), but not superior to ergotamine administration in another small trial (RR 1.17, 95% CI 0.94 to 1.46, P = 0.16). Seventy-six per cent of patients responded to NBOT. No serious adverse effects of HBOT or NBOT were reported. Conclusion: There was evidence that HBOT was effective for the termination of migraine in an unselected population, and weak evidence that NBOT was effective in cluster. Given the cost and poor availability of HBOT, more research should be done on patients unresponsive to standard therapy. NBOT is cheap, safe and easy to apply, so will probably continue to be used. manufacturer’s instruction. Results: Intravenous administration of lipopolysaccharide (2 µg/kg) caused increased levels of both core temperature and hypothalamic glutamate, hydroxyl radicals, and prostaglandin-E2 accompanied by increased plasma levels of tumor necrosis factor-α, interleukin-1β, and interleukin-6. Treatment with hyperbaric oxygen (100% at 253 kPa) once a day for consecutive 7 days prior to or 1 hour after injecting lipopolysaccharide significantly reduced the lipopolysaccharide-induced elevation of core temperature, circulating tumor necrosis factor-α, interleukin-1β, and interleukin-6, and hypothalamic glutamate, hydroxyl radicals and prostaglandin E2. Direct injection of tumor necrosis factor-α (20 ng), interleukin-1β (20 ng), or interleukin-6 (10 ng) into the lateral cerebral ventricle also caused a rise in both core temperature and hypothalamic glutamate and hydroxyl radicals, which could be attenuated by treatment with hyperbaric oxygen. Conclusion: Hyperbaric oxygen can be used as a prophylactic as well as a therapeutic agent for prevention or suppression of endotoxin-related systemic inflammation and fever in rabbits. OR07 Hyperbaric oxygen therapy induces antiinflammation and antipyresis in experimental studies 1 2 1 Lin Mao-Tsun , Gao Chunjin , Niu Ko-Chi 1. Department of Medical Research and Department of Hyperbaric Oxygen therapy, Chi-Mei Medical Center, Taiwan, China 2. Department of Hyperbaric Oxygen Therapy, Chaoyang Hospital Affiliate of Capital University of Medical Sciences, Beijing, China Recent data suggest nitrite as a product of the complex interplay between nitric oxide (NO), molecular oxygen and superoxide that takes place during hyperbaric oxygen therapy (HBOT). A rapid reversible decrease in endothelial NO bioavailability during hyperbaric oxygen exposure may possibly be due to this auto-oxidation of NO. Inorganic anions such as nitrite that were previously thought to be inert end products of endogenous nitric oxide metabolism are now being viewed as possible storage pools of NO-like activity. With the reduction of nitrite back to NO in the circulation indicated as a possible mechanism for hypoxic vasodilatation, nitrite is being investigated as an endogenous signaling molecule and regulator of gene expression. Given its role in blood flow regulation and hypoxic nitric oxide homeostasis, nitrite may not only serve as a diagnostic marker but also find a role as a potential therapeutic agent. Protein nitrotyrosine has been identified as a marker of formation of another potent oxidant, peroxynitrite from nitric oxide. Objective: To examine changes in the nitrite and peroxynitrite metabolites of NO in the blood of healthy subjects after a single HBOT session. Method: Fifty six healthy adults were included in the study. Plasma nitrite was measured in 22 test subjects and 12 controls before and one hour after HBOT with either 100% oxygen or compressed air at 2.5 ATA for sixty minutes. Determination of plasma nitrotyrosine was done separately with 15 test subjects and 7 controls using the same protocol. Results: Plasma nitrite and nitrotyrosine levels were not found to be significantly altered after the single HBOT in subjects who Objective: To ascertain whether hyperbaric oxygen therapy inhibits the increase of glutamate, hydroxyl radicals, and prostaglandin E2 in the hypothalamus and reduces fever during lipopolysaccharide-induced systemic inflammation in rabbits. Methods: Adult male New Zealand white rabbits, weighing between 2.2 and 3.2 kg at the start of the study, were used. The pyrogen assay was carried out with unanesthetized animals restrained in rabbit stocks. The microdialysis probes were stereotaxically and chronically implanted into the preoptic anterior hypothalamus of rabbit brain (the essential thermoregulatory center) for assessment of glutamate, hydroxyl radicals, and prostaglandin E2 in situ. For measurement of serum cytokines, 5 ml of blood was withdrawn from the marginal ear vein of each rabbit. The amounts of the cytokines tumor necrosis factor-α, interleukin-1β, and interlueimin-6 in the serum were determined by using double-antibody sandwich ELISA (R&D systems, Minneapolis, MN, USA) according to the OR08 Measurement of plasma nitrotyrosine and nitrite after a single treatment with hyperbaric oxygen in healthy human subjects Renu Agnihotri, Amy Welch, James Stewart, Dheeraj Bansal Saba University School of Medicine, Netherland Antilles received 100% oxygen therapy as compared to compressed air. There was a non-significant elevation of plasma nitrites and nitrotyrosine in both groups of HBOT subjects as compared to controls that received no HBOT. Conclusion: Increased oxygenation of tissues due to hyperbaric therapy may therefore be more significantly related to the production of reactive metabolites of nitric oxide than the oxygen content of the inhaled air, in short term HBOT. OR09 HBO in Tokyo Medical and Dental University in 2007 and The Effects of HBO on Soft Tissue Injury in Sports Activity Kazuyoshi Yagishita, Nobuo Yamami, Seiichiro Togawa, Yoshihiro Mano Hyperbaric Medical Center, Tokyo Medical and Dental University, Tokyo, Japan Objective: In our university hospital, multiplace chamber including 3 rooms and the capacity of 16 patients was set up in 2001. In 2007, 7970 times hyperbaric oxygen therapy (HBO) in 958 patients were performed, which is the most patients number in one institute in a year in Japan. The purposes of this study were to report the diseases and the patients performed with HBO in our hospital last year. The effects of HBO on crush injury and compartment syndrome were well documented by many authors, and randomized controlled studies revealed the effects of HBO on reduction of necrosis and edema. We now perform HBO aggressively to soft tissue injury including compartment syndrome, ankle sprain, kneeligament injury, and muscle strain. The purposes of this study were also to investigate the effect of HBO on soft tissue injury in sports activity. Patients and Methods: 7970 times HBO in 958 patients were performed in our hospital in 2007. The number of the patients and HBO times were evaluated. In 180 patients with soft tissue injury in sports activity, visual analog scale (VAS) scores and recovery time to previous sports activity were evaluated. Results: The number of the patients and HBO times in decompression illness were respectively 374 patients and 764 times, 87 patients and 934 times insudden deafness, 34 patients and 740 times in peripheral vascular disorder including diabetes and arteriosclerosis obliterans, 47 patients and 1046 times in osteomyelitis, 180 patients and 865 times in soft tissue injury related sports activity, 90 patients and 1644 times in myelopathy and radicuropathy, 19 patients and 220 times in carbon monoxide poisoning, and 18 patients and 259 times in radiation-induced cystitis. In patients with soft tissue injury in sports activity, VAS scores improved compared between pre and post 2-hour HBO. In patients nd with 2 grade medial collateral ligament injury of the knee in HBO group, recovery acceleration to previous sport activity was observed. Conclusion: In HBO procedure in our university in 2007, no major patient troubles and no chamber problems were recorded. The effects of HBO on soft tissue injury were strongly suggested in this study. OR10 Adjunctive use of hyperbaric oxigenacion (hbo2) in the managment of cerebral hemorrhage in a pregnant patient: a case report. Chávez A., Uribe R., Sánchez EC. Hospital Angeles Metropolitano, Mexico Introduction: The purpose of a craniotomy is decompress through a cranial bone resection. It does not reverse the primary injury, but reduces secondary damage caused by cerebral edema after a hemorrhagic vascular event. The association of HBO is beneficial if it is performed in the early stage. Material and Methods: We reported a 33-year-old female patient who has a cerebral hemorrhage secondary to an arteriovenous malformation. The case is complicated because the patient has a 25 weeks pregnancy. HBO (1.8 atm abs / 90 min / QD / 20 treatments) was used a adjunctive treatment as an early neuroprotector to inhibit ischemia reperfusion injury. MRI was done before and after HBO. Results: The patient improved clinically and by MRI. There was a marked improvement of the motor and cognitive function. The patient was able to maintain the pregnancy that was resolved by Caesarean section. There was no secondary effect of HBO to the neonate. Conclusion: This case was complicated not only by the cerebral hemorrhage of the mother but also by a 25 week pregnancy. HBO was used as an early neuroptotector. It inhibits ischemia reperfusion injury (I / R) when used at an early stage. There was a marked clinical and MRI improvement of the mother and there were no secondary effects to the product, specially retinopathy of the premature. This is the first case of the used of HBO for cerebral hemorrhage in a pregnant woman. OR11 Necropsic findings of syndrome of intratoracic hyperpressure in a young diver and a decompression accident after a deep scuba diving in veteran diver (two particular cases) 1 2 2 Batle J.M. , Poncela J.L. , Jimenez M.A. 1. MEDISUB Hyperbaric Research Institute, Palma de Mallorca, Spain 2. Legal Medicine Institute, Palma de Mallorca, Spain Introduction: On the coasts of our islands, (the Balearic Islands), the cleanliness and the almost constant temperature of the waters all year round , creates a great interest and a great number of followers to sub-aquatic activities either of a professional or recreative character. The depths of the Mediterranean sea ranges from 50 to 120 metres with the existence of red coral colonies highly valued in Jewellery shops. The Government controls the above mentioned professionals limiting the number of permits or authorizations to only a few and these boats are usually worked by a Captain and a sailor. Materials and Methods: 12 year old patient while diving and making an uncontrolled ascent suffered a Intrathoracic Overpressure Syndrome and an Arterial Gas Embolism. The professional divers are in the habit of diving depths from 80 to ll0 metres using scuba breathing Odstraněno: OR09 ¶ Hyperbaric Oxygen may accelerate tumour-bearing mice to death¶ Qingle LIU, Chenggang Zhe ng, Xiaohua Hang Changhai Hospital, the Second Military Medical University, Shanghai, China ¶ Objective: To explore the influence of hyperbaric oxygenation (HBO) on life-span in tumour-bearing mice. Method: Male Balb/c mice were randomly divided into celiac-tumour group: inoculating tumour cell into abdominal cavity of the animal, celiac-tumour-HBO group: inoculating tumour cell into abdominal cavity and then exposing to hyperbaric oxygen, back-tumour group: inoculating tumour cell under skin of the back of the animal, back-tumour-HBO group: inoculating tumour cell under skin of the back of the animal and then exposing to hyperbaric oxygen. There are 7 mice in each group. After s-180 tumour cell was translated to mice HBO was given once a day in concerned group. The life-span and skin ulcer were observed. Results: The life-span is 27.57 士 4.4693 days in celiac-tumour-group, 24 士 2.9439 days in celiac-tumour-HBO group, 63.43 士 21.844 days in back-tumour group, and 35.14 士 8.934 days in back-tumour-HBO group. The life-spans in celiac-tumour group and in celiac-tumour-HBO group are different, but P value is 0.133204; the life-spans in back-tumour group and in back-tumour-HBO group are significant and P value, 0.009002. Conclusion: The life-span of mice in back-tumour-HBO group was shorten by exposing HBO, and life-span in ... [28] equipment with three bottles of 3 x l8 litres and lighting equipment of l50w. besides a bag for the gathering of the coral . They are in the habit of hanging this from the neck and the pickaxe is hung from the right hand. The divers make decompression stops from 51 metres and are ascending gradually, when they are at l2 metres they go to surface where they have a decompression chamber installed in their boat, to continue their period of decompression returning to pressure again of 12 metres and to make the corresponding stops. To make the step of humid decompression to decompression in hyperbaric chamber, the surface maximum time is very limited to a maximum of 5 minutes. The 74 year old patient who after making his dive to 84 meters of depth was 20 – 25 minutes on the bottom and his decompression stops lost conscience inside the decompression chamber installed on board. The materials used are the usual ones of the Medical Legal Institute and two cameras. The methodology was the system used in all cases of death, not natural with technologies and specific enquiries for these cases. Results: The Signs that appeared in the case of SIHP were immediate at the arrival to the surface and were a neurological type. The findings found the levels of the different organs which have always been described in communications and literature are evident and in these cases, though it is necessary to emphasize certain organs reveal that they have still not been described. Conclusion and Discussion: It is possible to state that in the cases of Traumatic Embolism of Air widespread pathology happens which affects all organs. It is possible to state that in these cases, the accumulation of gas is in all the tissues of the organism, but in the moment of shock, moreover there are organs in charge of managing the crisis which also suffer the effects of the embolism. O12 24 cases of neurological decompression illness - 14 months of a single center experience 1 1 2 Jorge Calderón , Cristian Melián , andrés Reccius 1. Underwater Medicine Service, Hospital Ancud (UMSHA), Ancud, Chile 2. Pontificia Universidad Católica, Chile Objectives: To review the first 14 months of operation of the Underwater Medicine Service of the Hospital de Ancud, Chile (UMSHA). To describe the cases of treated neurological decompression illness (NDCI). Methods: Prospective systematic registry of the conditions with a detailed profile of diving and neurological examinations made by a neurologist specialized in diving medicine. Revision and analysis of these registries. Results: We review 60 cases of decompression illness treated from March 2007 to May 2008, 24 (40%) of them had NDCI. Of these, 13 had involvement of the spinal cord, four of the brain, and 7 had peripheral nerve disease. All patients were treated with 6 USN, generally with two prolongations to 18 meters. Most cases with spinal disease had paraparesia with a sensitive level and generally without compromise of propiocepcion. Nine patients didn’t have anterior spinal cord involvement, one patient had a complete spinal cord syndrome and one had a syndrome that couldn’t be systematized. There were 2 cases that couldn’t be classified in any subtype. Of these cases, four received lidocaine, and required between 0 and 12 sessions of hyperbaric oxygen therapy (HBO). Of the patients that did not receive lidocaine, three did not require more sessions and the rest required between five and ten sessions. The only patient who had a complete spinal disease required 25 sessions of HBO. From the cases that had a cerebral disease, two presented with alterations in consciousness. One of them died in spite of hyperbaric treatment and ICU treatment. The other had an alteration in consciousness and myoclonus and survived without sequels. The other two cerebral cases had lacunar syndromes that recovered completely with hyperbaric treatment. Of the 7 cases of peripheral disease, 6 of them had hypoestesia in the territory of the circumflex nerve, associated with articular and muscular compromise. Conclusion: A high percentage of the treated cases of decompression illness are NDCI. Possibly these cases are overrepresented. The presence of a “dissociation” or existence of different patterns of injury in the spinal cord could be explained because of different physiopathologic reasons, that is to say, arterial embolization in cases of spinal disease with respect of the posterior columns, venous thrombosis in cases of a complete medullary syndrome, and presence of bubbles in cases of a not systemizable spinal cord disease. The pattern of complete spinal disease seems to have a worse prognosis. All patients had important omissions of decompression. OR13 Effect of hyperbaric oxygen treatment on traumatic brain injury rat by magnetic resonance imaging 1 2 Xiang Huang , Chunjing Gao 1. Bejing Shunyi Hospital of China Medical University, Beijing, China 2. Beijing Chaoyang Hospital of Capital University of Medical Science, Beijing, China Objective: :To investgate dynamic changes of the effect of hyperbaric oxygen treatment(HBOT) on traumatic brain injury (TBI) during the initial 7 days by using lateral fluid-percussion (LFP) rat modal and magnetic resonance imaging (MRI). Meterials and Metheods : 30 male Sprague-Dawley rats were randomly divided into 4 groups: HBOT group(n=10), TBI group(n=10),1st day TBI group(n=6), sham control group(n=4). MRI was performed at 1 day, 3 day, 5 day, 7 day after severe injury on lateral fluid-percussion. HBOT was performed to rats in HBOT group each day after 24 hours. The rat brain imaging was evaluated according to a standard by 2 radiologist who didn’t know groups divided. All rats were sacrificed immediately after MRI exam; their brains were removed and prepared for pathologic exam. Results:There is no st difference between HBO and TBI group at 1 day according to MRI evaluation. The difference tendency rd th present at 3 day and 5 day suggesting better improvement in HBOT than TBI group. The difference th becomes significant at 7 day. Conclusions:HBOT is effective in accelerating brain tissue repair, promoting the lesion clearance and hematoma or edema’s absorbing by dynamic investigation of MRI. HBOT is also protective to brain tissue after the building of TBI rat modal for 24 hours which second brain damage have happened, the process is quantitative change to qualitative change. OR14 The effect of hyperbaric oxygenation on diabetic foot ulcers (the HODFU-study). A single centre, prospective, randomised, double-blind placebo-controlled parallel-group study 1 2 Christer Hammarlund , Magnus Londahl , Per 2 3 Katzman , Jan Apelqvist 1. Helsingborg Hospital, Sweden 2. Lund University Hospital, Sweden 3. Malmoe University Hospital, Sweden Objective: To evaluate effects of hyperbaric oxygenation (HBO) on long-term ulcer healing in patients with diabetes mellitus and chronic foot ulcers where further possibilities for vascular surgery has been ruled out. Methods: 94 Patients from three hospitals in southern Sweden were enrolled in the study. Randomisation was stratified for toe-pressure with a cut-off at equal or less than 30 mm Hg. Both HBO and hyperbaric air (HBA) treatment was given at the same time in the chamber in a double blind fashion. The patients received a minimum of 37 and a maximum of 40 treatments at 2.5 ATA and a duration of 90 minutes. Trancutaneous oxymetri was used for evaluating the effects of HBO/HBA-treatment. In this presentation are no subgroups analysed. Results: The median time to ulcer healing was 5 months in the HBO-treated group and 12 months in the HBA-group. A blinded observer did this evaluation. Approximately half of the wounds did not heal. Trancutaneous oxymetri showed successive higher oxygen levels on the forefoot during the chamber treatment in the HBO group compared with no rise in oxygen levels in the HBA group. The differences between the two treatment groups lasted at least 1½ year. Conclusion: Hyperbaric oxygenation is a valuable adjunctive when treating diabetic foot ulcers. OR15 Hyperbaric Oxygen Therapy for 16 Gas Gangrene Patients Injured by Earthquake Pan Fu-Qiong, Zeng Yu, Nie Cai-Xian, Huang Ling-Ling, Tang Ming-Chan, Li Yu-Feng, Zhang Yun Sichuan Provincial Hospital, Chengdu, China Objective: observe the therapeutical effect of Hyperbaric oxygen for 16 gas gangrene patients injured by earthquake. Methods: establish emergency isolation passage, rescue each case with hyperbaric oxygen at the pressure of 0.25Mpa,7 times per 3 days,20 times totally. And psychological guidance is added. Results: all wounds recovered in 16cases,including 4 cases with their unamputated limbs preserved. Fusiform bacillus can not be detected. Conclusions Hyperbaric Oxygen can effectively curb the growth of Fusiform bacillus, decrease the production of toxin, promote the heal of wounds, lower the disability rate and raise the survival rate. OR16 A survey on HBO treatment of traumatic brain injury this century in China—A important evidence of HBO improve curative effect and prognosis of Brain injury Zhou Shurong First Affiliated Hospital of Nanjing Medical University, Nanjing, China This report summarizes 214 articles about HBO treatment of brain injury published on the proceedings of the 7 national HBO academic congresses since this century. According to the statistics, 28878 cases of brain injury and 2088 case of PVS have been treated with HBO in this period. Among the 28878 cases of brain injury, 67.5%~ 88.2% were cured or notably effective, the total effective rate was 89.3%~99.6%. While in the 2088 cases of PVS, 46.7%~58.83% were cured or basically cured, the total effective rate was 82.25%~97%. In this report 12 articles were cited, the RCT and Meta-analysis of which were compared with the data from some brain injure therapy research centers in the world. The results show that HBO synthesize therapy is better than the routine treatment in the improvement of curative effect and prognosis. This report presente ample evidences for HBO sythesize therapy in raising effective and improving prognosis. OR17 Clinical analyses of 429 Cases of Acute CO Poisoning 1 1 2 1 Zhuo Li , Chunjin Gao , Xiang Huang , Huan Ge , Yu Ga 1 o 1. Beijing Chaoyang Hospital, Beijing, China 2. Beijing Shunyi Hospital, Beijing, China Introduction: Acute CO poisoning frequently occurs in winter in northern part of China. After CO poisoning, COHb has an evident increase. It is well known that rising COHb affects the transportation of oxygen and triggers the poisoning. Methemoglobin formation results from the oxidization of the bivalent iron of hemoglobin into trivalent iron, which lacks the capacity of carrying and releasing oxygen. However, there is no literature reporting the change of Methemoglobin formation in acute CO poisoning patents (ACOP). With the application of Rad-57 Pulse CO-Oximeter, (Masimo Corporation) we have observed the changes of COHb and MetHb of 429 acute CO poisoning patients and studied the roles of COHb and MetHb in triggering acute CO poisoning as well as their relations. Methods: The subjects are 429 acute CO poisoning patients in Beijing Chaoyang Hospital and Beijing Shunyi Hospital from November, 2006 to March, 2007 with 100 healthy people who do not smoke as the control group. We employed Rad-57 Pulse CO-Oximeter to observe the levels of COHb and MetHb of the emergency patients when they went to see the doctor. After 2h inhaling of oxygen (through nose at the rate of 3L/min) or one hyperbaric oxygen theraphy (2ATA, breathe oxygen for 60min), the levels of COHb and MetHb were measured again and the changes observed. We also recorded general situation, cause of the disease and clinical classifications etc. of the patients. Then we utilized SPSS11.0 software for statistic analysis. Results: CO poisoning of 98% of the patients is due to inappropriate use of coal stoves. Clinical classification: Light poisoning 274 cases; intermediate poisoning: 77 cases; severe poisoning: 78 cases. A total of 98 emergency patients have MetHb>1.2% at the first measurement. The concentrations of both COHb and MetHb of the patients are evidently higher than that of the control group (p0.05) although fifty patients out of 58 cases showed small decrease in MetHb. Discussion and conclusions: (1) Inappropriate use of coal stove is the main cause of acute CO poisoning in northern part of China. (2) MetHb may be involved in the physiopathological process of hypoxia of ACOP patients. MetHb of such patients is clearly higher than that of the control group, but only 98 patients have MetHb >1.2%. This indicates that the rise of MetHb level is not the key factor leading to hypoxia in ACOP patients. The increase of COHb level is the main cause. (3) Whether hyperbaric oxygen treatment can effectively cure methemoglobinemia still requires further study. (4) The Rad-57 Pulse CO-Oximeter provides a noninvasive tool to greatly facilitate the clinical diagnosis & treatment for CO poisoning patients. Table 1 group COHb (Mean%) MetHb (Mean%) Control group 1.28±0.68 0.25±0.12 ACOP group 18.28±8.40 0.86±0.82 P -value <0.01 <0.01 OR18 Review of Current situation on acute carbon monoxide poisoning in china Shuyi Pan, Xiaowen Pan, Yu Zhang, Yan Lu, Xiangen Me ng, Chen Yang, Mingxin Li, Qi Zhang, Liang Zhang Navy General Hospital, Beijing, China To summarize the study on acute carbon monoxide poisoning (ACMP) of Chinese Units in recent 10 years, including pathogenesy, clinic treatment and animal model building. And analyze the existing problems and reasons of ACMP. The conclusion that morbility foundation of ACMP and delayed encephalopathy may be poisoning cascade reactions in which multiple pathomechanisms play roles; It maybe one of important factor that patient breathed in concentration of CO for prognosis. The key to resolve this problem is early intervention. Reviving the respiration and circulation early to ensure utility filling into tissues and organs, sustaining cell normal metabolism, especially to brain tissue. The treatments are including, active HBO treatment, keeping breathing smooth, ensuring utility oxygenation and circulation, improving microcirculation, anticoagulation, reducing plasma fibronectin. In addition, cytoprotection measures such as anti-free radicle should be given at the right moment. At the same time, multicentre unite research should be carried out for better therapeutic measures. OR19 Effect of HBO on endogenous neural stem cells in rat models of acute CO poisoning Wenlan Wang, Jinsheng Li, Xiaoping Xie Department of hyperbaric oxygen treatment center, School of Aerospace Medicine, Fourth Military Medical University, Xi’ an, China Objective: To discuss the effect of HBO on endogenous neural stem cells (NSCs) in rat models of accute CO poisoning, and to analyses the mechanism of HBO treating brain injury after accurate CO poisoning. Methods: After set up models of accurate CO poisoning, H-E staining was used to observe the pathological changes of brain tissues and immunohistochemical staining was used to observe the expression of nestin (NSCs specified marker) and GFAP (astrocyte specified marker). Results: The H-E staining showed that the morphology of neurons in control group were normal, and which of poisoned groups were degenerated and necrotic in spots and sheets, and the cortex of CO poisoned groups were looser as well as the cone cells of hippocampus were thinner, but in HBO group the degenerated and necrotic neurons became less. The immunohistochemical staining showed the following: expression of nestin and GFAP was normal in quantity and morphology in control group, in CO poisoned groups the expression of nestin was increased lightly and the expression of GFAP was abnormal in quantity and morphology, in HBO group GFAP positive cells became normal, but the expression of nestin was increased obviously. There are nestin/GFAP double positive cells in cortex where the damage of neurons was extremely heavy. Conclusion: Compared to control group, the + quantity of nestin cells was increased lightly, astrocytes were proliferated and deformed and neurons get degenerated and necrotic in poisoned groups and HBO could make astrocytes become normal and have NSCs generate, immigrate and differentiate. It is suggested that the process of brain injury can make NSCs active and HBO can treat the brain injury by generation, immigration and differentiation of NSCs. OR20 Hyperbaric oxygen treatment attenuated the decrease in regional glucose metabolism of rats subjected to focal cerebral ischemia: a high resolution positron emission tomography study 1 2 3 1 M. LOU , H. ZHANG , J. WANG , S. Q. WEN , Z. Q. 4 5 6 1 TANG , Y. Z. CHEN , W. Q YAN , M. P. DING 1. Department of Neurology, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China 2. Department of Nuclear Medicine, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China 3. Zhejiang-California International Nanosystems Institute, Hangzhou, China 4. Department of Hyperbaric Oxygen, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China 5. Department of Neurobiology, Zhejiang University, School of Medicine, Hangzhou, China 6. Clinical Research Center, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China Cerebral hypoxia may be the main component of cell damage caused by ischemia. Previous studies demonstrated a neuroprotective effect of early hyperbaric oxygen (HBO) treatment in various animal models of focal cerebral ischemia. Neuropathologic study showed that exposure of HBO may prevent cell death in ischemic cortex. In the present study, we aimed to assess cellular function of ischemic rat brain after HBO treatment by means of a high-resolution positron emission tomography scanner (microPET) used specifically for small animal imaging. The male Sprague– Dawley rats were subjected to permanent middle cerebral artery occlusion (MCAO), with the regional cerebral blood flow monitored in vivo by laser Doppler flowmetry. One hour after ischemia, HBO therapy (3 atm absolute, 1 h) was initiated. Local cerebral glucose utilization in the ischemic area was measured before, 1 h and 3 h after ischemia, with 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) as a tracer. Neurological deficits and infarct volumes were assessed at 24 h after ischemia. Our study showed that early HBO therapy significantly reduced infarct volume of brain 24 h after ischemia. Moreover, glucose utilization in the ischemic area underwent asevere decrease during 1–3 h after MCAO, while the early HBO treatment significantly attenuated the decrease in cerebral metabolic rate of glucose in the ischemic core of the cortex compared with controls. We report for the first time the application of microPET to quantify the rates of glucose metabolism in the ischemic core of rats exposed to HBO. Our results suggest that the early exposure of HBO can partially reverse the downward trend for glucose utilization in the ischemic core, which might contribute to the reported beneficial effects of early HBO therapy on permanent cerebral ischemia. OR21 Treatment of micro-found drilling cranium and hyperbaric oxygen on 94 cases of patients with extradural hematoma Jincheng CHENG, Yiqun WANG, Bensong YU, Ganf SU, Shiquan YANG, Tian XIA 123th Hospital of People’s Liberation Army Objective: To evaluate the curative effects of micro-found drilling cranium and hyperbaric oxygen (HBO) for patients with extradural hematoma. Methods: According to the volume of hematoma and GCS points of patients, ninety four cases of extradural hematoma were divided into four groups: conservative group (14cases, the volume of hematoma<50ml), micro-found drilling cranium I group (16cases, the volume of hematoma<50ml), micro-found drilling cranium II group (28cases, the volume of hematoma≥50ml), micro-found drilling cranium+ HBO group (36cases, the volume of hematoma≥50ml); their curative effects, complications, the hospitalization time and hospitalization cost were compared respectively. Before and after the HBO treatment, the haemodynamics parameters of HBO group were detected and compared. Results: The 94cases got an excellent prognosis. The sequela, hospitalization time and cost in micro-found drilling cranium I group were lower than in conservative group (P<0.05); and in micro-found drilling cranium+ HBO group were lower than in micro-found drilling cranium II group (P<0.05). After the HBO treatment, the haemodynamics parameters of patients were ameliorated, and the difference were significant when compared with the before (P<0.05). Conclusion: The treatment of the micro-found drilling cranium combined with the HBO on patients with extradural hematoma can significantly increase the cure rate, decrease mutilation rate, and effectively shorten the hospitalization time, save treatment cost. OR22 The effect of hyperbaric oxygen on the osteoporosis rats Wang Peisong, Wan Jin’e, Yang Xizhong, Wang Shuzhen, Liu Xueling, Lu Qiuning Department of hyperbaric oxygenation, The affiliated Hospital of Qingdao University Medical College, Qingdao, China Objective: To inverstigate the impact of hyperbaric oxygen on bone mineral density and bone biomechanical property . Methods: Reproduce the osteoporosis model of ovariectomized rats and received hyperbaric oxygen and lycopene therapy. After 12 weeks therapy,bone mineral density and bone biomechanical property were measured. Results: The bone mineral density and biomechanical property of ovariectomized rats decreased significantly (P<0.05), and it increased after 12 weeks therapy using hyperbaric oxygen and lycopene, and there were no significantly between hyperbaric oxygen and sham groups. Conclusions: Hyperbaric oxygen and lycopene could improve and increase the bone mineral density and bone biomechanical property in ovariectomized rats; Hyperbaric oxygen and lycopene have the nearby effect . OR23 Research on the distribution of oxygen concentration in the Sinlge Hyperbaric Oxygen Chamber 1 1 1 Qibiao Weng , Hongjuan Wang , Lingzhen Chen , 1 2 3 4 XuelinChen , Zhenxin Huang , Huai Huang , Xiangxue Li , 4 4 Guirong Lin , FengxianWei 1.Department of Hyperbaric oxygen, Zhujiang Hospital, the Second Affiliated Hospital of Southern medical university, Guangdong province, China. Naformátováno: Písmo: (výchozí) Arial, 9 b., Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., Tučné Naformátováno: Zarovnat do bloku Odstraněno: Trial of cabin-oxygen-concentrati on distribution of Odstraněno: single oxygen pressurized module Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Zarovnat do bloku, Řádkování: jednoduché Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Písmo: (výchozí) Arial, 9 b., není Tučné Naformátováno: Zarovnat do bloku 2.Department of Hyperbaric oxygen, the Second Affiliated Hospital of Guangzhou medical college, Guangdong province, China. 3.Department of Hyperbaric oxygen, Guangzhou General Hospital of Guangzhou Military Area Command of Chinese PLA, Guangdong province, China. 4.Department of Hyperbaric oxygen, the Hospital of Guangdong Water Resources and Hydropower engineering Bureau 2, Guangzhou, China. Objective : This study was designed to explore the distribution of oxygen concentration in different parts of the hyperbaric oxygen chamber and the possible influence of the different locations of oxygen inlet/outlet and the methods of washing cabin. The oxygen inlet/outlet were located in different ways and the oxygen samples were gathered in the upper, middle and lower parts of the chamber in our test. The aim of our study was to select the most appropriate location of oxygen inlet/outlet and the most appropriate method to wash cabin so as to enhance the uniformity and concentration in the chamber, which could improve the theraputical efficiency of hyperbaric oxygen. Materials and methods: :We used 7 choices of combination of different ways letting in or letting out the oxygen. Meanwhile, whether patient was in chamber and if the continuous washing was executed had been concerned. Finally, 15 methods came out under manifold of situation. Result and Discussion:Three essential elements: the ways of oxygen inlet/outlet, the state of cabin, the ways of washing, was aimed in our trial for each of them takes great changes to the elevation of oxygen concentration and distributive uniformity. Three positions of inlet/outlet, three states and three opinions of washing cabin was developed in raising, stable and decreasing pressure period with 9 sampling spots set on the chamber. The trial was executed with the pressure under 0.1MPa, lasting for 80min and strictly following the rule of Chinese medical association-HBO branch. Measurement range is 0-100% with sampling interval of 2min. 1.Influential factors on the distribution of oxygen concentration. The main factors can be the size of stretcher and the location of oxygen inlet/outlet. Unsymmetrical distribution was found, causing by the gas shot circuit on the bottom of wide size stretcher, which was widely used in single hyperbaric oxygen chamber. In contrarily, the oxygen inlet on the top or middle side braces the concentration to 65-75% with the symmetrical distribution. On the other hand, the modification on stretcher make help to the gas diffusion in the chamber. 2.The best method of washing cabin. Only wash-procedure with the pressure-raise to 0.1MPa showed distinctive difference of 2% elevation at the top and 4% at the middle and bottom parts. Moreover, the normal pressure method can be the best for it raise the concentration effectively, especially up to 80%in 5 minutes in the middle part. 3.selection of sampling spots Since the different design of stretcher and the inlet/outlet locations vary, the regular way to set the spots on the top of stretcher and middle of chamber fails reflect the distribution of concentration. However, changing the inlet position and taking the appropriate way washing cabin can provide consistent samples everywhere in the chamber. 4.the distribution of oxygen concentration We found that the concentrations were same everywhere in the cabin while the pressure was at 0.1MPa lasting for 40min. Nevertheless, great difference took place while pressure reducing; concentration on bottom was higher than that in other parts. The concentration came to coordinate again when pressure dropped to 0.03MPa. Suggestion1.The location of sampling spots should be standardized.2.The location of oxygen inlet/outlet should be standardized. Oxygen inlet should be set at the top of the posterior part of the chamber, while oxygen outlet should be set at the bottom of the anterior part of the chamber.3.The way to wash cabin should be applied according to the need of the patient so as to achieve the appropriate oxygen concentration.4.The production of the stretcher should be standardized. First, it must be equipped with a mattress. Second, enough space should be vacated beside the stretcher in the chamber.5. A new function should be developed in order to mix the gas automatically and make help to the gas diffusion in the hyperbaric oxygen chamber. OR24 Clinical Research on Effect of HBO plus Electric Stimulation for Treatment the Cerebral Resuscitation Peidong Wang, Chunping Wu, Hulong Ma, Kangmin Xie, Yaojun Zhang, Xia Wang, Aiping Wang Chinese HBO Medicine Association Research Center of Brain Recovery, Nanjing, China To improve therapeutic effect on cerebral brain resuscitation, a comprehensive therapy with hyperbaric oxygen (HBO) treatment as the main method was adopted from 1991 April to 2006 Dec. Among total 973 cases of PVS patients; 14 cases patients were put to use electrical stimulation (ES) demonstrated more excellent effect. Judgment of therapeutic efficacy: - Rely on PVS scoring scale and criteria of therapeutic efficacy (Nanjing, 2001). Basic recovery (consciousness or cognition recovery) 371cases (38.13%); Obvious improvement (score ≥ 8 –12 points) 203 cases (20.86%); Obvious improvement (score ≥ 3 points) 190cases (19.5%); No improvement (no change, worsening or death) 209 cases; The general improvement rate is 78.48%; The HBO plus ES is superior to the results of similar HBO treatment. Some causes that affect efficacy in treatment of PVS are analyzed as follows: From the result, it can be seen that the efficacy of HBO treatment in traumatic cases is obviously higher than that of non—traumatic cases; the younger the onset happens, the higher the curative rate is; the earlier HBO treatment is used, the better the efficacy is; and HBO plus ES, if available in some indication cases, shows that the more excellent effect. We suggest that PVS patients should receive HBO therapy (and certain cases plus ES) as early as possible is the best choice OR25 Odstraněno: Huang 1 2 Zhenxin , Weng Qibiao , 2 Wang Hongjun , Chen 2 2 Lingling , Chen Xuelin , 3 4 Huang Huai , Li Xiangxue , 4 4 Lin Guirong , Wei Fengxian ¶ 1. Zhujiang Hospital attached to Southern Medical University, Department of Hyperbaric oxygen, Guangzhou, China¶ 2. The Second Hospital attached to Guangzhou Medical College, Department of Hyperbaric oxygen, Guangzhou, China¶ 3. General Hospital of Guangzhou military district, Department of Hyperbaric oxygen, Guangzhou, China¶ 4. Department of Hyperbaric oxygen, Hospital of Second Water and Electricity Office of Guangdong Province, Guangzhou, China¶ Naformátováno: Zarovnat do bloku Naformátováno: Písmo: Tučné Odstraněno: The medical oxygen pressurized cabin which is convenient and suitable for patients with different diseases and ages has been widely used for decades. Meanwhile, it is accepted by a majority of hospitals. To select appropriate input/output of oxygen, structure and washing method is beneficial to oxygen concentration elevation and distribution in cabin, because pure oxygen is used as medium for compression. Three ways of oxygen input/output(on the top, middle and bottom of the cabin), three states of the cabin(with a bed, with a bed and a patient, without a bed and a patient) and three ways of washing method(continued washing method with boosting pressure, washing method of boosting pressure of...the [29] Naformátováno: Angličtina (USA) Effect of Hyperbaric Oxygen Treatment on the content of VEGF, HIF-1,CX43 in random skin flaps of rabbits 1 1 1 1 Xuehua Liu , Chunjin Gao , Huan Ge , Fujia Liu , Yang 2 2 Liu , Hongying Zhao 1. Department of Hyperbaric Oxygen, Chaoyang Hospital, Capital Medical University 2. Department of pathology, Chaoyang Hospital, Capital Medical University Purpose: To observe the changes of capillary density, vascular endothelial growth factor(VEGF), hypoxia-inducible factor-1(HIF-1), Connexin 43(CX43)before and after hyperbaric oxygen treatment in the transplanted random skin flaps of rabbits and to explore the mechanism of capillary ingrowth of hyperbaric oxygen treatment on random skin flaps of rabbits. Materials and Methods: 12 rabbits were randomly divided into two different groups: control group(n=6), hyperbaric oxygen group(n=6). Random skin flaps models were established on the back of rabbits. The control group was placed in normal pressure atmosphere without hyperbaric oxygen treatment. The hyperbaric oxygen group started to accept hyperbaric oxygen treatment(2 ATA, 45min per time) after flap transplantation immediately, twice a day from post-operation to the third day, then reduced to one time per day to the seventh day, seven days altogether. we observed the survival area of random skin flaps and detected capillary density and content of VEGF, HIF-1, CX43 by using HE staining and immunohistochemistry at rd th 3 day and 7 day respectively. The SPSS11.5 software was used for statistical analysis. Results: 1.The survival area of skin flaps in the hyperbaric oxygen group was rd singnificantly higher than that of the control group at 3 th day and 7 day (p<0.01); 2.The capillary density in the hyperbaric oxygen group was higher than that of the rd control group at 3 day (p<0.05),the capillary density in hyperbaric oxygen group was singnificantly higher than th that of the control group at 7 day (p<0.01); 3.The content of VEGF in the hyperbaric oxygen group was higher than rd th that of the control group at 3 day and 7 day (p<0.05); 4. The content of HIF-1 in the hyperbaric oxygen group was rd th lower than that of the control group at 3 day and 7 day (p<0.05); 5.The content of CX43 in the hyperbaric oxygen group was singnificantly higher than that of the control rd group at 3 day(p<0.01),the content of CX43 in the hyperbaric oxygen group was higher than that of the th control group at 7 day (p<0.05). Conclusions: Hyperbaric oxygen treatment can accelerate capillary ingrowth by increasing the expression of VEGF and CX43, so improve the survival rate of transplanted random skin flaps. Hyperbaric oxygen treatment can improve the hypoxia state of transplanted random skin flaps and decrease the expression of HIF-1 in transplanted random skin flaps. 1, 2 2 3 Wang Youbin , Gao Chunjin , Liu Fujia , Sun Xuejun , Liu 2 Xuehua (Qi Zheng and Gao Chunjin contribute equally in this experiment) 1. Plastic Surgery Department of Peking Union Medical College Hospital, Beijing, China. 2. Hyperbaric oxygenic Deperpartment of Beijing Chaoyang Hospital associated with Capital Medical University, Peking, China. 3. Department of Chinese Military Medical University, Shanghai, Chnia. Objective: To study the interfering effect of preconditioning hyperbaric oxygenation on skin flap ischaemia tolerance. Methods: 18 SD rats were divided the control group and the HBO preconditioning group. In control group, an extended epigastric adipocutaneous flap was raised, based on the right superficial epigastric artery and vein. 3-hours flap ischemia was induced by clamping the pedicle vessels with microvascular clamp. At the end of ischemia induction, the clamp was removed and the flap was sutured back. Rats in HBO preconditioning group were treated with HBO two days before operation. Flap surgery began 1 hour after the last HBO treatment. The operation was the same as the control group. The size of the designed flap and the survived flap on the fifth postoperative day was duplicated with transparent paper. The condition of the flap was recorded with digital camera. , The picture of the paper was gotten with scanner and it s area which was equal to the area of the flap was calculated with Acrobat soft ware. Data were analyzed with SPSS soft ware. Results: The average designed 2 flap areas were 51.59 and 52.71 cm in the control group and the HBO preconditioning group. The average survival 2 flap areas were 7.38 and 15.82 cm . There were obvious difference between the control and the HBO preconditioning group (t=4.14, P=0.003) in average survival area. Conclusion: HBO preconditioning can rise flap ischaemia tolerance and enhance flap survival. OR27 Effect of early hyperbaric oxygen treatment on prevention of disorder of coagulation-fibrinolysis systems in rabbits with steroid-induced avascular necrosis of the femoral head 1 2 3 WANG Yong , GAO ChunJin , PANG BaoSen , YANG 4 1 2 JinCai , LI HaiDong , WU LianHua 1. Department of Hyperbaric oxygen, Fuxing Hospital, Capital Medical University, Beijing, China 2. Department of Hyperbaric oxygen, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China 3. Department of Respiratory Diseases, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China 4. Department of Orthopaedics, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China Objective: To establish animal model of steroid-induced OR26 Hyperbaric Oxygenation Preconditioning Induce Skin Flap Ischaemia Tolerance in Rat Model avascular osteonecrosis of the femoral head (SANFH); To investigate the effects of hyperbaric oxygen (HBO) therapy on histopathology, coagulation and fibrinolysis of SANFH. Methods: 1. Experimental animal and group: Male adult New Zealand white rabbits, ranging in weight from 2.5 to 3.5 kg, were obtained from experimental center of capital university of medical sciences and randomly divided into eleven groups including Group N (control group); Group M24h, M48h, M1, M2, M4, M6(model groups); GroupH1, H2, H4, H6(HBO groups). Each group had eight rabbits. 2. Model establishment and HBO therapy: According to Yamamoto T et al’s method, animals in group M and H reveived lipopolysaccharide (LPS) 20µg/kg intravenously 2 times at an interval of 24 hours, injected methylprednisolone 20mg/kg intramuscularly into the gluteus medius 3 times at intervals of 24 hours after the second injection of LPS. Animals in Group H1, H2, H4, H6 were received HBO therapy after the second injection of LPS, 2.0 ATA, 1 hour daily, once a day. Group H1, H2, H4 , H6 were treated 1, 2 ,4 weeks and 5 weeks respectively. 3. Experiment parameters: Antithrombin-III (AT-III) 、 Thrombomodulin(TM) 、 Tissue-type plasminogen activator(tPA) and Plasminogen activator inhibitor-1(PAI-1 ) were measured in each group; Animals in group M and H were killed at 2 weeks, 4 weeks and 6 weeks respectively after the second injection of LPS and the tissue samples of the femoral head were observed with light microscopic examination. Results: 1. Histopathologic examination: In group N, the bone trabeculaes align trimly in subchondral zone of femoral head. Empty lacunae were found occasionally. Large hematopoietic tissues were seen in marrow with fat cells disseminated sporadically. In group M, it was distinguished that fat cells were increased in both the number and the size, whereas hematopoietic tissues were decreased; Subchondral bone and bone trabeculae showed empty lacunae, pycnotic nuclei and apparently discrete; Among trabeculae, fat cells showed hyperplasia and hypertrophy, such pathologic changes showed particularly significant in group M4, in which marrow were nearly accumulated with fat cells and the disruption and fusion of fat cells were seen obviously. In group H, the number of fat cells was more than that in group N, less than that in group M, obviously changes were found in group H4 and H6; Apparently trabeculae loose were not found; pycnotic nuclei and empty lacunae rate were significantly decreased than those of group M. Fibrous tissue becomes more prominent in marrow in group H6 and there were apparently active osteoblasts surrounding bone trabeculae in metaphyseal area. 2. Hematologic examination: AT-III : Compare to group N, group M were significantly higher at 24 hours after the first injection of LPS(P<0.05), began to decrease at 48 hours, and reached minimum at 1 week (P<0.05), Group H were not different in comparison with group N, whereas obviously decreasing at 4 and 6 weeks(P<0.01); TM: Compare to group N, group M began to increase at 24 hours after the first injection of LPS, and reached maximum at 1 week(P<0.01), group H were significantly lower than group M at 1week(P<0.05), whereas more higher at 4 weeks(P<0.05); tPA: Compare to group N, group M began to decrease at 24 hours after the first injection of LPS and reached minmum at 2 weeks(P<0.01), group H were significantly higher than group M at 2 weeks(P<0.05), whereas not different than group N; PAI-1: Compare to group N, group M began to increase at 24 hours after the first injection of LPS and were significantly higher at 48 hours, 1 and 2weeks(P<0.01), then began to decrease after 2 weeks, the value were not different than group N at 4 and 6 weeks. group H were significantly lower than group M at 2 weeks(P<0.01), whereas not different than group N. Conclusion: HBO intervention can inhibit hyperplasia and hypertrophy of fat cells in marrow, reduce the extent of osteonecrosis and enhance the ability of fibrous reparation and bone reconstruction after osteonecrosis; HBO therapy can improve obstruction of coagulation and fibrinolysis of SANFH. OR28 Hyperbaric oxygen preconditioning protects against traumatic brain injury at high altitude Shengli Hu, Rong Hu, Fei Li, Yongzhi Xia, Hui Meng, Gao yu Cui, Hua Feng Department of Neurosurgery, Southwest Hospital of the Third Military Medical University, Chongqing, China Background Recent studies have demonstrated that preconditioning with hyperbaric oxygen (HBO) can reduce ischemic and hemorrhagic brain injury. The aim of this study was to investigate the effects of HBO preconditioning on traumatic brain injury (TBI) at high altitude and examine the role of matrix metalloproteinase-9 (MMP-9) in such protection. Methods Thirty-nine male Sprague-Dawley (SD) rats were randomly divided into three groups: HBO preconditioning group (HBOP n=13), high altitude group (HA n=13) and high altitude sham operation group (HASO n=13). All groups were subjected to head trauma using a weight drop device except for the HASO group. The rats in the HBOP group received 5 sessions of HBO preconditioning (2.5 ATA, 100% oxygen, 1 hour daily) and then were kept in a hypobaric chamber at a pressure of 0.6 ATA(simulate the pressure of high altitude of 4000 meters) for 3 days before operation. The animals in the HA group received control pretreatment (1 ATA, room air, 1 hour daily), then followed the same procedures to the HBOP group. In the HASO group, rats were only opened a skull window without injuring the brain. Twenty-four hours after TBI, neurological function and brain water content of 7 rats in each group were examined and 6 rats in each group were killed for hematoxylin-eosin staining and immunohistochemical analyses. Results The neurological outcome in the HBO group (0.71±0.49) was better than that in the HA group (1.57±0.53; PP<0.01). The brain morphology and structure presented by light microscope was destroyed greatly in the HA group, including massive cells necrosis, conspicuous edema of interstitium, hemorrhage, and so on, while less pathological injuries occurred in the HBO group. Compared to HA group, pretreatment with HBO significantly reduced the number of MMP-9-positive cells (92.25±8.85 vs. 74.42±6.27; P<0.01). Conclusions HBO preconditioning can attenuate TBI in rats at high altitude. The decline of MMP-9 expression may contribute to HBO preconditioning-induced protection of brain tissue against TBI. OR29 The effect of hyperbaric oxygen on the proliferation and death of Nasopharyngeal Carcinoma Cells and its mechanisms Zhengrong Peng, Juan Liu, Weihong Zhong, Pingtian Xia n Xiangya Hospital, Central South University, Changsha, China Objective: To investigate the effect and the possible influencial mechanisms of hyperbaric oxygen(HBO) on the proliferation and death in human nasopharyngeal carcinoma(NPC) cell line CNE2Z by viewing the inhibition ratio of proliferation(IROP) and mortality rate(MR) and the content of superoxide dismutase(SOD) and malondialdehyde(MDA) of nasopharyngeal carcinoma cells through HBO disposal. Method: Nasopharyngeal carcinoma(NPC) cell line CNE2Z were divided into 3 groups randomly, Group A: control group; Group B: hyperbaric oxygen(0.20MPa);Group C:hyperbaric oxygen(0.25MPa). The IROP in CNE2Z cells of all groups were detected by MTT reduction assay and the MR were detected by PI staining; as well as the content of SOD and MDA were detected. Result: The IROP and MR of B, C groups were dramatically increased comparing with A group(P0.05);There were no statistical difference in the content of SOD between A, B and C groups(P>0.05);There were statistical difference in the content of MDA between A、B and C groups(P0.05). Conclusion: HBO disposal could increase the IROP and MR of human NPC cell line CNE2Z, and elevated the MDA content in nasopharyngeal carcinoma cells, it had hinted that HBO disposal could inhibit the proliferation of NPC cells and promoted the death of NPC cells by increasing the content of MDA. OR30 Effect of hyperbaric oxygenation (HBO) on unilateral spatial neglect (USN) Liu Jinglong Heilongjiang Rehabilitation Hospital, Ha’erbin, China Objective: To evaluate the effect of Hyperbaric Oxygenation (HBO) on unilateral spatial neglect (USN) and basic activities of daily living (B-ADL) after stroke. Methods: Sequentially access 93 stroke patients with hemiplegia admitted to the Heilongjiang Province Rehabilitation Hospital, according with the following: first stroke, no aphasia, no dementia, no cognitive disorder and serious system disease, were classified upon admission as having USN (group A; n = 43; 46.2% of the entire sample) or not having such disturbance (group B(control group ); n = 50; 53.8% of the sample). The age of all was between 35 and 75 ,and began to get rehabilitation within 4weeks .By ‘cross-out’ test, ‘digit cancellation’ test, ‘line-bisection’, clock drawing, ‘free hand drawing’ test, we examined the unilateral spatial neglect. When 3 of the 5 tests are abnormal or more, we thought the patient had unilateral spatial neglect. Both groups received standard rehabilitation treatment at most 6 weeks after stoke onset, including daily physiotherapy, occupational therapy, traditional Chinese medicine and other therapy in accord with individual needs. The group A was randomly divided into two groups –group A1(experimental group)(22) and A2 (observation group)(21).And group A1 was in Hyperbaric Oxygenation (HBO) synchronously ,but group A2 not .HBO was 2 hours per day and 6 times per week . The Modified Barthel Index (MBI) was used to assess patients' capacity in B-ADL. Assessment was done upon admission to rehabilitation and 6 weeks afterwards. Results: Before treatment, the patients in A1 and A2 scored significantly lower with BI than those in B (P < 0. 05). After treatment, the patients in all groups scored significantly higher with BI assessment (P < 0. 001). However, the score with BI assessment in A2 was lower than those in B, but no significant difference (P >0. 05), and there was no significant difference between A1 and B (P > 0. 05). But there was significant difference between A1 and A2 (P< 0. 05). Conclusion: USN had significant impact on the recovery of the independent living of stroke patients. The rehabilitative intervention for USN may improve ADL performance of stroke patients with USN. 壁报交流 Poster Discussion P01 Postoperative treatments with hyperbaric oxygen and management of critical complications in 181 patients with severe brain injury Xiaowen Pan, Shuyi Pan, Juan Meng, Yu Zhang, Xiangen Meng, Yan Lu, Huijun Hu, Chen Yang, Qi Zhang, Mingxin Li Navy General Hospital, Beijing, China brain injury is more frequently occurred among vegetative state patients. A standardized nomenclature and diagnostic criteria are needed. The pathogenesis remained unknown and its therapy is only focused on symptomatic treatment. HBOT won’t be disturbed after the symptoms are controlled. Objective: to summarize our experience on postoperative management of patients of very severe brain injury with combined therapy of hyperbaric oxygen(HBO). Methods: retrospectively summarizing 181 postoperative patients of very severe brain injury from January, 2001 to December, 2005, in our section, all patients were treated by HBO. Results: of the 181 cases, 5 died (3%), 15 went into persistent vegetative state (8%), 112 cases were severely disabled (62%), 49 patients were mild disabled or completely recovered (27%). Conclusions: the prognosis of VSBI could be significantly improved on condition that early, safe, and efficient hyperbaric oxygen treatment being performed, combined injuries and crucial complications being prevented and managed in time. P03 Experimental research on hyperbaric oxygen therapy against traumatic brain injury 1 1 2 Guo-Hua Wang , Xiang-Gen Zhang , Yong-Cai Li , Yong 2 1 Wang , Zheng-Lin Jiang 1. Nantong University, Jiangsu, China 2. First Hospital of Nantong, Jiangsu, China P02 Vegetative state and paroxysmal dysautonomia after brain injury Qiuyou Xie, Ronghao Yu, Yanbin He, Jin Gu Hyperbaric Oxygen Medical Centre, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China Objective: To analyze the clinical features, nomenclature, criteria for diagnosis, possible pathogenesis, pharmacological management and hyperbaric oxygenation therapy (HBOT) of vegetative state patients with paroxysmal dysautonomia after brain injury. Methods: The clinical presentations, auxiliary examinations, treatment effect and prognosis were retrospectively analyzed for 19 vegetative state patients with paroxysmal dysautonomia after brain injury. Results: Among 19 patients, There were 12 cases of severe traumatic brain injury, 1 case of cerebellar hemorrhage and received evacution of hematoma, 1 case of heroin toxic encephalopathy, 2 cases of severe carbon monoxide poisoning, 3 cases of hypoxic-ischemic encephalopathy after cardiopulmonary resuscitation (1 for electrical injury, 1 for coronary angiography and coronary stent implantation and 1 for cardiac arrest due to anaesthetic accident). They had most of the symptoms such as agitation, hyperthemia, diaphoresis, tachypnea, tachycardia, hypertension, dystonia. No epileptic wave was found on their electroencephalogram (EEG). Latent period of physiological waves was prolonged and amplitude was fallen down on brain auditory evoked potential (BAEP) and somatosensory evoked potential (SEP). Varied degree lesions were detected in the cortex, subcortex, or brainstem by neuroimaging. Most frequently used drugs were dopamine agonist or antagonist, benzodiazepines and muscle relaxants. Once their symptoms were controlled, HBOT could be prescribed for them. Conclusions: Paroxysmal dysautonomia following Objective: To observe the therapeutic effect of hyperbaric oxygen (HBO) against traumatic brain injury (TBI) in rats, the time window of efficacy and optimal treatment times, and to investigate the underlying mechanisms of HBO for TBI treatment. Methods: TBI was induced in rats with the modified Feeney’s method. For the sham-operated group, only a bone window was opened without traumatic injury. An animal hyperbaric oxygen chamber was used to carry out HBO treatment. Treatment pressure was maintained at 3ATA of duration 60min with compression or decompression time of 6min, respectively. The chamber was kept ventilation with pure oxygen at a flow rate of 2L/min during compression and HBO exposure. The treatment groups received HBO therapy at 3h, 6h, 12h and 24h, respectively, after TBI. In addition, at 24h after TBI three groups of rats received HBO therapy for once, three, or five times, respectively. The neurological behavior score, brain water content and Nissl staining were measured to identify the time window of efficacy and optimal treatment times. The content of SOD and MDA, levels of inflammatory cytokines (TNF-α, IL-6, IL-1β and IL-10) and cell apoptosis (TUNEL method and mRNA of bax, bcl-2 and caspase-3) in the surrounding brain tissue of the primary injury were determined to uncover the underlying mechanisms of HBO therapy. Furthermore, the expression of the markers of glia cells (GFAP, Vimentin and S-100) were detected with immunohistochemistry. Results: In addition to the time point 24h after TBI, HBO treatment at other three time points 3h, 6h and 12h displayed significant therapeutic efficacy on TBI, with decreases of the neurology deficit score, brain water content and the damage of brain tissue (P0.05). Compared with control group, HBO treatment at 6h after TBI elevated the content of SOD and IL-10, reduced the level of MDA, TNF-α, IL-6 and IL-1β in traumatic brain tissue. HBO treatment also increased the expression of bcl-2 mRNA with decrease of the ratio of bax/bcl-2, reduced the bax and caspsase-3 mRNA and the TUNEL positive cells. Moreover, the three markers of glial cells all showed a high expression in the surrounding tissue of the primary traumatic cortex. Conclusion: HBO exerted a neuroprotective effect on the brain tissue after TBI, the efficacy increased when HBO treatment was carried out at earlier time after TBI. Meanwhile the increase of treatment times raised the therapeutic effect of HBO at 24h after TBI. This effect of HBO may be potentially mediated through following mechanisms: inhibiting the oxidative stress, reducing the release of inflammatory cytokines, and suppressing the neuronal apoptosis. P04 HBO treat 22 cases drowning child Mao Lixian Wenlin Hospital, Taizhou, China Objective: TO study the tread plan and interfering effect of HBO on drowning child. Methods: sum up our experiencement on treat total of 22 drowning child with HBO in 2000-2007. Use large-scale HBO: prepare medicine etc, keep airway unblocked. Results: 19 cases (86percent) was recovered, 2 cases leftover sequelae of nervous system 1cases was dead. Conclusion: HBO may decrease and inhibit micro-thrombokinesis by to increase microcirculation blood flow dynamic, to improve the merphous and function of blood cell and endotbelial cell. Using HBO for drowning child is distinct improvement particularly. HBO may decrease the sequelae of nervous system partianlarly. P05 HBO treatment of ACOP poisoning delayed encephalopathy 51 cases Yang Jingfu Peoples Hospital of Baodi District, Tianjin, China Objective: To study the clinical, HBO treatment of ACOP poisoning delayed encephal opathy. Methods: 51 cases of patients .HBO treatment,the pressure of oxygen chamber for the 0.2-0.25mpa,Using the 6 personal small air pressurized module of the XINYING oxygen chamber plant HangZhou. Each of the cabin is 60mins,one for a group of treatment, The number of treatment is 30-60(that is 3-6 courses). Results: The group of 51 cases cared in 32 cases, Markdely effective in 10 cases, better in 8 cases. Invalid in 1 cases, the total efficiency was 98%. Conclusions: For severe ACOP patients, advanced age, accompanied with hypertension, hypercholesterolemia, cerebral Infarction or other disease, longer time for coming round and insufficient HBO treatment might be important risk factors related to DEACMP. It is scientific and effective for ws to use mannitol reasonably and to give ACOP patients sufficient HBO treatment together with glucocorticoid, medicine of promoting blood circulation and removing bolld stasis, antiplatelet aggregation agent and medicine of improving cerebral metabolism. P06 Hyperbaric oxygen induces endogenous neural stem cells to proliferate and differentiate in hypoxic-ischemic brain damage in neonatal rats Yu-Jia YANG, Xiao-Li WANG, Chong-Feng CHEN, Qing-Hong WANG, Yue YAO, Meng LI Division of Neonatology, Department of Pediatrics, XiangYa Hospital, Central South University, Hunan, China Objective: Studies suggest that after brain injury, hyperbaric oxygen (HBO) is neuroprotective by stimulating cell proliferation. We examine whether HBO promotes neural stem cells (NSC) to proliferate and differentiate in neonatal hypoxic-ischemic brain damage (HIBD) rats. Methods: Seven-day-old rat pups were subjected to unilateral carotid artery ligation followed by 2 hours of hypoxia (8% O2). HBO was administered 2 ATA, once daily for 7 days within 3 hours after HIBD. The proliferating neural stem cells in the subventricular zone (SVZ) and dentate gyrus (DG) were dynamically examined by 5-bromo-2-deoxyuridine (BrdU)/nestin immunofluorescence. Nestin protein was detected by Western blot analysis at various time points (from 6 hours to 14 days) after HIBD. The migrating NSCs were examined by BrdU/doublecortin (DCX) immunofluorescence 7 and 14 days after HIBD. The phenotype of the newborn cells was identified by BrdU/β-tubulin, BrdU/ glial fibrillary acidic protein (GFAP) and BrdU/O4 (oligodendrocyte marker) immunofluorescence. Myelin basic protein (MBP) was examined by immunohistochemistry and pathological changes of the brain tissue were detected 28 days after HIBD. Results: In neonatal HI rats treated with HBO, the proliferation of endogenous NSC was observed in the SVZ and DG. Cell numbers peaked 7 days after HIBD and proliferating NSC migrated to the cerebral cortex at 14 d after HIBD. Twenty-eight days after HIBD, an increase in newly generated neurons, oligodendrocytes and MBP was observed in the HBO group compared to the untreated and HIBD rats. Conclusions: This study suggests that HBO treatment may promote neurogenesis of the endogenous NSC in neonatal HIBD rats, contributing to repair of the injured brain. Acknowledgments Projects supported by National Natural Science Foundation of China (the Science Fund of the Chinese Academy of Sciences), Grant 30672240. P07 Hyperbaric oxygen preconditioning induces mitochondrial phenotype to prevent early apoptosis after spinal cord ischemia in rats 1 2 1 2 Liping Wang , Xuejun Sun , Wenxian Li , Zhimin Kang , 2 2 2 3 Yun Liu , Hengyi Tao , Weigang Xu , John Zhang 1. Department of Anesthesiology, Changhai Hospital, Secnod Military Medical University, Shanghai, China 2. Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China 3. Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, California, USA Objective: It is clear that hyperbaric oxygen preconditioning (HBO-PC) provides spinal cord protection against ischemia-reperfusion (IR) induced injury. This study tested hypothesis that HBO-PC induces expression of endogenous antioxidant enzymes and anti-apoptotic proteins Bcl-2 resulting in a motor neuronal mitochondrial phenotype to prevent early apoptosis. Methods: Male Sprague-Dawley rats were preconditioned with consecutive 4 cycles of 1-h HBO exposures (2.5 atmospheres absolute [ATA], 100%O2) at a 12-h interval. At 24 h after the last HBO pretreatment, rats underwent 9 min of spinal cord ischemia induced by occlusion of the descending thoracic aorta in combination with systemic hypotension (40 mmHg). Neurological function, TUNEL analysis and activities of caspase-3,9 were assessed during the first day after reperfusion. Mitochondria isolated from spinal cord of non-preconditioned (control) and HBO-preconditioned rats were studied before or after spinal cord ischemia. Results: Spinal cord ischemia produced marked neuronal death and neurological dysfunction in animals. HBO-PC enhanced expression of Mn-superoxide dismutase (Mn-SOD), catalase, and Bcl-2 in the mitochondria in the normal spinal cord at 24 h after the last pretreatment (before spinal cord ischemia) and retained higher levels throughout the early reperfusion in the ischemic spinal cord. HBO-PC decreased superoxide and hydrogen peroxide levels in mitochondria and reduced cytochrome c release into the cytosol in the lumbar spinal cord at 1 h after reperfusion. HBO-PC attenuated caspase-3 and -9, reduced motor neuronal apoptosis in the lumbar ventral horn, and improved neurological function at 24 h after spinal cord ischemia. HBO-PC increased nitric oxide (NO) production. L-nitroarginine-methy-ester (L-NAME, 10 mg/kg), a nonselective nitric oxide synthase (NOS) inhibitor, applied before each HBO-PC protocol, and abolished these beneficial effects of HBO-PC. Conclusion: We conclude that HBO-PC reduced spinal cord ischemia-reperfusion injury by increasing Mn-SOD, catalase and Bcl-2, and by suppressing mitochondrial apoptosis pathway. NO may be involved in this neuroprotection. P08 Hyperbaric oxygen preconditioning induces tolerance against brain ischemia 1 2 1 2 Jiasi Li , Wenwu Liu , Suju Ding , Weigang Xu , 1 3 2 Yangtai Guan , John H Zhang , Xuejun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China Objective: The present study examined the hypothesis that cerebral ischemic tolerance induced by hyperbaric oxygen preconditioning (HBO-PC) is associated with an increase of antioxidant enzyme activities. Methods: Male Sprague-Dawley rats (250-280g, n=74) were divided into sham, middle cerebral artery occlusion (MCAO) for 90 min, and MCAO plus HBO-PC groups. HBO-PC was conducted four times by given 100% oxygen at 2.5 atmosphere absolute(ATA), for 1 hour at every 12 hours interval for 2 days. At 24 hours after the last HBO-PC, MCAO was performed and at 24 hours after MCAO, neurological function and Nissl Staining were performed to evaluate the effect of HBO-PC. Malondialdehyde (MDA) content, activities of catalase (CAT), superoxide dismutase (SOD) and glutathione peroxidase (GSH-px) sampled from hippocampus, ischemic penumbra or core of cortex were measured. Results: HBO-PC improved neurological recovery, lessened neuronal injury, reduced the level of MDA and increased the antioxidant activity of CAT and SOD. Conclusion: These observations demonstrated that an upregulation of the antioxidant enzyme activities by HBO preconditioning plays an important role in the generation of tolerance against brain ischemia-reperfusion injury. P09 Hyperbaric oxygen prevents ischemia-reperfusion injury of gut in rats after resuscitation from trauma and hemorrhagic shock 1 2 2 Gang Wang , Lifang Jin , Weicheng Wang Hyperbaric Emergency, Chinese Medical University, Shenyang, China Background Hyperbaric oxygen (HBO) has been used therapeutically in intestinal ischemia/reperfusion (I/R) injury models established by clamping superior mesenteric artery, with ameliorating intestinal ischemic damage. This study was designed to investigate the effects of hyperbaric oxygen (HBO) on the ischemia-reperfusion (I/R) injury of gut in rats after resuscitation from trauma and hemorrhagic shock (T/HS) and elucidate the underlying mechanisms. Methods An iron mass from a retainable height smashed to the left thigh of Wistar rat vertically, and at the same time, rats was bled to establish T/HS model and subsequently resuscitated with shed blood and normal saline. Just prior to resuscitation, Wistar rats were randomly divided into 4 groups: sham group, shock group, one HBO treatment (HBOT) and three HBO treatment group. Results The levels of lactic acid, induced nitric oxide synthase (iNOS), nitric oxide (NO), and tumor necrosis factor-α (TNF-α) in intestinal tissue in one HBOT and three HBOT group after 24 hours from resuscitation were significantly lower than those in the shock group (P<0.05); The histological injury grading score of intestinal tissue in one or three HBOT group was lower than that in shock group and the difference between them was significant (P<0.05). Transmission electron microscopic photographs of intestinal epithelium displayed that microvilli were hampered and lost, tight junction opened, mitochondrial crista disappearing, mitochondrium lysis, rough endoplasmic reticulum expansion, desmosomes disappearing etc in shock group; whereas, the tight junction, desmosomes and mitochondrium appeared preserved in HBOT groups. All the above-mentioned indicators of three HBOT group were better than those of one HBOT group, but the difference was not significant (P>0.05). Conclusion HBO therapy can improve oxygen supply to intestine after resuscitation from T/HS, reduce the anaerobic metabolism, preserved tight junction and mucosal barrier, and decreased the production of inflammatory factor after resuscitation from T/HS, inhibit the excessive inflammatory reaction. Thus HBO prevented intestine and mucosal barrier from I/R injury after resuscitation from T/HS. P10 Kidney dysfunction caused by rat hind limb ischemia/reperfusion and effect of hyperbaric oxygen on it Chun-jin GAO, Biao YUAN, Guo-zhong WANG, Da-zhi CHEN Beijing Chaoyang Hospital, Beijing, China Objective: Acute limb ischemia is one of the most challenging problems encountered by the contemporary vascular practitioner. Its incidence approximates 1.7 cases per 10,000 population per year. Despite improvements in patient care and operative technique, the morbidity and mortality remain high, with mortality rates in excess of 25% and amputation in 20% of the survivors. The high rate of morbidity and mortality of acute limb ischemia should be mainly attributable to the ischemia /reperfusion itself. Severe hypoperfusion of a limb, if left untreated, will inevitably develop into tissue infarction and irreversible cell death. Patients with acute occlusion of the abdominal aorta are in an extremely compromised state. The patient's status will likely further deteriorate at the instant of reperfusion, and sudden cardiovascular collapse is commonly encountered with the release of accumulated metabolic by-products into the circulation, which maybe results in remote multiple organ injury, that is, multiple organ dysfunction syndrome(MODS). The reason is that lower limb ischemia/reperfusion injury triggers a systemic inflammatory response (SIRS, systemic inflammatory response syndrome). Morbidity and mortality following reperfusion of the acute ischemic limb may be a manifestation of multiple organ dysfunction caused by a systemic inflammatory response triggered by reperfusion of the ischemic extremities. Hyperbaric oxygen(HBO) has been used therapeutically in a variety of I/R injury models, and the application of HBO to I/R disease appears effective. The basic mechanisms responsible for the beneficial effect of HBO in treating I/R injury are becoming better understood. HBO treatment may simultaneously provide a beneficial effect directed at many components responsible for I/R injury, including neutrophil, endothelium, inflammatory mediators, lipid peroxidation, cellular energetics, and microvascular blood flow. But so far, there has been no literature on the application of HBO to kidney dysfunction which results from acute limb I/R. The purpose of this study is to determine whether there is potential protective effect of HBO on kidney dysfunction which is associated with hind limb ischemia/reperfusion in rat model, and to discuss mechanism of HBO on it. Methods: Adult male SD rats weighing 220~250g were used in the study. Animals were kept under standard condition. They were anesthetized with intraperitoneal urethane(1.0g/kg) and secured in a supine position on a heating pad(which is controlled by a model CMA/150 Temperature Controller system); body temperature was o kept at 37 C after being shaved. Tracheostomy was performed with PE-240 tubing(1.67 mm internal diameter), which allowed spontaneous ventilation with room air .The left carotid artery was cannulated with PE-50 tubing(0.58 mm internal diameter), and arterial pressure and heart rate were monitored continuously on a model 7702B recorder with a 1280 series transducer. The right external jugular vein was cannulated with PE-50 tubing(0.58 mm internal diameter)for fluid administration. All animals were then allowed a 30-minute equilibration period. Intravenous Ringer’s lactate was administered to maintain the systolic blood pressure > 90 mmHg throughout the experiment. The laparotomy was performed. Bilateral hind limb ischemia was induced by applying an atraumatic clip at the end of abdominal aorta adjacent to junction site of both femoral artery. At the end of the ischemic period, reperfusion of the limbs was achieved by releasing the clamp. The experimental animals was randomly divided into three groups, and each group had 10 rats. (1) In surgical sham group, the animals were subjected to the operation without clamping abdominal aorta. (2) In ischemia/reperfusion group, after hind limb ischemia for 2h, reperfusion period was 1h. (3) In HBO group, after hind limb ischemia for 2h, this group animals were put into a model DWC150-300 hyperbaric oxygen chamber(HBO pressure in chamber is 0.2MPa)to be treated for 1h during 1h reperfusion period. The other above groups were put into the normal pressure air. By using laser Doppler flowmetry (LDF), the microvascular blood flow was measured in kidney of the animals. The mean immunofluorescence intensity of CD31, CD61 or positive percentage of CD62p were measured by the flow cytometry(FCM). Ultrastructural histological pathological changes in kidney were studied. Results: Compared with I/R group, the microvascular blood flow of the kidney in HBO group was significantly increased, had significant statistical difference (P<0.05). Compared with surgical sham group, the expression of platelet membrane glycoprotein CD31,CD62p in I/R group was much higher(P<0.05). The expression of platelet membrane glycoprotein CD31,CD62p in HBO group was much decreased than that in I/R group(P<0.05). In I/R group, extensive ultrastructural histological pathological injury of kidney occurred. The ultrastructural histological pathological changes in HBO group was obviously alleviated. Conclusions: The expression of CD31 and CD62p on the platelet membrane significantly increased after rat hind limb ischemia/reperfusion model, indicating the platelet-activating factor(PAF) was activated, which partially result in inducing SIRS and remote multiple organ injury. According to this study, early HBO therapy can significantly decreased the expression of CD31 and CD62p on the platelet, indicating the PAF was inhibited, maybe which stopped a series of PMNL activation , adhesion and systemic inflammation after reperfusion of ischemic hind limb. And the microvascular blood flow of the kidney in HBO group was significantly increased, the ultrastructural histological pathological changes such as kidney in HBO group was obviously alleviated .As a kind of effective therapy , HBO can alleviate the pathological changes in kidney dysfunction caused by rat hind limb ischemia/reperfusion model. P11 Monitoring and disinfection of air culture in single-chamber with pure oxygen 1 1 1 2 Xiufang MEI , Chaoqun TU , Xiaomei XIE , Hui LI , 2 Xiaodan CHEN 1. The Shenzhen Peoples Hospital, Shenzhen, China 2. The People’s Hospital of Longgang Region, Shenzhen, China Object: To evaluate the effect of chlorhexidine acetate solution on single-chamber with pure oxygen and to study the convenient, effective, rapid and simple routine method to prevent from cross infection in the single-chamber with pure oxygen. Methods: There were 5-7 sessions of HBO in single-chamber with pure oxygen, in which it took 60-80min and interval 10min between 2 sessions. It was disinfected by spaying with chlorhexidine acetate solution after HBO. The air culture was done before, after every session of HBO, after disinfection for 5 consecutive days. Results: The average total bacterial count (TBC) before 3 first HBO was 189±49cfu/m . The TBC shortly after HBO 3 were more than1500cfu/m . Nevertheless, the TBC after 10min disinfected by chlorhexidine acetate solution were 3 less than 200 cfu/m . Conclusion: It is rapid, simple, effective with chlorhexidine acetate solution on disinfection to single-chamber with pure oxygen. P12 Effects of preconditioning with hyperbaric oxygen on expression of GFAP and Nestin after spinal cord injury in rats Peigang Lu, Hua Feng, Yongzhi Xia, Weihua Chu, Guoqi Gong Department of Neurosurgery, Southwest Hospital, Third Military Medical University Objective: To study the effects of preconditioning with hyperbaric oxygen on expression of GFAP and Nestin after spinal cord injury in rats at different time. Methods: fifty-five adult Sprague-Dawley adult rats, weighing from 250 to 300g, were randomly divided into 3 groups, hyperbaric oxygen preconditional group(25,n=5) , normal injury group(25,n=5)and control group(5,n=5). In the experimental groups, the rat spinal cord injury models , were established by the way of Allen s method and the expression and proliferation of nestin and GFAP at different time(1 day, 5 day, 7 day, 10day, 14day) were observed with immunohistochemical staining and the analytical system of photographs. Results: In the normal control group, the expression of nestin was hardly seen except ependymal cells of central canal, and the low expression of GFAP was seen. In the experimental groups, the nestin and GFAP expressions increased obviously in the injured sites and adjacent sites 1 day to 5 days after injury, reached the peak value after 7days and followed by gradual decrease from 10 days to 14 days. There were statistically significant differences in the nestin and GFAP expressions between the preconditional group and normal injury group especially the control group. Conclusion The above results suggest that spinal cord injury can induce the expression of nestin and GFAP.HBO preconditioning can induce the proliferation and differentiation of the neural stem cells in rats after spine cord injury. P13 Observation on curative effect of early hyperbaric oxygenation to pediatrics brain injury Guiying He, Guanwen Zhang, Ping Yang, Wenping Han, Kefang Chen Xinjiang Kelamayi Central Hospital, Kelamayi, China Objective: To observe curative effect of early hyperbaric oxygenation to pediatrics brain injury. Methods: the clinical data of 51 cases of pediatrics brain injury in our hospital from 1995,july to 2008.Feb were retro spectively analyzed. Results: The cure rate of the curative group and the control group were 78.27% and 52.17% respectively, the results showed that the control group were better than those of the control group and the difference was significant (p<0.05). Conclusion: Early hyperbaric oxygenation to pediatrics brain injury is an effective method, which can raise cure rate reduce disabled rate and improve the prognosis . P14 Efficacy and nursing technique of hyperbaric oxygen therapy on neonatal hypoxic-ischemic encephalopathy Fei Lianfeng Capital University of Medicine Affiliated Beijing Children’s Hospital, Beijing, China Objective: To explore the short-term effect of hyperbaric oxygen(HBO)based on conventional therapies in full-term neonates with hypoxic-ischemic encephalopathy (HIE),and the effect of ameliorate sequelaes such as deafness, cerebral palsy and mental retardation. Methods: 100 full-term neonates with HIE were comprised, 52 were administered with HBO and conventional therapies, and the control group comprised 48 patients who were administered with conventional therapies only. Brainstem auditory evoked potential and brain CT scan before, 3 months after and 6months after management were registered respectively. Results: The amelioration rate of Brainstem auditory evoked potential in treatment group and control group were 84%, 73% respectively. The amelioration rate of brain CT scan in treatment group and control group were 95%, 80% respectively. There is distinct difference between the two groups (P<0.01). The therapeutic effect was significant in HBO group than in the control group. Conclusion: HBO therapy has a marked short term effect in HIE patients and need to be used as early as possible. Because of the severity of illness, rapidness of changes and lack of response, the patients need to be observed and nursing carefully while taking HBO. P15 Recent advance in researches of laboratory and clinic on hyperbaric oxygen therapy and stem cell Chen Yifei Guangzhou City First Peoples Hospital, Guangzhou Medical College, Guangzhou, China Hyperbaric oxygen therapy (HBO) is a relatively new medical treatment that was developed in 1960’s and has been applied extensively in medical system now. It has been successfully used in treating a lot of diseases, such as carbon monoxide poisoning, decompression sickness, gas Infarction and gas gangrene. There have been numerous basic and clinical researches on HBO in the decades. However, the treatment mechanism of HBO should be explored further and detailedly. Human stem cell (HSC) is one kind of cell that plays a very important role in the development and growth of human body and possesses very strong self-renewal and differentiation potential. HSC can differentiate into almost all of cell types of adult body. Compared with traditional therapy, Application of HSC to treatment of human disease has many advantages: lower toxin or non-toxin, long effective, no immune repulsion when using self-HSC transplantation. Therefore, HSC has huge medical value and extensive application potentials and has been a hot spot of scientific research in the world now. Reseaches on HSC are focused in Embryonic Stem Cells, neural stem cell and hemopoietic stem cell.Recently, a lot of researches from laboratory and clinic suggested that HBO could mobilize marrow stem cell into peripheral circulation; it also could induce proliferation and differentiation of endogenetic neural stem cell and reduce death of damaged stem cell. Clinical investigation showed that HBO could effectively mobilize the hemopoietic stem cell of peripheral blood. Thus, it is causing tremendous interest and attention of medical researchers that HBO, a safety, effectiveness, economy and practicality of therapy, has action on human stem cell. This article will review the advance in recent researches on HBO and stem cell, including 1. biological functions of stem cell; 2. recent laboratory and clinic researches about HBO impact on HSC; 3. potential applications of HBO impact on HSC to clinical treatment of diseases. This article will further highlight the mechanism of HBO therapy and provide the newest information of HBO and HSC for medical workers. P16 Report of a case with serious cerebral air embolism due to routine hyperbaric oxygen therapy, and successful rescue 1 1 1 1 Xiaowen pan , shuyi pan , xiangen meng , huijun hu , 1 1 1 1 2 yu zhang , chen yang , mingxin li , qi zhang , hongbo liu , 3 wen zhong 1. General Hospital of Navy, Beijing, China 2. Zhuhai People’s Hospital, Zhuhai, China 3. PLA No.422 Hospital, China We report of a Case with serious cerebral air embolism due to routine hyperbaric oxygen therapy, and successful rescue. The patient is female, 44 years. At 2pm, June 3, 2007, the patient entered 12-person-seat air pressure chamber without oxygen inhalation, she did not feel abnormally uncomfortable during compression and stabilizing pressure, and at 3 minutes before leaving chamber, she suddenly developed dizziness, weakness, subsequently was unconscious, however, other patients had no abnormal condition in the chamber. Out of the chamber, subsequently, her consciousness exacerbated gradually, which was considered as decompression disease. She was placed into high oxygen pressure chamber, with pressure of 0.3MPa, and received oxygen inhalation, but he patient’s condition was worse, restless, loss of sight, and right extremity paralysis after she left the chamber. In this report, we will discuss: (1) Occurring condition of cerebral air embolism; (2) Differential diagnosis between cerebral air embolism and other acute cerebrovascular diseases; (3) Compression treatment of air embolism; (4) Contraindications for treatment of bullae and high pressure oxygen. P17 Research progress of hyperbaric oxygen and free radical Jun Wang, Chao Sun Qingdao Municipal Hospital, Qingdao, China With the method of documentary data and consulting the relative literature at home and abroad in recent years, this paper makes a review on the study progress of Hyperbaric Oxygen and Free Radical. Respectively, effects of hyperbaric oxygen on free radicals, hyperbaric oxygen might reduce the free radical in separately certain pathology situation, hyperbaric oxygen to be possible to increase the free radicals in the tumor organization, the relation of different oxygen exposure doses with free radicals and the mechanism of hyperbaric oxygen preconditioning-induced ischemic tolerance in spinal cord with free radical relational several aspects has been expounded. P18 The fast infection and isolation measures in Hyperbaric Oxygen Therapy rescure procedure for gas gangrene patients injured by earthquake Huang Ling-Ling, Chen Shu-Lan, Zhang An-Qin, Nie Cai-Xian, Tang Ming-Chan, Zeng Yu The medical science college of Sichuna province, Sichuan Provincial Hospital, Chengdu, China Objective: Observe the effect of fast infection and isolation measures in Hyperbaric Oxygen Therapy rescue procedure for gas gangrene patients injured by earthquake. Methods: individual Hyperbaric Oxygen Chamber into clean area, half-contaminated area and contaminated area, working staffs wear isolation gown. During Hyperbaric Oxygen Therapy procedure, disinfect contaminated objects and floor with 500mg/l chlorine antiseptic, ultra-violet ray radiation and 3%peroxyacetic acid fumigation. Disinfect Hyperbaric Oxygen Chamber repeatedly and take samples after therapy. Results: patients recovered, no crossing infection occurred, and chamber samples culture showed no bacteria grow. Conclusions: crossing infection can be prevented effectively with strict infection and isolation measures. P19 The clinical efficacy of hyperbaric oxygen methods in the treatment of non-insulin-dependent diabetes mellitus Shou-Chao LI, Chun-He LIU, Yin-Chun ZHANG People’s Hospital, Weifang, China Yong-Xin MA, Objective: To study the clinical efficacy of Hyperbaric oxygen (HBO)methods in the treatment of non-insulin-dependent diabetes mellitus. Methods: 163 cases of Non-insulin-dependent Diabetes Mellitus patients were randomly divided into HBO group (87 cases) and hypoglycemic treatment group (76 cases), we tested blood glucose, HbA1c, insulin concentration, Cholesterol, triglyceride, and other indicators respectively in the two groups after 10 days, 20 days. Results: Blood glucose and HbA1c levels were significantly decreased in HBO treatment group after 20 days, there was no significant difference between HBO treatment group and hypoglycemic treatment group (p> 0.05). At the same time, insulin concentration, HDL-C and APO-A levels increased significantly, and cholesterol, triglyceride concentration decreased significantly, there were significant differences compared with drug treatment group (p 1c could maintained for 20 days with similar levels (p> 0.05). Conclusion: HBO methods are stable and endurable in the treatment of diabetic hypoglycemic, it also can improve the fat metabolism disorder. HBO methods have the exact effect in the treatment of non-insulin-dependent diabetes mellitus. of the people first arrived at high altitude, which was particular worked by increasing the SaO2 and PO2. P21 The observation on tinnitus treated with hyperbaric oxygen and ginaton Xiang-Hui Li, Yan Li, Xiao-Ying Luo, Hui-Min Sun General Hospital of Chinese People’s Armed Police Forces, Beijing, China Objective: To discuss the clinical value of hyperbaric oxygen and Ginaton in the treatment of tinnitus. Method: From January 2002 to April 2008, 106 patients suffering tinnitus were treated with hyperbaric oxygen and Ginaton. Pressure of hyperbaric oxygen was 0.2MPa, Breathing oxygen 60 minutes, One time everyday, One period of treatment include ten times, The treatment of every patient is always 10-20 times. At the same time, Ginaton 20ml transfusion, two times everyday. One period of treatment is seven days, The treatment of every patient is always 7-14 days. Results: The cure rate, the clearly effective rate and the total effective rate were respectively 12.3%, 33%, 82.1%(P<0.01). Conclusion: It is suggested that hyperbaric oxygen and Ginaton have a better effect on tinnitus. P20 The effect of air pressure chamber treatment on SaO2 and arterial PO2 of people first arrival at plateau Chun-yang He, Kai Zhou, Jian-wen Gu, Xi Fu Chengdu Military General Hospital, Chengdu, China P22 Therapeutic effects and probable mechanisms of hyperbaric oxygenation protocol of durative-9-hour Qiuhong Yu, Yaling Liu, Yali Wu, Lianbi Xu Department of Hyperbaric Oxygenation, Beijing Tiantan Hospital, Capital Medical University, Beijing, China Objective: To study the effect of air pressure chamber treatment on blood oxygen saturation, and arterial biood gas analysas of people first arrival at plateau. Methods: 130 new enlisted soldiers were recruited. 65 of them were enrolled as therapeutic group and the others as control randomly. The therapeutic group subjects were trentmented with air pressure chamber(0.1-0.12Mpa,40-50min ,once a day) after their arrival at plateau., .The test index included blood oxygen saturation, arterial, blood gas analysis, morphology of erythrocyte under the light microscope and anoxia symptom. Results: After the arrival at Lhasa, some subjects suffered from anoxia symptom, were faded away after laser treatment of air pressure chamber. The oxygen saturation (SaO2)decreased in all subjects, from 98% at Chengdu airport to 80%(SaO2),PO2 decreased to 50.3mmHg around at the evening of the day after arrival. The saturation automatically increased from the second day gradually. But the group with air pressure chamber, were significantly more than the control (p<0.01) . At the end of observation, the SaO2 restored to 97% around in treated group, and to 90% around in the control group (p<0.01).The PO2 restored to 83.6mmHg around in the control group,and to 50.3mmHg around in the control group(p<0.01). Conclusions: The treatment of air pressure chamber can increase anoxia-resisting capability Objective: The aim is to assess the effectiveness of adjunctive HBOT in the treatment of permanent MCAO rats for only once continue 9 hours in super-early stage, and to find one of the probable mechanisms of HBOT. Methods: (1) models and groups: Using the intraluminal suture method, we subjected male Sprague-Dawley rats to permanent middle cerebral artery occlusion model , then the rats were randomly divided into MCAO control group and HBOT group, a sham control group and a sham-HBOT group also be used. And the groups were divided into 13h and 5d subgroups. (2) HBOT protocol: After being modeled for 3 hours, rats in the sham-HBOT and HBOT groups stayed in the hyperbaric cabin for 9 st rd th th hours. They inhaled pure oxygen at the 1 , 3 , 5 , 7 and th nd th th th 9 hours, and hyperbaric air at the 2 , 4 , 6 and 8 hours. After being created into models, rats in the sham control group and MCAO control groups breathed room air. (3) Main Outcome Measures: ① The Garcia neurological grading systems were used on 3h, 13h, 24h, 3d and 5d to assess the therapeutic effect of HBOT. ② The infarction volume was calculated with the TTC pathological staining on 13h and 5d points. ③ The expression of VEGF was measured using immunohistochemical stainingon 13h and 5d points. Results: (1)The neurobehavioral outcomes were improved with time going in all subgroups, there is significant different between 13h subgroups using Garcia scale(P<0.01).Also, neurobehavioral outcomes improved after 13h in 5d subgrops, those of the HBOT group were more improved comparing with MCAO group, but there is no different (P>0.05). (2) Cerebral infarction volume of rats in MCAO group was larger on 5d than that on 13h(P<0.05), and the infarction volume was smaller in HBOT group comparing with MCAO group on 5d, there is significant different(P<0.05). (3) The expressions of VEGF were increased in MCAO groups and HBOT groups. HBOT groups showed increased VEGF expression significantly compared with MCAO group on 5d point (P<0.01). Conclusions: (1) Durative-9h HBOT protecol was effect, HBOT inproved neurobehavioral outcomes and cerebral infarction volume, but the effectiveness was to be further defined. (2) Stimulate the more production of endogenous VEGF which related with capillary formation, reduced infarction volume and neural protection is one of the probable mechanisms of HBOT. P23 Therapeutic window of hyperbaric oxygen therapy 1 2 1 Xiao-Li WANG , Yan-Song ZHAO , Yu-Jia YANG , 1 1 Qing-Hong WANG , Chong-Feng CHEN 1. Division of Neonatology, Department of Pediatrics, XiangYa Hospital, Central South University, Changsha, Hunan, China 2. Department of Ophthalmology, Weifang Medical University, Weifang, China Objective: Previous studies showed that hyperbaric oxygen (HBO) promoted cell proliferation in hypoxic-ischemic brain damage (HIBD) neonate rats. Neural stem cells (NSC) existed in the brain lifelong and can be activated. This study was undertaken to assess whether HBO treatment promoted the proliferation of NSC and repaired the brain damage regardless of when it is started, thus to explore the therapeutic window of HBO treatment. Methods: Seven-day-old Sprague-Dawley rats underwent left carotid ligation followed by 2 hours of hypoxic stress (8% O2 at 37°C). Hyperbaric oxygen therapy was administered 3, 6, 12, 24, and 72 hours after HIBD. 5-bromo-2’-deoxyurindine and 5-bromo-2’-deoxyuridine/nestin were detected by immunofluorescence and nestin was examined by western blot analysis 10 days after HIBD. T-maze forced alternation, the foot-fault test, and the radial arm maze were conducted at P 22 days (14 d after HIBD), P 30 days, and P 34 days. Thereafter, cerebral morphology was examined by Nissl-staining 28 days after HIBD. Results: There were remarkable increases in the proliferation of neural stem cells in the HBO-treated group, 3, 6, 12, and 24 hours after HIBD, as compared with the HIBD group. The HBO-treated group, 3, 6, and 12 hours after HIBD, performed better in the behavioral test and had less neural loss in the hippocampal CA1 region as compared with the HIBD group. Conclusion: The therapeutic window for effective HBO treatment could be delayed up to 12 hours after HIBD, while the effect decreased 24 hours after HIBD. Acknowledgments Projects supported by National Natural Science Foundation of China (the Science Fund of the Chinese Academy of Sciences), Grant 30672240. P24 Three phenomenon and the theoretical explanation of hyperbaric oxygen medicine Xiao Pingtian Xiangya Hospital, Central South University, Changsha, China In the natural world, it is common that many things can be divided into three different parts, which are so called “three-morphous phenomenon”. Moreover, there are always some inherent correlations and regularities with these three different forms of the same things. For example, the quantitative traits have three typic normal distributions and the objects have three typical movement modes. With regard to human body, there are three typical modalities of organs’ connection. “three-morphous phenomenon” does exist commonly in the field of hyperbaric oxygen (HBO) medicine, such as tristate therapy, three states of substances, three stages and three functions of HBO therapy, three methods of compression and de-compression, three laws of gas getting into or out of the body due to the changes of environmental gas pressure. The study of “three-morphous phenomenon” in HBO medicine will further enhance our understanding the intrinsic laws of HBO and benefit the patients for a better therapeutic effect. P25 Hyperbaric oxygen therapy in professional athletes muscle injuries. a series of 51 cases Philippe Colombani, Olivier Simon, Andréas Kauert, Bern ard Gamain, Jean-Marc Lapoussière, Marcel Chatel Nice Hyperbaric Oxygen Center, Pasteur University Hospital, Nice, France Background: Traumatic muscle injury affects muscular fibers, but also conjunctive and vascular tissues. It provokes lesions similar to an ischemia-perfusion syndrome, reason why hyperbaric oxygen therapy (HBOT) has been suggested to contribute efficiently to structural and functional recovery. However, until now, clinical studies were conducted only on delayed-onset muscle soreness (DOMS) and there is no study with statistical evidence of improvement due to HBOT. Patients and methods: Fifty-one professional athletes were treated in Nice Hyperbaric Oxygen Center, among them, 67% were professional soccer players (mean age 29 +/-10 y). Wounds occurred during training or competition. They concerned mostly lower extremities. Muscles injuries were of various grade: pulled, strained or torned. Beside of conventional local treatments, HBOT was prescribed (100% O2 at 2,7 ATA during 45 min; 2 sessions per day). Mean number of sessions was 12 (range from 1 to 31). Results: Assessment criteria were clinical, radiological and functional: 1. Clear reduction of the volume of the limb and rapid decreasing spontaneous or provoked pain level. 2. Echography or MNR imaging: reduction of size of hematoma and inflammatory oedema. 3. Shortening of the resumption of training and quality of muscle strength. Conclusions: Although this was not a “control cohort” study, this series suggests that HBOT is apt to bring a clear-cut and fast improvement in clinical symptoms and imaging findings after traumatic muscle injury. HBOT performed in the early stages of intensive sport practice muscle injury provides a quicker and better quality of recovery, which is highly important for professional athletes (and their coach!). Controlled randomized studies should be done imperatively for confirming these preliminary results. P26 Neural protection and toxicity of hyperbaric oxygen on neonatal rats with hypoxic-ischemic brain damage Yu-Jia YANG, Bo-Xiang QI, Qing-Hong WANG, Miao JIN, Meng LI, Yue YAO, Chong-Feng CHEN Division of Neonatology, Xiangya Hospital, Central South University, Changsha, China Objective: It is well known that high-concentration oxygen (HO) can cause retinopathy of prematurity (ROP) and bronchopulmonary dysplasia (BPD). However, high-pressure oxygen (HBO) in the treatment of hypoxic ischemic brain damage (HIBD) process is also toxic effect is not clear. The purpose of this study was to investigate the neuroprotection of HBO and its toxicity on HIBD neonatal rats. Methods: Seven-day-old Sprague-Dauleys(SD)rats were randomly divided into six groups: (1) Control group; (2) HIBD group; (3) HO group; (4) hyperbaric air group (HA); (5) HBO group; (6) HO+HBO group. The HA and HBO groups were administered respectively with 2.0 ATA for 60 minutes of air or oxygen in HIBD after 2 hrs, once daily for 7 days. The HO group was given 90% oxygen inhalation after HIBD for 7 days. The HO +HBO groups were given 90% oxygen inhalation and HBO daily for 7 days. The animals were killed on the 21st., Results: Comparison with the CON group, the number of TUNEL positive cells in hippocampal CA1 were increased significantly in the HIBD, HA and HO groups, but not obvious increase in HBO and HO+HBO. The number of nuclei of the new vessels was higher in HO and HO+HBO groups. Retinal stretched preparation vessels in HO and HO+HBO groups increased significantly, while there were no changes in evidence in the other groups. Retina VEGF expression was stronger in HO and HO+HBO group than other groups. Lung tissue stained with HE showed that the alveoli pulmonis were damaged obviously in HO and HO+HBO groups. Conclusions: HBO treatment has neuroprotective effects on HIBD neonatal rats, but no toxicity on ocular and lung. Retinal vessel proliferation induced by high-concentration oxygen was related to the increasing of the VEGF expression., Acknowledgments Projects supported by National Natural Science Foundation of China (the Science Fund of the Chinese Academy of Sciences), Grant 30672240. P27 Expression of MCP-1 in brain of acute CO-poisoning rats and development after HBO Xiaoping Xie, Jinsheng Li, Wenlan Wang Department of Hyperbaric Oxygen Treatment Center, School of Aerospace Medicine, Fourth Military Medical University, Xi’ an, China Objective: To investigate the expression of monocyte chemoattractant protein-1 (MCP-1) and aggregation of monocytes/macrophages in brain of acute carbon monoxide (CO) poisoned rats and to provide new evidence for immunological mechanism of delayed neuropathological sequelae (DNS) after CO exposure. Methods: 50 SD male rats were randomly assigned to control, CO exposure for 1d, 3d, 7d and HBO treatment for 7d groups, and ten rats for each group. HE, immunohistochemical staining and reverse transcription polymerase chain reaction (RT-PCR) were performed to study the expression of MCP-1 and aggregation of monocytes/macrophages in brain. Results: Expression of MCP-1 was very low in control group, which increased quickly after 1d of CO exposure. It reached peak value in 3d exposure group, but decreased after 7d of exposure. In HBO treatment group, expression of MCP-1 decreased significantly (P<0.01) as compared with that in 7d exposure group, but still higher than that in control group (P<0.05). There was scarcely aggregation of monocytes/macrophages in brain of control rats. After 1d to 7d exposure of CO, the number of monocytes/macrophages-positive cell increased progressively and reached its peak value at 7d exposure group. Just as the expression of MCP-1, the number of monocytes/macrophages-positive cell decreased significantly (P<0.01) in HBO treatment group as compared with that in 7d exposure group, but still more than that in control group (P<0.05). Conclusions: the expression of MCP-1 and aggregation of monocytes/macrophages may play a role in the happening of DNS after CO poisoning. HBO may alleviate the damage of brain through decreasing the expression of MCP-1 and preventing the aggregation of monocytes/macrophages. P28 Effect of hyperbaric oxygen on acute focal cerebral ischemia-reperfusion injury in rats Jinsheng Li, Yaoming Chang, Li Liu, Xiaoping Xie Department of hyperbaric oxygen treatment center, School of Aerospace Medicine, Fourth Military Medical University, Xi’ an, China Objective: To investigate the effect of hyperbaric oxygen(HBO) on focal cerebral ischemia-reperfusion (IR) injury in rats. Methods: Rat model of focal cerebral ischemia induced by intraluminal filament occlusion of middle cerebral artery (MCA) was used. Histopathological changes of infarct size, neuronal damage , neutrophil infiltration and NOS positive neurons in the ischemic brain area after MCA occlusion for 1 hour and reperfusion for 4,11,23 and 71 hours were examined. During the reperfusion period, normal pressure pure oxygen (99.5%O2) or 0.25 MPa (ATA) HBO treatment for 1, 2, 3 and 5 times were applied to respective groups and their results compared. Results: The infarct size, neuronal damage and neutrophil infiltration in normal pressure pure O2 group were similar to those of ischemia-reperfusion (IR) group at 71 hours. Whereas the infarct size and neuronal damage in HBO group after 5 times of HBO treatment at 71 h were reduced for 8.43% (level before optic chiasma), 11.20%(level of optic chiasma) and 8.66%(level behind optic chiasma), and the numbers of neuronal damage in 5 high power (×400) fields (Nr/5F) were 11.36 (preoptic area), 8.94 (medial striatum), and 14.25(cortex) less as compared with IR group respectively. Besides, the neutrophil numbers (number/5 fields, 100×) in preoptic, striatum and cortex at the level of optic chiasma were 3.84, 4.61, 2.56 at 5 h, 6.64, 7.34, 5.72 at 12 h and 9.78, 10.48, 7.84 at 24 h after the IR respectively; and they were much lower in HBO group at 12 h (5.01, 5.22, 4.03) and 24h (7.13, 7.21, 6.14) as compared with IR group (P<0.05, respectively. The numbers of degeneration NOS positive neurons were increased gradually after MCA occlusion in brain area. After HBO therapy, the numbers of degeneration NOS positive neurons were obviously decreased in cortex, preoptic area and medial striatum (P0.05). Conclusions: HBO (0.25MPa, 5 times) have significant effects of reducing infarct size, lessening neurological symptom evaluation score, inhibiting neutrophil infiltration, inhibiting the degeneration of NOS positive neurons and decreasing the neuronal damage in “penumbra” area on acute focal IR injury in rats. P29 Effect of hyperbaric oxygen combined therapy on vegetative state following cerebral trauma in 124 cases Ronghao Yu, Qiuyou Xie, huai Huang, Yan Shen, Yanbin He, Lingling Sun Guangzhou general hospital,Guangzhou Military Command, Guangzhou, China Objective: To study the efficacy and influence factors of hyperbaric oxygenation (HBO) combining therapy on patients with vegetative state (VS) following cerebral trauma. Methods: One hundred and twenty-four cases of VS treated with HBO combined therapy from 2003 to 2007 were analyzed retrospectively,including the effects of treatment juncture on therapy and treatment times. The pressure used for HBO was 0.2 MPa. The patients breathed pure oxygen for 80 min with an interval of 10 min in the middle. Once a day, twenty times was a course of treatment. Results: twenty-two(17.7%)patients were free from the VS within 1 month. In 102 cases of persistent vegetative state (PVS), the total effective rate was 90.20%. Fifty-seven patient regained consciousness (55.9%). Two groups in which the patients receive HBO oxygenation after cerebral trauma for less 31 days recovered better the other one in which the patients receive HBO oxygenation after cerebral trauma for less 30 days. Conclusion: The HBO combining therapy is an effective therapy for patients with persistent vegetative state following cerebral trauma. The efficacy and regained consciousness was related with the beginning time of hyperbaric oxygenation. P30 Effect of early hyperbaric oxygenation on bone mineral density in spinal cord injured rats Min Liu, Min Tong, Xiangping Wu The Second Xiang Ya Hospital of Central-South University, Changsha, China Objectives: To establish an animal model of spinal cord injury (SCI),and to explore the effect of early hyperbaric oxygenation on bone mineral density (BMD). Methods: 36 healthy 3-month-old female SD rats were randomly divided into three groups: Sham group (10 rats), SCI group (13 rats) and SCI+HBO group (13 rats). Rats in sham group underwent laminectomy, while rats in the other 2 groups underwent complete spinal cord transection at the level of the tenth thoracic vertebra. Rats in the SCI+HBO group were treated with hyperbaric oxygenation 2th day after SCI ,1/d, 10 times as 1 course of treatment, for 3 courses, with a 6 days,interval between courses .All rats were sacrificed 7 weeks after operation, BMD of lumbar spine (L4-6 ), every region of femur and tible in vitro were all measured by dual-energy X-ray absorptiometry (DEXA) using QDR-4500A equipments. Results: BMD in region 2 at the distal femur ,BMD in region 6 at the proximal femur and BMD in region 1 at the proximal tible in vitro were markedly decreased in SCI group at 7 weeks post-operation compared with that in sham-operated group (P < 0.05~0.01) ,BMD of every region at 7 weeks post-surgery in SCI+HBO group was slightly higer than that in SCI group , but no significant difference between SCI+HBO group and SCI group was found . Conclusion: (1) The pattern of osteoporosis in complete spinal cord transection rats was succeed in experiment. (2) HBO could not obviously improve bone loss in complete spinal cord transaction rats. P31 Comprehensive treatment of neonatal hypoxic ischemic encephalopathy by sequential hyperbaric oxygen therapy in the air-pressurized oxygen chamber: analysis of 257 cases Xiaoxin Lu, Huiping Peng, Yongjian Tiang, Weihong Fang, Xinru Hong, Maoying Lin, Chengfeng Wang Department of Hyperbaric Oxygen Therapy, Fuzhou General Hospital, Fuzhou, China Objective: To evaluate the effect of hyperbaric oxygen therapy (HBO) on the early phase of mandible lengthening in the goat model. Methods: Six healthy goats were randomly divided into two groups (n = 3 each). Animals underwent corticotomy of the hibateral body of the mandible after placement of distraction devices. Distraction, at a rate of 1 mm/day and a rhythm of 2 turns/day, began after a 5-day latency period for ten days. Only the second group underwent HBO for 1.5 hours daily for fourteen days from the second day of the latency phase. Twenty-eight days after completion of the distraction protocol, the animals were killed and the distracted mandibles were harvested. The appearance of the samples, radiological changes, bone mineral density, and mechanical strengths and histology were examined. Moreover, Serum alkaline phosphatase was measured before HBO and every four days thereafter from 3 days pre-treatment till first day post-treatment. Results: 1. In the experimental group, the surgery region swelling abated quickly; in the control group, surgery region in one animal had an infection. Every goat had bony callus, and the experimental group resulted in harder and wider healing bone. 2. X-ray: All specimens showed a progressive calcification of the distracted area between the mandibular segments, and the bone cerebral cortex connected completely except the infected animal. The distracted zone in the experimental group exhibited higher radiodense opacity. 3. Bone density showed that the experimental group resulted in a denser healing bone (P<0.05). 4. Three-point bending test showed that the maximal loading in the experimental group was higher than in the control group (P<0.05) .5. In the control group, three zones exhibited progress of intramembranous ossification. 6. Statistical analysis of the percentage of bone trabeculae area in the distraction gap revealed that experimental group showed a significant increase compared with the control group (P<0.05). 7. Serum alkaline phosphatase: early after surgery, every animals serumal alkaline phosphatase level increased, and in the experimental group it increased more significantly than in the control group (P <0.05). Conclusion: HBO can enhance the anti-infection capacity of the surgery district and accelerate the rate of bone regeneration and ossification, and increase the activity of serum alkaline phosphatase. The domestic internal distractor has a stable biomechanical property and good biocompatibility. P32 Clinical study of the impact of hyperbaric oxygen therapy on hemorheology and neural function rehabilitation in patients with cerebral infarction Zhong Qiaofen Guizhou Provincial Peoples Hospital, Guizhou, China Objective: To investigate the impact of hyperbaric oxygen on hemorheology and neural function rehabilitation in treating cerebral infarction. Methods: Clinical observation with 48 cases of cerebral infarction treated by HBO therapy. Compare the preselected indexes and contrast the condition with those before therapy, then make a statistical analysis. Results: Compared with the hemorheological indices before HBO therapy, whole blood viscosity in high, middle and low shear rate, plasma viscosity, hematocrit (Hct), erythrocyte aggregation index(EAI), erythrocyte electrophoretic time(EPT) and platalet aggregation rate(1,3,M) were more obviously decreased (p < 0.05-0.01); erythrocyte deformity index was significantly increased (p<0.05); both the scores of erythrocyte sedimentation rate(ESR) and erythrocyte rigidity index were not statistically significant (p>0.05). More over, the average of neurological functional deficit scales was more obviously decreased (p<0.01). The total effective rate was 87.5﹪. Conclusion: Hyperbaric oxygen therapy is recommendable because of its operational safety as well as the therapeutic effect in treatment. Hyperbaric oxygen therapy can not only obviously reduce the neurological deficit, but clearly improve the hemorheological properties. P33 Change of cerebral metabolism rate of glucose in patient of delayed neuropsychological sequelae after CO poisoning following combining hyperbaric oxygen treatment Yu Gao, Chunjin Gao, Tie Wang, Huan Ge, Lianhua Wu, Liming Zhao Beijing Chaoyang Hospital, Beijing, China Objective: To estimate the effect of hyperbaric oxygen treatment on cerebral metabolism rate of glucose(CMRglc) in patients with delayed neuropsychological sequelae after CO poisoning (DNS). Method: Thirty cases of DNS were 18 F-FDGPET examination before hyperbaric received oxygen treatment (HBOT) and after 40th HBOT respectively. At the same time 17 healthy examiners were 18 also received F-FDGPET examination. The ratio of mean radioactivity of cerebral lobe to that of cerebellum as semi-quantitative parameters was used to evaluate brain glucose metabolism. Result: The CMRglc of DNS patient decreased in bilateral frontal lobe、parietal lobe、temporal lobe and occipital lobe before HBOT. After HBOT , there were obvious improvement of CMRglc in bilateral parietal lobe、occipital lobe and left side temporal lobe and no difference in bilateral frontal lobe 、right side temporal lobe. Conclusion: The CMRglc, decreased, on the early phase of DNS. Combining hyperbaric oxygen treatment can improve CMRglc and cerebral function. P34 Analysis of therapeutic effect of hyperbaric oxygen on idiopathic facial palsy Fang Liu, Hua Su, Jia Chen First Affiliated Hospital, Fujian Medical University, China Objective: To analysis different degree and different factors influencing on effectiveness of hyperbaric oxygen (HBO) on patients with idiopathic facial palsy and to evaluate the clinical significance of hyperbaric oxygen on them. Methods: First, the influencing factors were investigated statistically through a retrospective analysis of total effective on 196 patients with idiopathic facial palsy, including sex, age, basic disease, HBO treatment, house-brackmann facial grading and speed of signal conduction of facial nerve. Secondly, according to the different methods of treatment the patients were divided into group A (routine treatment) and group B(HBO treatment), compared effectiveness of HBO treatment in different serious degree. Results: HBO treatment, house-brackmann facial grading and speed of signal conduction of facial nerve were major influencing factors. The total effective rate of group B was significantly higher 2 than that of group A (x =3.96, P<0.05).No significant difference was found between A and B group when house-brackmann facial grading was Ⅱgrade, the same result when speed of signal conduction of facial nerve was slight slower. The effective ratio of group B was higher than that of the group A when house-brackmann facial grading was Ⅲ~Ⅳ and Ⅴ~Ⅵ grade (P<0.01, P<0.05), the same result when speed of signal conduction of facial nerve was middling and serious slower (P<0.01, P<0.05). The effective ratio of group B was higher than that of the group A when the delayed treatment time was less than 3 days and more than 31 days (P<0.01). Conclusions: The curative effect of HBO on different degree of patients with idiopathic facial palsy is significant particularly in middling and serious degree patients. Receive HBO treatment early will help to improve herapeutic effect. P35 Effect of multiple course of HBO therapy on the proliferation and differentiation of neural stem cells of HIBD neonate rats Qinghon Wang, Chongfen Chen, Men Li, Yue Yao, Miao Jin, Yujia Yang Division of Neonatology, Department of Pediatrics, Xiang Ya Hospital, Central South University, Changsha, Hunan, China Objective: To observe whether to increase the therapeutic course of HBO can promote neural stem cells (NSC) proliferation and differentiation into neurons and to improve the efficacy of HBO therapy in HIBD neonate rat. Methods: Seven-day-old Sprague-Dawley rats underwent left carotid ligation followed by 2 hours of hypoxic stress (8% O2 at 37°C). One, two, or three therapeutic courses o f HBO (Group HBO-1, Group HBO-2, and Group HBO-3) were administered after 2 hours later (2 ATA, once daily for 7 days as a therapeutic course). At 35 days, T-maze forced alternation, the radial arm maze and foot-fault test, BrdU/nestin and BrdU/NSE immunofluorescence, nestin protein (western blot) were performed. Results: (1) The + + number of BrdU /nestin cells of SVZ was largest increases in group HBO-3 compared with that in HBO-1 and HBO-2; (2)There was no obvious increase in + + BrdU /nestin cells of DG in all HBO treatment groups; (3) + + The number of BrdU /NSE cells of brain was largest increases in group HBO-3 compared with that in HBO-1 and HBO-2; (4) Westen blot showed the express of nestin protein was highest in group HBO-3 than other groups; (5) The HBO treatment groups performed better in the behavioral tests with the increase in therapeutic courses. Conclusion: To increase therapeutic course of HBO may promote the proliferation and differentiation of endogenous NSC in HIBD neonatal rats. Acknowledgments Projects supported by National Natural Science Foundation of China (the Science Fund of the Chinese Academy of Sciences), Grant 30672240. P36 Acute air embolism with bilateral pneumothorax after a 24meter dive Chen Yang, Xiaowen Pan, Xuechang Li Navy General Hospital, Beijing, China A diver had an emergency ascent from 24m depth in a dive accident, and suffered barotraumas with bilateral pneumothorax and air embolism in CNS. When he was sent to our hospital 19h after the accident, he was almost unconsciousness. This is the first case of barotrauma with bilateral pneumothorax in dive accident in our hyperbaric center. The patient was successfully treated by recompression with HBO. It was effective for the air embolism of the CNS to treat with HBO even after 20h. P37 Analysis of 156 childhood Carbon monoxide poisoning managed by hyperbaric oxygen Zhang Jin Capital University of Medicine Affiliated Beijing Children’s Hospital, Beijing, China Objective: To discuss the characteristics of children withCarbon monoxidepoisoning (COP), andhyperbaric oxygen(HBO)therapy, in children. Methods: Carboxyhemoglobin, (COHb) levels were not parallel with severity of illness .Therapeutic pressure was due to the age of patient. Mild COP patients need 1~10 times HBO process , moderate COP patients need 10~20 times, severe COP patients need 20~30 times , all patient got recovery and follow up 2~6 months , no sequelaes have been found yet. Results: Children COP manifestations vary a lot, COHb levels can only be a reference when judging the degree of COP. The prognosis will be good if HBO can be used as soon as possible and long enough. Retrospectively analyzed 156 children with COP treated in Beijing Children’s Hospital HBO department in recent 3 years. Conclusion: COP occurs in all ages of children, and can cause variety manifestations. Infant usually have untypical manifestations. P38 Experience with non-survivors of acute carbon monoxide intoxication who received hyperbaric oxygen therapy 1 2 Te-Chun Hsia , Wan-Yun Hsiao 1. HBO Department, China Medical University Hospital, Taiwan, China 2. Respiratory Therapy Department, China Medical University Hospital, Taiwan, China Purpose: The main purpose of this study was to determine the reason for the carbon monoxide (CO) poisoning-related deaths at out hospital and to describe the demographic data and epidemiology. Methods: We retrospectively selected this group of acute CO intoxication patients that received emergency hyperbaric oxygen therapy (HBOT) from April 2000 to August 2005 at our hospital. Data regarding age, gender, duration of CO poisoning exposure, cause of the episode, underlying disease, number of HBOT courses, hospital course, cormorbidity and cause of mortality were obtained from the medical records. We also reviewed the admission data records, including vital signs, Glasgow Coma Scale, arterial blood gas, carboxyhemoglobin level, and intubation or not. Results: One hundred thirty-seven patients and 5 fatalities related to CO poisoning were reviewed; the mortality rate was 3.65%. The 5 fatalities were all male, in the prime of life (27~37 years old), and without major underlying disease. Four (4/5) patients committed suicide by inhaling CO from burning charcoal. They all received emergent HBOT. Prolonged unconsciousness was noted after series HBOT in 4 (4/5) patients. Four (4/5) patients developed rhabdomyolysis and acute renal failure. The causes of death were multiple organ failure (3/5, 60%) and septic shock (2/5, 40%). Conclusions: The causes of acute CO poisoning among the fatalities were suicide by inhaling CO from burning charcoal (4/5, 80%) and a fire accident (1/5, 20%) at our hospital. They were in the prime of life without major underlying disease. The brain is an oxygen dependent organ, and the damage may be severe and irreversible after CO intoxication and hypoxia. Rhabdomyolysis and acute renal failure may also occur. Secondary infection and septic shock may worsen the already poor condition. The cause of death may be considered as multiple organ failure, including the brain, lung, and kidney. P39 Survival and physiological derangement of rats in the extreme hypobaric hypoxia environment: Toward a new animal model of acute mountain sickness 1 2 3 Wang Chia-Ti , Niu Ko-Chi , Lin Mao-Tsun , 4 1 1 Chang Ching-Ping , Syong Ci-Huei , Lin Hung-Jung 1. Department of Emergency Medicine, Chi-Mei Medical Center Tainan 710, Taiwan, China 2. Department of Hyperbaric Oxygen, Chi Mei Medical Center, Tainan 710, Taiwan, China 3. Department of Medical Research, Chi-Mei Medical Center, Tainan 710, Taiwan, China 4. Department of Biotechnology, Southern Taiwan University, Tainan 710, Taiwan, China Objective: To understand the survival and physiological derangement of rats in the extreme hypobaric hypoxia environment. Methods: Both anesthetized and un-anesthetized male Sprague–Dawley rats (350-400g) were exposed to extreme hypobaric hypoxia and, normobaric normoxia. Hypobaric hypoxia was achieved by a decompression chamber. The pressure was decreased to 210 mmHg, which is equivalent to the pressure of 0.27 atm or at 9000m height, in a controlled rate. Survival time was measured after target pressure achieved and maintained. The femoral arteries and veins of anesthetized rats were cannulated for blood pressure, MAP and HR monitoring, and the arterial partial pressure of CO2 (Paco2), O2 (Pao2), SatO2, HCO3 and PH value were measured via a blood gas analyzer. The brain neurotransmitters expression was analyzed via stereotaxically implanted microdialysis probe, and lactate, glycerol, pyruvate and glutamate levels were measured. The blood-brain barrier (BBB) expression and brain edema were measured by Evans blue method and brain dry/wet ratios respectively. We compared the extreme hypobaric hypoxia group and normbaric nomoxia group for understanding the difference in physiological characteristics. Result: The average survival time was 29±5.4 min (n=10) for un-anesthetized rats; and 26±6.5 min (n=10) for anesthetized rats in our extreme hypobaric hypoxia setting. The arterial partial pressure of CO2 (Paco2), O2 (Pao2), SatO2, HCO3 and PH value significantly decreased, and the neurotransmitter expressions in brain such as glycerol, glutamate and pyruvate/lactate ratio were significantly increased in extreme hypobaric hypoxia. We found no significant difference in the blood-brain barrier (BBB) expression and brain dry/wet ratios in our study. Conclusion: We report the survival time and provide the evidence of changes in physiological characteristics and brain neurotransmitters of rats in extreme hypobaric hypoxia environment. The development of a new animal model for rats under extreme hypobaric hypoxia is advantageous for academic researches for diseases related to hypobaric hypoxia, such as acute mountain sickness. P40 A thermodynamic mechanism for explaining the concurrence of joint ache and neurological deficit in one limb Cristian Melián Asociación Chilena de la seguridad, Puerto Montt, Chile Objective: To suggest a physiopathological mechanism that explains the clinical observation of spinal cord-articulation congruency. Materials and methods: a) Revision of records b) Analysis of Data. Results: Thermodynamic hypothesis of probability of bubbles appearance in a tissue subjected to mechanical energy: “For any heterogeneous open thermodynamic system, with non-adiabatic walls constituted by several non-compressible phases, with inert gases dissolved in them and subjected to pressure, the probability of formation of gas bubbles in the system when the pressure diminishes is directly proportional to the total energy (determined by factors such as thermal energy and mass of gas) accumulated by the system during the period of time in which it was subjected to pressure; and inversely proportional to the speed of energy transfer from the system into the environment in the form of heat or mass of gas”. The specific place of bubble formation will be the phase presenting a greater ∆E and its surroundings. The skeletal muscle system, in the four limbs, receives a similar mass of gas. The diver applies work to the skeletal muscle system; for example, to the right arm: kinetic energy is generated which turns into an increase of internal energy and heat in the limb. The longer the time the action is performed the greater the energy load and mass of gas. When the diver ascends the pressure diminishes, the speed of elimination of gas mass and heat is surpassed in the right arm, secondary to the energy accumulation during the task, with bubbles appearing in tissues with a greater ∆E and in its surroundings; for example, in the right shoulder. In the spinal cord, specifically in the synapse of the 1st and 2nd motor-neurons in the right arm, a greater amount of heat and gas mass accumulates, the elimination speed rate is surpassed and bubbles appear. The specific phase for the spinal cord will then be the inter-synapse space and its surroundings. The bubbles would cause a mechanical blockade of the nervous stimulus that would be transformed into a sensitive or motor deficiency. So, the degree of neurological deficiency would be given by the number of synapses involved. Neurological recovery would be given by: number of synapses involved, quantity, size and time the bubbles interact in the synapses, passing from a reversible mechanical-physiological dysfunction to an irreversible anatomical alteration. P41 Decompression sickness (DCS)-Is there a relationship between the anatomical location of joint pain and location of injuries in spinal cord? Cristian Melián Asociación Chilena de la seguridad, Puerto Montt, Chile Summary: A retrospective, cross-sectional and descriptive investigation was realized in 35 patients with DCS Type I (joint pain) and Type II (neurological deficit) in the same episode of DCS. The patients were treated in “Unidad de Baromedicina ACHS Puerto Montt (Chile)”, in the period between March 2006 and March 2008. A registry of the anatomical location of joint pain and neurological deficit was realized, dividing the body in 4 quadrants. There were defined four types of relation of congruence. 1) Congruence of quadrant 2) Congruence of side 3) not demonstrable Congruence 4) there is not congruence of quadrant. Objective: To describe the existence of a relation between the anatomical location of the joint pain and the location of the lesion in spinal cord (spinal cord - articulation congruency). Materials and Methods: It made a review of records and analysis of data obtained from each patient. Results: A congruence of side (spinal cord - articulation congruency) was observed in the 100% of the cases, in which it possible demonstrated positively or negatively congruence. In 80 % of these cases the congruity Medular - articulate is in the same quadrant. In 0% of the cases “there is not quadrant congruence”. Conclusions: A relation between the anatomical location of the joint pain and the location of the lesion in spinal cord was observed. P42 Activation of FGF-2/MEK/ERK 1/2/NF-κB and PKC/JNK Pathways by Hyperbaric Oxygen Stimulated proliferation in Osteoblast 1 2 CHEN-PU HSIEH , CHING-YUANG LIN 1. Orthopaedic Surgery Department and Hyperbaric Center ,Changhua Christian Hospital, Taiwan, China 2. Institute of Medical Research, College of Health Sciences, Chang Jung Christian University, Tainan, Taiwan, China Background: To investigate whether the hyperbaric oxygen(HBO) can promote the growth-arrest osteoblast (OB) cells to proliferate and differentiate, and to determine the probable mechanism .Methods: OB cells were exposed to O2 with different levels of saturation and pressure for 3 days and 7 days. The OB cells were divided into four groups: 1.TheControl Group (Group C ):cells were cultured under ambient oxygen (21% O2) and normal pressure(1ata). 2.ThePressure Group(Group P) :cells were treated with high pressure(2.5ata) only twice daily. 3.High Oxygen Group(Group O): Cells were treated with high concentration oxygen(50%) only twice daily. 4.Pressure and High Oxygen group(Group P+O): Cells were treated with high pressure(2.5ata) and high concentration oxygen(50%) twice daily. XTT was used to detect the cells proliferation and cell cycle progression was determined by Flow analysis. Expression of growth factors was assayed by RT-PCR. In addition, we determined HBO activated signaling pathway in OB cells by Western Blot analysis. Results: HBO therapy did significantly promote OB cell proliferation and stimulated cell cycle progression after the cells had been treated for three days.Afterward, the effect attenuated day by day. HBO also stimulated the OB cells to produce the FGF-2 growth factors. Multiple signaling pathways, s6k including FGF-2/MEK/ERK 1/2/Akt/p70 /NF-κB and PKC/JNK, are involved in the proliferation of OB cells by HBO stimulation .Conclusions: The pressure and high saturation of pressure have positive effects on stimulating grow-arrested OB cells to proliferate and differentiate s6k through activation of FGF-2/MEK/ERK 1/2/Akt/p70 /NF-κB and PKC/JNK signaling pathway.However,we were unable to determine between air pressure and oxygen concentration which is the more important factor.It is believed that HBO can be useful for fracture healing in clinical application in an optimal situation. P43 Hyperbaric oxygen therapy for chronic refractory osteomyelitis of the sternum: a case report Raymond C Shields, Francis C Nichols, William G Buchta, Paul L Claus Mayo Clinic and Mayo Foundation, Rochester, MN, USA Objective: To review a case of chronic refractory osteomyelitis of the sternum. Methods: A 32-year-old female with a history of lye ingestion at 14 months of age underwent multiple esophageal surgical procedures including subcutaneous colonic interposition with conversion to substernal colonic interposition requiring median sternotomy, revision of pharyngocolostomy, and eventual revision of cologastric anastomosis for obstruction. The last surgical procedure was complicated by a nonhealing draining sinus tract at the sternum. Clinical and computed tomography findings were consistent with chronic sternal osteomyelitis without anastomotic leakage. Narcotic analgesics were frequently required for pain management. Hyperbaric oxygen therapy (HBOT) was initiated. Twenty four of 40 recommended sessions were completed which included a profile of 100% oxygen administered via an oxygen hood (Sea-Long, Series 500 Hood / Neckdam System, Louisville, KY, USA) at 105 kPa (2 atmospheres absolute, 33 fsw) for 90 minutes with a 5 minute median air break. All sessions were conducted in a multiplace chamber (Fink Engineering TL24-165 AH11, Queensland, Australia). Ertapenem antibiotic therapy was continued throughout HBOT and discontinued at completion. No surgical debridement was required. Results: Dramatic pain relief was seen early along with cessation of sternal drainage. Upon completion of 24 sessions, the sternal wound had healed completely. The C-reactive protein improved from 16.1 mg/L before HBOT to less than 3 mg/L at completion. Conclusion: HBOT is beneficial for chronic osteomyelitis by reversing tissue hypoxia, enhancement in leukocyte bacterial phagocytosis, and improving tissue perfusion. These mechanisms appear to have been important in the healing of chronic sternal osteomyelitis in this patient. Reports of HBOT for sternal osteomyelitis remain limited in the English literature. Further investigation with well-designed clinical trials of HBOT for this indication is necessary to substantiate this treatment P44 Hyperbaric oxygen and concurrent chemotherapy: what are the concerns? John Feldmeier University of Toledo Medical Center, Radiation Oncology Department, Toledo Radiation Oncology, USA Objective: To review the published literature and putative effects of cancer -chemotherapy on patients receiving hyperbaric oxygen. Methods: Electronic computer data base literature searches as well as manual searches of known references in hyperbaric medicine were employed in order to define the potential interactions of hyperbaric oxygen and chemotherapy in cancer patients undergoing active treatment. In the past decade several new drugs with new mechanisms of action have become available. These drugs may target growth factors such as VEGF (vascular endothelial growth factor) or EGF (epithelial growth factor) while traditional cytotoxic chemotherapy is designed to directly disrupt cancer cell proliferation by interfering with mitosis. Results: The interaction between hyperbaric oxygen and cancer chemotherapy is complex and not well-studied. Older recommendations that absolute contraindications exist for most traditional drugs are not justified by available published literature. For newer drugs targeted against growth factors, the mechanism of action suggests that they will inhibit hyperbaric oxygen’s salutatory effect on wound healing. More study is needed before definite recommendations for these new drugs can be made. The review of these issues suggests that prior concerns regarding traditional cytotoxic chemotherapy are not justified by the published experience. Special considerations do relate to Bleomycin where reports document occasional but potential life threatening pulmonary fibrosis in patients exposed to oxygen-enhanced breathing gasses even some time after Bleomycin administration. Some drugs may be potentiated in their cytotoxic effects on cancer cell growth though this application has not been widely investigated or adapted to clinical advantage. For some of the newer drugs such as Bevacizumab and Cetuximab, there is not yet an adequate published experience to make definite recommendation; however, based on their mechanisms of action, these and other drugs with similar mechanism are likely to interfere with the hyperbaric oxygen delivered to enhance wound healing or treat delayed radiation injuries. Conclusions: The interaction between hyperbaric oxygen and cancer chemotherapy is complex and not well-studied. Older recommendations that absolute contraindications exist for most traditional drugs are not justified by available published literature. For newer drugs targeted against growth factors, the mechanism of action suggests that they will inhibit hyperbaric oxygen’s salutatory effect on wound healing. P45 Analysis of dynamic state of rheo-encephalogram during the procedure of hyperbaric oxygen therapy 1 1 1 Hongjun Wang , Qibiao Weng , Lingling Chen , 1 2 1 1 Xuelin Chen , quyun Yang , Jin Liu , Guimei Zhou 1. Zhujiang Hospital attached to Southern Medical University, Department of Hyperbaric oxygen, Guangzhou, China 2. The First Hospital attached to Guangdong Pharmaceutical College, Guangzhou, China 3. Shilong People’s Hospital of Dongguan City, Guangdong Province, Guangzhou, China 4. The Second People’s Hospital of Nanhai District, Foshan City, Guangdong Province, Guangzhou, China Objective: Three dynamic states of rheo-encephalogram (before HBOT, during HBOT and after HBOT) of patients who received the HBOT (hyperbaric oxygen therapy) were analyzed, so as to observe and analyze the effect of the whole procedure of HBOT on function of cerebral vessels, to know about the diversity and rule of function of cerebral vessels and change of cerebral blood flow, and to provide theory of HBOT on cerebral diseases. Method: Rheo-encephalogram was done in the following states: in normal atmospheric pressure, in 0.2 MPa, after 40-minute’s HBOT, in normal atmospheric pressure after the whole procedure of HBOT. All data is analyzed by SPSS 11.5. Result: Differences are significant in the following items: resistent index, rise time, whole recovery time, elasticity index, increased angle, top included angle. Items of rheo-encephalogram of internal carotid artery and vertebrobasilar artery are dissimilar between “patients after inhale oxygen, patients go out the hyperbaric chamber” and “before pressure is elevated, after pressure is stable”, while differences are not significant between “before pressure is elevated” and “after pressure is stable”, so do “patients after inhale oxygen” and “patients go out the hyperbaric chamber”. Conclusion: HBOT plays a positive role in vascular resistance and angiotasis when HBOT was received, while HBOT exerts no influence on volume of blood flow of cerebral vessels. It is indicated that change of vascular resistance and angiotasis is mainly affected by stimulation of high pressure oxygen on vascular smooth muscle rather than elevated oxygen pressure. Advanced research is required on cause of cerebral vessels’ contraction without reduction of volume of blood flow and duration of effects of elevated oxygen pressure on function of cerebral vessels. P46 18F- FDG PET imaging before and after hyperbaric oxygen combined therapy in persistent vegetative state Yu Ronghao, Xie Qiuyou, He Yanbin,et al. Department of Hyperbaric Oxygen, Guangzhou general hospital, Guangzhou Military Command, Guangzhou, China Objective: To evaluate the therapeutic effect of hyperbaric oxygen combined therapy in persistent 18 vegetative state, (PVS) patients with F18 fluorodeoxyglucose ( F- FDG) position emission tomography (PET) imaging. Methods: Ten patients with 18 PVS received F- FDG PET imaging examination before and after hyperbaric oxygen combined therapy. Results: All of the 10 cases were with abnormal cerebral glucose metabolism. Some abnormal cerebral glucose metabolism areas were concordant with the changes on brain CT or MRI,, but some were not. As PVS recovered, improvement of cerebral glucose metabolism or complete 18 return to normal were also observed., Conclusions: FFDG PET imaging is a safe and reliable modality, which not only can directly reflect the level of cerebral cerebral glucose metabolism and serve as a supplementary work up to brain CT and MRI, but also can be used to evaluate the therapeutic effect of hyperbaric oxygen combined therapy in PVS and to predict the prognosis. P47 Combined treatment of hyperbaric oxygen therapy, acupuncture and rehabilitation in four cases of neurological decompression sickness Hui-Chieh Lee Zuoying Armed Forces General Hospital, Taiwan, China Objective: The neurological decompression sickness (DCS) may cause severe symptoms and sequelae such as paraplegia and difficulty in, micturition and defecation. Traditional treatments includes United, States Navy (USN) treatment tables, hyperbaric oxygen (HBO2) therapy, & rehabilitation. In order to improve the therapeutic effects, we, tried to use a combined treatment of HBO2 、 acupuncture &, rehabilitation in the neurological DCS . Methods: Four cases of neurological DCS were collected, via our emergent room and diagnosed by means of diving history,, clinical manifestations, and adjunctive examinations such as, hemoglobin level(Hgb), hematocri(Hct), computerized tomography, (CT), and magnetic resonance image (MRI). All cases received the, combined treatment :the USN treatment table 6A and subsequent, HBO2 therapy (50 ft/ 120 min); acupuncture of head, neck, hand, abdomen, back, buttock, leg and blood letting of Wei-Chung, acupuncture point and physical therapy. Results: Four male fishermen had a repetitive dives to the depth, (25-52 m) for 40-100 min with SCUBA or surface supply compressed air., All dives exceeded no decompression limit without adequate, decompression stop . The clinical symptoms included changed, mentality, ptosis of eyelid, numbness and weakness of upper limbs or, lower limbs, difficulty in urination and defecation. Two cases had increased Hgb and Hct. One CT scan showed the brain edema and two had, positive MRI findings of brain and cervical spine. After the combined, treatment, three cases (75%) had complete recovery of motor function, and walked smoothly leaving the hospital. One serious case could walk, for a short distance with the walking stick. Hypoesthesia over lower, trunk improved markedly. Two cases had urination by themselves and, smooth defecation. The other two had sensation of urination and, increased power of anal sphincter but still needed urinary catheter, and laxative. The hospital stay was all within 30 days for four cases. Conclusion: From these clinical results, we suggest that this, combined treatment of acupuncture, HBO2 and rehabilitation may be, another useful choice in the management of neurological DCS. P48 Mechanically ventilated patients poisoned with carbon monoxide: outcome after hyperbaric oxygen therapy 1 1 1 Wang Chia-Ti , Cheng Chin-Jen , Liu Te-Ming , 2 Niu Ko-chi 1. Department of Emergency Medicine, Chi Mei Medical Center, Tainan, Taiwan, China 2. Department of Hyperbaric Oxygen, Chi Mei Medical Center, Tainan, Taiwan, China Objective: To review the outcome of severely poisoned patients who receiving mechanical ventilation and HBO therapy. Methods: We reviewed the case records of 16 patients required mechanical ventilation for severe carbon monoxide poisoning treated with HBO at Chi-Mei Medical center between May 2001and December 2005. We obtained numbers of days admitted in ICU and wards, underlying diseases, laboratory data. We analyzed the mortality and the morbidity in these treated patients. Only patients without any other comorbidity, like trauma or burn injury, can be included in our study. Results: Fourteen (87.5%) of 16 patients committed suicide by burning charcoal, 1(6.25%) was poisoned by car exhaust and 1(6.25%) was poisoned by faulty water heating installations. All patients received endotracheal tube insertion before HBO therapy and HBO therapy subsequently. Although 15 patients received HBO therapy th within 2 days after admission, one was treated on the 16 day after admission due to his unstable condition. Mean ICU stay was 7 days and total hospital stay was 16.7 days. There was 1 mortality case, and the other three were also defined as poor outcome due to their vegetative status. Twelve (75%) patients who underwent HBO therapy were discharged without severe sequelae. Conclusion: According to our experience, mechanically ventilated CO-poisoned patients who receive hyperbaric oxygen had a fair prognosis. Although the risks for the mechanically ventilated patients are relatively high, HBO therapy seemed to reduce the risk of serious neurological deficit in severe CO poisoned patients. P49 Experience in the treatment of decompression sickness from the mountain lake diving in Taiwan Shyanher WANG Department of Occupational and General Medicine, Tungs’ Taichung MetroHabor Hospital, TaiZhong, Taiwan, China Decompression sickness (DCS) occurred in the mountain lake is extremely rare in Taiwan., However, there were 3 victims during a 6-day rescue dive after the Mindulle typhoon attacks., It damaged the water gate in the Carp Reservoir where located 300 meters above sea level. Eleven male participated the dive., Their average age, body weight and diving experience were 25 year-old, 72 kg and 3 years, respectively., The rescue started 24 hours after ascending., The surface-supply dive was adopted due to the limited time and space., The bottom time was 30 minutes and the depth 60 meters under the mountain lake., Two dived each time. The patients were treated with the modified and extended recompression tables according to the individual condition. One victim with bend over multiple joints was treated with a modified table 5A., He got complete remission after the 5-hour treatment., The other two victims with bend and numbness over multiple limbs were treated with a modified table 6A for 8 hours., Because both had some residual symptoms, a table 5 was added on the next day., Both got complete remission thereafter., All three victims received no other medicines except of isotonic saline., None of them has late complication to date. The relative high incidence of DCS in this mountain lake dive might be from the hostile environment. The modified table 5A and table 6A, added with a followed table as necessary, might be tailored to optimize the treatment of the DCS occurred in the mountain lake. P50 Hyperbaric oxygen treatment of bone marrow edema (BME) and avascular osteonecrosis (AVN) of knee joint in comparison to talus. first long term results (5 years) in therapeutic outcome Johannes von Reumont, Anke Fabian Hyperbaric Centre, Heidelberg, Germany Objective: Positive effects in the BME and AVN treatment of the knee joint were first-time observed during a pilot study in our centre, in 1998 and 99. These results entailed, to a prospective clinical study to evaluate the therapeutic benefit of hyperbaric oxygen therapy (HBOT) in a large, patient population. Moreover a, first five years follow-up study, should give a prediction for the stability of the results after therapy. Method: Within the past 8 years 266 patients with MRI confirmed diagnosis of BME or AVN were evaluated. They were classified according to the Association for Research of Circulation Osseous (ARCO), knee joint (n = 207) and ankle joint, (n = 59). Clinical examination, (range of movement , pain score) was done before, during and after therapy and within the follow-up period. MRI control after, HBOT was classified for results. The number, of HBOT sessions (250/60) varied, according to, the clinical, success (minimum 15 or more). Classification of Result: 3+ no complaints/ 2+ clear approvement 1+ less 0 no progress. In the follow-up study group (FSG) n = 104, patients with interaction of interfering factors (e.g. operation, arthrosis) were excluded to evaluate, the real effect of HBOT stability (n = 64). Results: Mean age knee group (KG) was 57 years in comparison to the talus group (TG) 40 years. Number of sessions 27(KG) and 25 (TG) Clinical outcome ARCO stage 2, KG: 77,2% rated 3+, 19% rated 2+ in comparison with outcome stage 2 TG: 64,3%, 3+, 28,6 2+. Clinical outcome ARCO stage 3 knee group 60% 3+ versus 42,2% TG. The MRI outcome varies significantly in this stage: 3+ rated in 38,4% versus 9,1% TG. 94 % in the FSG answered our questionnaire. 81% remained in an unchanged therapeutic outcome, improvement in 6% and symptomatic aggravation also in 6%. Most of the changes were, seen within the first year. Conclusion: HBOT administered as a conservative causal therapy leads to very good results in earlier ARCO stages particularly, in the knee joint. There is a significant difference in MRI rating in stage 3. The therapeutic follow-up outcome already shows very stable results within the first year. P51 Effect of hyperbaric oxygen therapy on bone regenerating ossification during mandibular distraction osteogenesis in goats 1 1 2 Mingxing Li , Xiaoxin Lu , Jie Zheng 1. Department of Hyperbaric Oxygen, Fuzhou General Hospital, Fuzhou, China. 2. School of Stomatology , Fujian Medical University, Fuzhou, China Objective: To evaluate the effect of hyperbaric oxygen therapy (HBO) on the early phase of mandible lengthening in the goat model. Methods: Six healthy goats were randomly divided into two groups (n = 3 each). Animals underwent corticotomy of the hibateral body of the mandible after placement of distraction devices. Distraction, at a rate of 1 mm/day and a rhythm of 2 turns/day, began after a 5-day latency period for ten days. Only the second group underwent HBO for 1.5 hours daily for fourteen days from the second day of the latency phase. Twenty-eight days after completion of the distraction protocol, the animals were killed and the distracted mandibles were harvested. The appearance of the samples, radiological changes, bone mineral density, and mechanical strengths and histology were examined. Moreover, Serum alkaline phosphatase was measured before HBO and every four days thereafter from 3 days pre-treatment till first day post-treatment. Results: 1. In the experimental group, the surgery region swelling abated quickly; in the control group, surgery region in one animal had an infection. Every goat had bony callus, and the experimental group resulted in harder and wider healing bone. 2. X-ray: All specimens showed a progressive calcification of the distracted area between the mandibular segments, and the bone cerebral cortex connected completely except the infected animal. The distracted zone in the experimental group exhibited higher radiodense opacity. 3. Bone density showed that the experimental group resulted in a denser healing bone (P<0.05). 4. Three-point bending test showed that the maximal loading in the experimental group was higher than in the control group (P<0.05) .5. In the control group, three zones exhibited progress of intramembranous ossification. 6. Statistical analysis of the percentage of bone trabeculae area in the distraction gap revealed that experimental group showed a significant increase compared with the control group (P<0.05). 7. Serum alkaline phosphatase: early after surgery, every animal's serumal alkaline phosphatase level increased, and in the experimental group it increased more significantly than in the control group (P <0.05). Conclusion: HBO can enhance the anti-infection capacity of the surgery district and accelerate the rate of bone regeneration and ossification, and increase the activity of serum alkaline phosphatase. The domestic internal distractor has a stable biomechanical property and good biocompatibility. P52 Breath hold apnea tables for lower embolism (BATLE) experience after more than six years 2000 – 2008 John M Batle MEDISUB Hyperbaric & Underwater Research Institute Palma de Mallorca, SPAIN In the Balearic Islands, there is a great number of people interested in submarine fishing. Although fish are becoming scarcer to find, and the bigger ones are at a deeper depth which leads to the use of electric scooters ( submarine scooters) arriving to depths of up to 63 metres in apnea in the space of approximately two minutes to the said pressure with intervals on the surface of about two or three minutes.The number of dives per hour is about fifteen and each sesión is usually done over a period of between three to eight hours. Materials and Methods: Since l994 to present date, a study has been made of about forty cases of disbaric diving accidents in apneaatended by Medisub Hyperbaric Institute during the period l995 -2005. In the year 2000, the first tables of Breath Hold Apnea?Tables?for Lower Embolism ( BATLE ) were published at the EUBS Congress in Malta, and the second generation of tables were published in ICHM 2002. Now with more than six years of practise and experience of submarine fishing with the said tables. Results: The number of accidents diminished progressively and since then, few accidents have been presented in divers practising submarine fishing. Conclusion and Discussion: The extensión of the time the divers spend on the surface after each dive, thanks to the conclusión of Breath Hold Apnea Table for Lower Embolism has made accidents due to the formation of bubbles caused by the excess of nitrogen accumulated in the time of diving almost extinct. P53 Summarization of 3180 children with hyperbaric oxygen therapy Chen Yanhua, Capital University of Medicine Affiliated Beijing Children’s Hospital, Beijing, China Objective: Hyperbaric oxygen department of Beijing Children’s Hospital was founded in 2001-6-1. It has been 7 years since then. Our department has become the biggest pediatric HBO unit in Beijing region. Now we have 2 adult pure oxygen chanbers, 5 infant chanbers. There are 50 person-times per day on average and now we have treated over 70000 person-times safely, including more than 10 kinds of disease. Methods: Now we summarize our experiences of management of all kinds of disease in children as follows: Neonatal hypoxic-ischemic encephalopathy, Cerebral paralysis, Zentrale koordination storung, Virus encephalitis, Carbon monoxide poisoning, Virus encephalitis combined with cortex blindness, Congenital heart disease after operation, Exterior waterhead, Sudden deafness, Brain trauma, Toxicosis encephalopathy ,crushing syndrome etc. Age: the youngest patient is 8 hours after birth, the oldest is 18 years. Therapeutic scheme: Therapeutic pressure range from 0.05MP to 0.1 MP. Result: According to our experiences, pediatric HBO is a valuable method for most cases, especially for those Carbon monoxide poisoning, Virus encephalitis combined with cortex blindness, drug toxicosis, HIE, crush syndrome and virus encephalitis. Conclusion: We consider that pediatric HBO is a very effective and safety method as far as strictly abide the rules and criterions. The sooner the management begin, the better the result will be. 刊载交流 Publish Only K01 Observation of hyperbaric oxygen therapy’s effects on delayed encephalopathy after acute carbon monoxide poisoning Li Li Xu, Yi Liu, Hong Mei Chen Taihe Hospital Affiliated To Yunyang Medical College, Hubei, China Objective: To discuss the effects of hyperbaric oxygenation in delayed encephalopathy after acute carbon monoxide poisoning. Methods: 50 patients were divided randomly into control group (19) with drage therapy and experimental group(31) with hyperbaric oxygen therapy based on drage treatment . And then to evaluate the effects after 1courses, 2courses and 4courses of theatment. Results: The efficacy of experiment group is obviously difefent (P <0. 05), the curing time of experiment group was shorter than that of the control group, the result is signicant different (P <0. 05). Conclutions: Full dosage HBO therapy has obvious curative effect on delayed encephalopathy after carbon monoxide poisoning. K02 The observation of curative and nursing the children brain damage by Hyperbaric Oxygenation Dao-dong Liu, Dao-lin Liu 1. The people’s hospital of Lu’an city, Anhui province, Lu’an, China 2. Luan City Hospital in Anhui Province, Lu’an,China. Purpose: To observe the curative effect of the hyperbaric oxygen action used for treating craniocerebral injury of children and sum up the experience of nursing care. Method: To retrospect and analyse 160 cases (82 children as an observation group and 78 as a control group). For the observation group, use the hyperbaric oxygen action and conventional therapy, at the same time; exert the holistic nursing of care, such as mental nursing. At the same time, provide the knowledge about the hyperbaric oxygen action for the children and the parents in order to get their coordination. Result: The effective hyperbaric oxygen action and nursing care made the curative ratio of the observation group outclass that of the control group (P<0.005). Conclusion: Treating craniocerebral injury of children with hyperbaric oxygen action could get better effect. While at the same time, the effective nursing care is indispensable. K03 Brain hippocampus cellular apoptosis and expression of bcl-2, Bax, caspase3 protein following acute carbon monoxide poisoning 1 1 2 2 Fujia Liu , Chujin Gao , Chengqing Xia , Hongying Zhao , 2 Man Qi 1. Hyperbaric Oxygen Department, Beijing Chaoyang Hospital, Beijing, China 2. Pathological Department, Beijing Chaoyang Hospital, Beijing, China Objective: To study the change of apoptotic cells and expression of bcl-2 protein, Bax protein and caspase3 protein in mice brain hippocampus after acute carbon monoxide poisoning (ACMP). Mathods: 56 Male KunMing mice were devided into seven groups (control group, CO-exposed 1h group, CO-exposed 6h group, CO-exposed 12h group, CO-exposed 24h group, CO-exposed 3d group and CO-exposed 7d group), eight mice each group. The control groups were exposed to air and the poisoning groups were exposed to CO. General TUNEL, immunohistochemistry stain and flow cytometry were used to observe the neurological damage and the change of caspase3, bcl-2, Bax protein expression. Results: TUNEL staining positive cells significantly increased on 3d in hippocampus after acute CO poisoning(P<0.05), and got much higher value on 7d(P<0.01); caspase3 protein expression increased at 1h after poisoning, reached the highest at 24h and recovered on 7d; bcl-2 protein expression increased at 1h in hippocampus after acute CO poisoning, peaked at 24h and recovered on 7d; Bax protein expression increased at 1h in hippocampus after poisoning, peaked at 24h and recovered on 7d. Conclusions: There existed delayed neurological apoptosis and apoptosis-associated factors expression in mice brain hippocampus after acute CO poisoning. Celluar apoptosis might be one of the pathological mechanism of delayed encephalopathy after acute carbon monoxide poisoning. K04 Hyperbaric oxygen therapy to the resumption of mycoplasma encephalitis patients 1 case Wencheng Liu, Haiying Jia, Xin Yang, Juan Song Beijing 306 Hospital of PLA, Beijin, China Objective: study the role of hyperbaric oxygen therapy to the resumption of mycoplasma encephalitis patients. Contents: Female, 5-year-old. She came to hospital because of fever one day, six hours unclear sense. Admission diagnosed as mycoplasma encephalitis merger demyelinating; mycoplasma pneumonia, bacterial pneumonia, septic shock. She was given such treatment as expansion, down intracranial pressure, anti-mycoplasma, antibiotic, nutritional support to brain cells, etc. After admission 20 days, pulmonary inflammation was absorped, and she has a clear awareness, but not audible, remaining urine incontinence. Right leg muscle strength Class II, left leg muscle strength at class I. Review skull MRI: a little bleeding edge of the bilateral frontal lobe; bilateral subthalamic a small amount of bleeding. At that time hyperbaric oxygen therapy started. Methods: GY3200 oxygen chamber of Oxygen Co. Ltd. in Yantai Hongyuan, the pressure for the treatment of 2.0 ATA, each 1 days, a total of 30 times. Results: Ater 10 treatments, coordination of activities was improved and she,s hands shake reduction. Ater 20 treatments, she can stand and walk. Treatments of 30, she can speak simple words. Review skull MRI: brain lesions were disappeared, bleeding was absorped. Conclusion: Hyperbaric oxygen therapy plays good on mycoplasma encephalitis. Perhaps we should start a earlyer application of high-pressure oxygen treatment to mycoplasma encephalitis patiant just when the disease is under control. K05 Interfering effect of hyperbaric oxygen and Ozagrel Sodium on progressive stroke Liu Xinying Jigang General Hospital, Jinan, China Objective: To approach the therapeutic effect and the safety of hyperbaric oxygen and Ozagrel Sodium on progressive ischemic stroke. Methods: Patients with progressive ischemic stroke were treated with Ozagrel Sodium in the control group, while in the trial group with hyperbaric oxygen and Ozagrel Sodium. We judged the clinical nervous function and defect degree before and after 7d, 14d, 28d treatment according to the nervous defect standard (NDS) and the changes of hemorrheology. Results: There was a significant difference in general effective rate and significant effectiverate between the trial group and the control group (P<0.05), and in all laboratory indexes there was also an apparent effects. Conclusion: The therapeutic effects of hyperbaric oxygen and Ozagrel Sodium is satisfactory and safe. K06 Effects of large doses of hyperbaric oxygen on NF-KB DNA binding activity of brain tissue on super-early stage of acute permanent MCAO in rats Yaling Liu, Qiuhong Yu, Chunjuan Wang, Lianbi Xue Department of Hyperbaric Oxygenation, Beijing Tiantan Hospital, Beijing, China Objective: We investigated the effects of large doses of hyperbaric oxygen (HBO) on acute permanent focal cerebral ischemia in rats. And we examined if hyperbaric oxygen treatment (HBOT) could influence NF-KB DNA binding activity of peri-infarction region of brain tissue. Methods: Seventy rats underwent MCAO operation and were randomized to hyperbaric oxygen treatment group, control group, sham group. Hyperbaric oxygen treatment began 5h after surgery. HBOT was delivered at a dose of two atmospheres absolute (ATA) for 1 hour ten times four day. Control animals were exposed to air at ambient room pressure. Other rats underwent sham surgery. Neurological outcome was measured 3h, 24h, 2d, 3d, 5d after surgery using Garcia scores. TTC pathological staining and Image J software were used to determine infarction volume at the point of 3h, 24h, and 5d after surgery. And we investigated NF-KB DNA binding activity of brain tissue 3h, 24h, 5d after surgery using electrophoretic mobility shift assays (EMSA). Results: (1)Garcia scores of HBO group(3.64±0.18) at the point of 24h after MCAO were significantly higher than control group (3.21±0.12) (P<0.05). There was no significant difference in Garcia scores between HBO group and control group 3h and 5d after MCAO. (2) At 3h after cerebral ischemia there was no infarction region. There was no significant difference in infarction volume between HBO group and control group at 24h after cerebal ischemia. From 24h to 5d after MCAO HBO group infarction volume didn’t change, but that of control group decreased. (3)NF-KB DNA binding activity in HBO group (1.66±1.15) at 5d after MCAO was significant lower than control group (7.28±3.10) (P<0.05). But at 3h, 24h after MCAO there was no significant difference in NF-KB activity between two groups. And there was no significant difference in NF-KB DNA binding activity between ischemic ipsilateral cortex and contralateral cortex. Conclusions: (1) Hyperbaric oxygen could protect ischemic brain tissue at 24h after MCAO surgery, but after 24h HBOT should be used carefully ,because it might damage brain tissue. (2) Hyperbaric oxygen could decrease NF-KB DNA binding activity of ischemic ipsilateral cortex. K07 Fracture treatment by hyperbaric oxygenation Yi Liu, Cao Cui Taihe Hospital Affiliated to Yunyang Medical College, Hubei, China Objective: To investigate the curative effect of hyperbaric oxygenation in patients with recent fracture. Methods: 80 cases were divided into hyperbaric-oxygenation group and the control group; in the hyperbaric oxygenation group, under 0.2 MPa pressure, patients inhaled pure oxygen for 60 minutes each day, and between10 times and 60 times. Results: there was great difference between two groups(P<0.05). Conclusion: Hyperbaric oxygenation can promote the healing of fracture. K08 Effects of supplementing Qi and activating blood circulation and hyperbaric oxygenation on pia mater microcirculation in gerbil after cerebral ischemic reperfusion injury Guoping Yu, Shilong Lin, Min Fang Shangahi Kaiyuan Orthopaedics Hospital, Shanghai, China, Objective: To explore the efficacy of Chinese drugs with the function of supplementing Qi and activating blood circulation and hyperbaric oxygen (HBO) on the pia mater microcirculation in gerbil after cerebral ischemia / reperfusion injury. Methods: Forty - four Mongolian gerbils underwent following operations: A cranial window was created in the left parietal bone and covered with absorbent cotton soaked with artificial cerebro-soinal fluid. The bilateral common carotid arteries were squeezed by clamps for 30 minutes and then the clamps were loosened so as to cause reperfusion.The gerbils were equally divided into four group at random: drug group (compound solution including Astragalus root, Chinese angelica, and red sage root was infused intraperitoneally), HBO group (exposed to 0.25MPa hyperbaric oxygen for 60 min) ,combined treatment group (both the two above methods were used) ,and control group (normal saline was infused intraperitoneally), LMB-1 laser microcirculatory mater and JI-200 laser microcirculatory moving analytical meter were used to observe the changes of pia mater microcirculation through the cranial windows before cerebral ischemia. Results: After the common carotid arteries were squeezed, the microvessels contracted obviously, microthrombus were seen, and blood flow rate of the arteriole decreased to 0.45mm/s, and the blood flow rate of the venule decreased to 0.38mm/s.It was observed that in the drup group, HBO group, and combined treatment group the microthrombi in pai mater were loosened gradually, and exudation around microvessel was gradually entered absorption up to extinction. The arteriole blood flow rate was 1.46-1.56mm/s, the venule blood flow rate was 1.27-1.44mm/s,significantly higher than those of the traditional. Conclusion: Chinese drugs with the function of supplementing Qi and activating blood circulation by playing a role in improving microcirculation. Their effects are closely related to acceleration of the blood rate, regulation of the caliber of the arterioles and the venules, and improvement of cerebral blood flow except oxygen content increased. K09 The effects of hyperbaric oxygenation on the treatment of spinal cord injury Zhicai Li, Yiping Song, Xiaoping Mu No. 97 hospital, Xuzhou, Jiangsu, China Aim: To observe the effects of hyperbaric oxygenation on the function restoration in patients with spinal cord injury. Methods: All patients with spinal cord injury were confirmed with CT and/or MRI. 126 patients enrolled after January 1986 were assigned to treatment group (T group, with hyperbaric oxygenation therapy) and 56 patients enrolled before December 1986 were assigned to Control group (C group, without hyperbaric oxygenation therapy). There was no significant difference between two groups on the gender, age, course and injured position. Patients in two groups were operated and administrated with dehydrant, anti-inflammation, and drugs to against the oxygen free radicals. The puncture and other physical treatments were given to all patients, but only the patients in T group were treated with hyperbaric oxygenation. The hyperbaric oxygen chamber was pressurized to 0.2Mpa and maintain at this level. The patients in T group were given oxygen with mask according to the protocol schedule of 30min×2+10min, and total time was 120min. A patient would need 2-4 periods of treatment dependent on the severity of injury and 10 times as one period of treatment. The relationship between efficiency and the beginning time of hyperbaric oxygenation therapy was observed. Results: The rate of efficiency and improvement was 61.9% and 31.0% respectively in T group, which was significantly more than 23.2% and 37.5% in C group (p<0.05). Conclusion: Hyperbaric oxygenation could promote the function restoration of injured spinal cord, especially for the patents with partly spinal cord injury. The patients with spinal cord injury should be treated with hyperbaric oxygenation as earlier as possible. K10 Cases reports for conventional hyperbaric oxygen treatment on altitude decompression sickness Guangsen LIU, Shuhui ZHANG The Centre of HBOT in 458th Hospital of PLA, Guangzhou, China Objective: The purpose of this study was to evaluate clinical effects of conventional hyperbaric oxygen treatment on 17 cases with altitude decompression sickness (DCI). Methods: 17 male patients (age: 25-45yr) with altitude decompression sickness were received by conventional HBO in single chamber filled with pure oxygen. The high altitude presented DCI occurred from 7500m to 14000m because of chamber windows breaking abruptly. The study population consisted of experienced pilots with the flight time from 400 to 4500 hrs. All of them had different symptoms respectively, i.e. memory loss, hearing loss, confusion, blurry vision, headache, fatigue, joint ache. Some symptoms lasted 3-23 days after landing. All of them had received 1-3 sessions HBO (0.295MPa, 90min, one session per day) in first 3 days, and then 1 session HBO (0.20 MPa, 80min). Results: All symptoms of them were completely relieved after 1-3 sessions with HBO. The all examinations for the study population were normal as before after 20 sessions HBO. 16 of 17 pilots, except 1, continued high altitude flight as before. Conclusion: In this study population, symptoms with altitude DCI would be relieved by conventional HBO. K11 Curative effect of hyperbaric oxygenation peripheral neuropathy in type II diabetics Jiaxiang Bai, Yanxin Liu Tianjin Hospital, Tianjin, China on Objective: To observe the curative effect of hyperbaric oxygenation (HBO) on peripheral neuropathy in type II diabetics. Methods: 76 diabetics were divided into 2 groups equally. Diabetic diet, hypoglycemic agents, vitamin B1 20mgtid Oral treatments were used in control group. HBO combined with the above treatments were used in HBO group. Patients stayed in 2.5 ATA HBO chamber, wearing masks and inhaling pure oxygen for 20 min 4 (of pure oxygen absorption 80 minutes), with 5 min interval. Once a day for 10 times as a course, altogether 4 courses for each patient, breaks 3-5 days. Electromyography (EMG) was measured before treatment and two months after the HBO treatment done. Results: In HBO group, the clinical symptoms improved significantly or disappear, the motor nerve conduction velocity (MNCV) and sensory nerve conduction velocity (SNCV) of EMG were increased significantly after the treatment than before (P < 0.01), while clinical symptoms of the control group had no significant improvement, in EMG Figure part (upper) a slight improvement in nerve conduction velocity, and no other significant changes. Conclusion: HBO can effectively improve diabetic peripheral neuropathy, worthy of promotion. were significantly higher than in control group (P<0.05). Conclusion: HBO may help to recover injured patients’ language abilities. K12 Effect of hyperbaric oxygen treatment on hydrocephalus in animal with acute ischemic cerebral injury 1 2 2 1 Shilong Lin , Jingchang Liu , Peizhu Xin , Guooping Yu 1.Shanghai Kaiyuan Orthopedic Hospital , Shanghai, China 2.Naval Medical Research Institute of PLA, Shanghai, China Objective: To approach effect of hyperbaric oxygen (HBO) treatment on hydrocephalus in animals with acute cerebral ischemic injury. Methods: 60 gerbils were divided into the cerebral ischemic group, the hyperbaric oxygen exposure group and the control group. These animals were anesthesia with 20% urethane (1.2g/kg.BW) or 20% pentobarbital sodium (40mg/kg B.W.). Acute cerebral ischemic injury was resulted from occluding both carotid for 30min. Animals were exposed at 0.25MPa HBO for 60min after cerebral ischemic injury in the HBO group. Cerebral ischemic injury group was exposed to N2-O2 with O28%-N292% at 0.25MPa for 60min. The control group animals were exposed to normal pressure for 60min in the chamber. Blood flow dynamic effect in microcirculation, morphosis in micro-vascular endothelial cell and cerebral nerve cell detected. Result: after 30min to block up carotid, cerebral nerve cell injury occurred, part nerve cell nucleus was vacuole, denaturalization and swell. Cerebral tissue was edema. Endothelial cell structure and function changed, and edema formed around micro-vessel. After HBO exposure for 60min, cerebral nerve cell swell improved in animal with cerebral injury. Only spot exudation occurred around micro-vessel. Endothelial cell injury obviously decreased. Hydrocephalus entered absorption. After HBO exposure at 0.25MPa for 60min, blood perfusion flow increased than the control group in animals with cerebral ischemic injury (P<0.01). Conclusion (1) Acute ischemic cerebral injury may cause hydrocephalus resulted in cerebral nerve cell, endothelial cell and other cerebral tissues injury. (2) HBO has therapeutical effect by reducing injury in nerve cell and micro-vessels endothelial cell in animals. K13 Interfering effect of hyperbaric oxygen on alogia in acute cerebral injury Lin Ying Hyperbaric Oxygen Derpartment of the Affiliated Zhong Shan Hospital of Xiamen University, Xiamen, China Objective: To study the interfering effect of hyperbaric oxygen on aphasia people with acute cerebral injury. Methods: 120 cerebral injury people were divided into the hyperbaric oxygen (HBO) exposure group and the collator group. Each group had 60 people. HBO group were accepted HBO treatment. Results: After 12-24 times or more HBO treatment, it showed that the blocked vessels were repassed or injured cerebral zones were rebuilt from CT or MRI impression. Injured patients’ language abilities K14 Hyperbaric oxygen treatment of 28 cases of children viral encephalitis Xiuqing Liang, Xiaole Wang, Xiaohong Wang Shanxi Province Maternal and Children Care Hospital, Xi’an, China Viral encephalitis in pediatric clinical is common, and major features of fever, headache, convulsions, disturbance of consciousness, abnormal behavior, high intracranial pressure. Laboratory abnormalities can be found in cerebrospinal fluid, the virus culture positive, cranial CT and EEG abnormalities, etc. In 1991 to 2007, admitted in October to 11-year-old children with 28 cases of encephalopathy with anticonvulsant, decrease intracranial pressure and the anti-virus treatment, especially add to hyperbaric oxygen therapy. All of the patients were given oxygen chamber treatment. 0.08 Mpa pressure lasts two hours, once a day for 10 consecutive treatment every week treatment interval. course of treatment is from 2 to 8. The results showed that cured 16 cases, eliminate clinical symptoms, EEG, cerebrospinal fluid and cranial CT returned to normal. 9 cases turn for the better, eliminate clinical symptoms, cerebrospinal fluid of normal, but abnormal EEG and cranial CT abnormal; invalid three cases, No clinical symptoms improve, continuing convulsions, abnormal EEG and cranial CT, brain conversion is shown. Hyperbaric Oxygen Therapy encephalopathy is mainly to facilitate the brain tissue collateral circulation, reducing hypoxic brain damage, increasing reticular activating system’s oxygen, to speed up the unconscious child awake. Compared with simple dehydration, anti-virus and anticonvulsant treatment, hyperbaric oxygen is significantly. In addition, we also found that the severe convulsions, plus saiga horn oral solution, which can effectively reduce the seizures occurred and prevent temperature rebound. K15 Study on prevention of the delayed neuropsychologic sequelae after acute carbon monoxide poisoning in hyperbaric oxygen treatment Li Zengmin Hyperbaric oxygen section of City center hospital, Xian, China Objective: Research how lower the delayed neuropsychologic sequelae of outbreak rate in the hyperbaric oxygen treatment the acute the carbon monoxide poisoning of process. Methods: Through review cultural heritage and r former clinical data of analysis, take a series valid measure, to hyperbaric oxygen treatment the project did correspond of improvement. Results: Make acute carbon monoxide poisoning the delayed neuropsychologic sequelae of outbreak rate reduced obviously. Conclusion: Combine immediate, enough of hyperbaric oxygen treatment and reasonable of comprehensive treatment are the best treatment project. K16 Purpose judged curative effect of wean cerebral palsy by hyperbaric oxygen treatment. Zuomin Li, Wenying Huang First Renmin Hospital of Chenzhou, Huhan, China Purpose: Judged curative effect of wean cerebral palsy by hyperbaric oxygen treatment. Method: 75 case cerebral palsys were divided into two groups: treatment group 38 case and antitheses 37 case. Compared the two groups with symptom, system by crued fore-and-aft; and compared the conclusion based on CT or MIR result. Result: Myospasm, involuntary movements, incoordination, intellectuality, speech function improved in; epilepsy spasm `times decreased; it is more difference compare with antitheses of HBOT group’s case (p<0.05). Conclusion: HBOT is credibility and affirm method than simplicity medication in wean cerebral palsy treatment. K17 Monitoring bacteria status in the water and container of humidifying in single-chamber with pure oxygen Chaoqun TU, Xiaomei XIE, Xiufang MEI, Meilian LAN, Sh uliang LI The Shenzhen Peoples Hospital, Shenzhen, China Objective: To observe the bacteria status in the water and container of humidifying in the single-chamber with pure oxygen in order to find right method to prevent from second contamination from humidifying water in the chamber. Methods: 1.The water in the container of chamber and from spraying nozzle in the chamber was cultured for consecutive 5 days. The water was divided into three groups, non-heating water, drinking water and distilled waterdistilled water, was changed on alternate 3 3 days145±26 cfu/m )found at the two sites from non-heating water appeared on third days. The TBC from drinking water and distilled water were respectively 3 3 472±69 cfu/m , 357±91cfu/m on forth days. 2. No bacteria appeared at the above sites from the water of drinking and distilled water on the third day when water had been changed on alternate 3 days. Conclusion: 1.The distilled water should be best liquid fit to humidify in the single-chamber with pure oxygen. 2. It should be to clean the container and distilled water should be changed at least on alternate days . . and was cultured at the same method on third day. Results: 1. No bacteria of three kind of water were found at the two sites. The bacteria (average total bacterial count, TBC. 2. The water divided into two groups, drinking water and K18 The affection research of micronucleus frequency in pregnant mice bone marrow erythrocyte treated by hyperbaric oxygen Li Zhang Second hospital attached to Kunming medical collage, Kunming, China Objective: This paper has evaluated the frequency of micronucleus in the pregnant mice bone marrow erythrocyte treated by hyperbaric oxygen. Methods: We have treated the pregnant mice by hyperbaric oxygen one time every day, and examined the frequency of micronucleus in the pregnant mice bone marrow erythrocyte, in order to research the affection of the genetic materials in pregnant mice treated by hyperbaric oxygen. Results: The frequency of micronucleus in the treated group is significant different compared with the control group. Conclusion: Perhaps excessive hyperbaric oxygen can make damage of the genetic material in the pregnant mice to a certain degree. K19 The penis plants again match carried on the hyperbaric oxygenation treatment to cure 1 Li Zengmin Central Hospital XIAN, Xi’an, China Objective: The penis plants again behind for the sake of anti- infect and improve the blood oxygen a supply ,the match carried on the hyperbaric oxygenation treatment. Methods: The treatment adopts large air to add to press cabin ;normal regulations treatment project. Results and Conclusion: Thus for again the surgical operation provided a guarantee successfully. K20 Effect of Hyperbaric Oxygen Treatment on learning and memory aspects of transient global cerebral ischemia in rats 1 1 2 1 Yajuan Li , Chunjin Gao , Yu Zeng , Zhipeng Xu , Hui W 1 ang 1. Capital Medical University affiliated Beijing Chaoyang Hospital, Beijing, China 2. Sichuan Provincial Peoples Hospital, Chengdu, China Objective: To observe the effect of hyperbaric oxygen treatment (HBOT) on rat’s abilities of leaning and memory in the transient global cerebral ischemic model and to explore the mechanism of hyperbaric oxygen treatment on recognition impairment after cerebral ischemic diseases. Methods: 46 male Sprague-Dawley rats were randomly divided into 4 different groups: blank group (n=10), sham-operation group (n=10), cerebral-ischemia group (n=9), HBO group (n=9). According to Pulsinelli’s 4-vessel occlusion method to establish transient global cerebral ischemic model on the cerebral ischemia and HBO group. The sham-operation group didn’t block the vertebral artery and the carotid artery. The blank group has no operation, only take part in Morris water-maze. HBOT was performed to rats in HBO group after the second operation for 7days, one time for one day, then we give all the rats a test of Morris water-maze. We observed the time of escape latent and the last day when move off the platform, the time of rats through the platform .The average time of every day and every group was compared. The SPSS11.5 software was used for statistical analysis, st th rank sum test was used in the 1 -5 ,analysis of variance and Newman-Keuls test were used in the last day, p<0.05 has statistical significance. Results: 1. The escape latent comparison:the HBO group is shorter than the cerebral ischemia in the 3rd -5th day (p<0.01 or p<0.05), the difference has statistical significance; the HBO group and sham operated group in the 1st -5th day has no difference; the sham operated group is shorter than the cerebral ischemia group in the 3rd and 5th days (p<0.01 or p<0.05), the difference has statistical significance; the blank group is shorter than the sham operated group in the 2nd- 5th day (p<0.01 or p<0.05), the difference has statistical significance.2. The times of through platform's comparison: the HBO group is larger than the cerebral ischemia group in the last day (p<0.05), the difference has statistical significance; the HBO group and the sham operated group has no difference; the sham operated group is larger than the cerebral ischemia group(p<0.01), the difference has statistical significance; the blank group is larger than the sham operated group (p<0.01), the difference has statistical significance. Conclusions: 1. The learning and memory abilities of transient global cerebral ischemia in rats are decline. 2. HBOT can improve the impairment of learning and memory after transient global cerebral ischemia in rats. K21 Effect of High pressure oxygen (HBO) for Treating Neonates with Bypoxic ischemic encephal opa-thy of the newbom (HIE) Yuxian Li, Mei Lin Youjiang Medical College for Nationalities of Affiliated Hospital, Guangxi, China Objective: To study the effect of HBO for treating neonates with HIE. Methods: 160 cases hospitalized in our department who were diagnosed with HIE according to the diagnosis stander. They wear divided into treatment group and control group. There was no significant difference between the two groups of the clinical classification, lesion degree and days (p>0.05). Control group was given regular treatment, while treatment group was added HBO after the life sings was stable. The treating pressure adjusted to the days old.10 days were a course .They were assessed after the treatment .The results were compared. Results: There was difference between the two groups of the effective rate. Effect of treatment group was better than that of control group. All cases were followed up for half a year. Their neural development and the intelligence were observed .There was statistic difference between two groups adverise prognosis rate. Conclusion: patients with HIE should be given HBO as soon as possible after stable disease .It can improve the clinical symptom and the cure rate shorten ,the course of disease. K22 The hyperbaric oxygen therapy for spinal cord injury caused by acute cervical disc herniation Shaohua Liang, Xiaoju Tang, Ruzhuan Liu The Ruikang Hospital Affiliated to Guangxi University of Traditional Chinese Medicine, Nanning, China Objective: To evaluate the clinical effects of the hyperbaric oxygen therapy for spinal cord injury caused by acute cervical disc herniation. Methods: To retrospectively analysize the clinical data of spinal cord injury caused by acute cervical disc herniation of 45 cases ,which was treated with the hyperbaric oxygen therapy after surgery. To evaluate the clinical effects, based on the Frankel grade and the JOA score improvement rate of preoperative and postoperative situation. Result: the Frankel grade of patients improves 1-4 level. The time of follow-up is from 6 months to 2 years, the average time is 10 months. the JOA score improvement rate: excellent: 23 cases(51.1%), good: 18 cases(40.0%), average:3 cases(6.7%), poor:1 case (2%), The good-to-excellent rate is 91.1%. Conclusion: The hyperbaric oxygen therapy for spinal cord injury caused by acute cervical disc herniation, is the effective therapy of recovery of spinal function. K23 Clinical studies on sudden deafness via hyperbaric oxygen therapy 1 2 Ying Mei , Chaofeng Xie 1. HBO Department, People’s Hospital of Guangdong Province, Guangzhou, China 2. E.N.T Department, Shantou Second People’s Hospital, Shantou, China The therapeutic effect on the clinical efficacy of hyperbaric oxygen treatment on sudden deafness was discussed in this study. The method is that 300 cases of sudden deaf patients were randomly divided into two groups: drug treatment group (group A),and the hyperbaric oxygen treatment with drug group(HBO group, or group B). the two groups with drug treatment made the same effect, but in addition, HBO group was given the treatment of HBO, that is, under the following conditions: the pressure-0.22Mpa,oxygen absorption-30min*2,the interval-5min,one treatment for one day,12 days for a course. Generally, the effect comparisons were taken in one to three courses. Overall, the effect of the combinative group is better than the drug group, and the variation is obvious (P<0.05). And the conclusion is: the treatment on sudden deafness with hyperbaric oxygen and drug is obvious, and should be advocated broadly in the clinical application. Keywords: sudden deafness hyperbaric oxygen combination treatment K24 To treat hard facial nerve paralysis with hyper--baric oxygen (HBO)combined with electric acupuncture Shunyong Li, Aixiang Du, Guicui Wang WeiHai Municipal Hospital, Weihai, China Objective: To compare the curative effect of HBO in patients with hard facial nerve paralysis with of HBO combined with electric puncture. Methods: 37 cases of patients were treated simply with HBO once per day,the duration of one period of treatment lasted for 10 days. 39cases of patients were treated with HBO and electric acupuncture for five period of treatment (To acupuncture the routine facial nerve paralysis points once per day, ten times of acupuncture made up of one period of treatment). Results: Of the HBO group, 12 cases (32.43%) were cured, 18cases (48.65%) were relieved, 7cases (18.92%) were no curative effect. Of the HBO combined with electric acupuncture group, 24 cases (61.54%) were cured, 12 cases (30.77%) were relieved, 3cases (7.69%) were no curative effect. Conclusion: The curative effect of using HBO combined with electric acupuncture in treating patients with hard facial nerve paralysis is significantly better than that of using HBO simply. K25 Effect of early intervention of hyperbaric oxygen and hypobaria on CGRP and ET level in rats under hypobaric environment 1 1 1 Shuyi Pan , Xiaowen Pan , Xiangen Meng , 1 1 1 2 Mingxin Li , Yu Zhang , Chen Yang , Baoguo Li 1.Navy General Hospital, Beijing, China 2.Shi jitan Hospital, Beijing, China Objective: To explore the effect of early intervention of hyperbaric oxygen and low atmospheric pressure on CGRP and ET level under hypobaric environment, and to compare the effects of two methods. Methods: The Wistar rats were randomly divided into 6 groups: (1) Control group, (2) 3800m (2h) group, (3) 3800m (3d) group, (4) 3800m (7d) group, (5) Hyperbaric oxygen intervention group, (6) Hypobaric environment intervention group. Firstly, the rats in the second, third and fourth groups were placed in low pressure oxygen chamber, and the pressure in chamber was decreased at equal speed from 0.1mpa to 0.062mpa from the sea level, to simulate hypobaric environment on mountain at 3800m above sea level. At 2h, 3d and 7d time points, the rats were decapitated to obtain blood for later examination; Secondly, the rats in the fifth group received hyperbaric oxygen treatment (0.2mpa, once per day, oxygen inhalation for 60 minutes, successively 5 days). At the sixth day, the rats were placed in low pressure oxygen chamber, and the chamber was decreased at equal speed to 0.062mpa. At 2h time point, the rats were decapitated to obtain blood for later examination; thirdly, the rats in the sixth group received hypobaric hypoxia treatment (0.062mpa, once per day, 2h once, for successively 5 days). At the sixth day, the rats were placed in low pressure oxygen chamber, and the chamber was decreased at equal speed to 0.062mpa. At 2h time point, the rats were decapitated to obtain blood for later examination; the blood samples obtained from above different treatment methods were centrifugated to obtain the supernatant, and CGRP and ET levels were measured by radioimmunology method. Results: Compared with control group, CGRP level shows decreasing tendency with time extension, without significant difference. The hyperbaric oxygen treatment has no effect on CGRP level, but hypobaric hypoxia pretreatment can make CGRP level decrease more obviously, without significant difference. ET level shows increasing tendency with time extension, but without significant difference. However, EF level after hyperbaric oxygen and hypobaric hypoxia pretreatment shows significant increasing, P<0.05. Conclusion: The hyperbaric oxygen and hypobaric hypoxia training mainly influences ET level change in rats, and hyperbaric pretreatment might enhance body adaptive capacity on mountain. K26 Observation of hyperbaric oxygenation theraphy on patients with insomnia Yulin Nie, Kunru Zhou Buji people’s hospital, Shenzhen, China 0bjective: To observe the effects of hyperbaric oxygenation on sleep quality of the patients with insomnia. Methods: Ninteen patients with insomnia were treated with hyperbaric oxygenation, and observe the effects of hyperbaric oxygenation on sleep quality and simultaneous phenomenon. Results: 5 cases totally recovered, 12 cases had obvious effect, and 2 cases had no effect. Conclusion: Sleep quality and simultaneous phenomenon of the patients with insomnia can be improved with hyperbaric oxygenation. K27 Use hyperbaric oxygen therapy to treat radiating injury Jun Qu, Jun Meng HuanHu Hospital, Tianjin, China We all know that radiating injury often can be found in radiation therapy of malignancy tumour. Rradiating injury has a strong impact on patient’s life quality. Hhyperbaric oxygen therapy (HBOT) which known as a useful way to some disease had application in curing the patients. But there were few reports about radiating injury now. This review was discuss about the mechanism of how radiating injury happened and the mechanism of HBOT to treated it. HBOT also can be consider as a new way to cure radiating injury. K28 The diagnosis and treatment experience of hyperbaric oxygen (HBO) comprehensive treatment for persistent vegetative state (pvs) Juan Meng, Xiaowen Pan, Yu Zhang, Huijun Hu, Yan Lu, Shuyi Pan, Xiangen Meng Hyperbaric oxygen center in the General Naval Hospital, Beijing, China Objective: to discuss and study the treatment effect of hyperbaric oxygen (HBO)comprehensive treatment for persistent vegetative state(pvs) and the importance of advanced radiological technology for pvs. Methods: for 280 pvs patients with HBO cooperating with blood magnetization therapy and drugs treatment and with advanced radiological technology. Results: this group of patients showed that the diagnosis coincidence rate reached 100%, the curative ratio (85 cases of clear consciousness, normal intelligence and self-care of living) is 30.4%, the improvement rate (48 cases of clear consciousness, basal self-care of living and basal normal intelligence) is 52.8%, 15.2% (43 cases) of patients have not left PVS, 98.4% of patients have gained improvement of general condition (276 cases of control of infection, correction of complication, pulling out of urethral catheter, nasal feeding tube and tracheal tube after tracheotomy and improvement of nutrition status), 1.6% of patients (4 cases) died. The major abnormal signs in cerebral CT of this 280 cases PVS patients contained: cerebral edema, malacia focus, focus of infarct, subdural effusion, obstructive hydrocephalus, bilateral hypophloeodal diffuse white matter demyelination change, bilateral cerebrum atrophy, thinner cortex, ventricles of brain enlarging, broaden of sulcus and schizencephaly, malacia focus of basal nuclei and globus pallidus in the damage region. 76 cases of MRI examination could also show the atrophy of patients’ mesencephalon and brain stem except for the signs before. Cerebral SPECT: 32 cases showed decreasing of bloodstream perfusion in bilateral or unilateral cerebral cortex, cerebellum, unilateral or bilateral frontal lobe, temporal lobe and occipital lobe. The radiological imaging of mostly patients improved along with improvement of state of illness. Conclusion: the HBO comprehensive treatment scheme was reasonable, advanced, practical and innovative. The curative effect was good: Management to complications was timely and effective. Advanced radiological technology cerebral CT and MRI are not only helpful to diagnosis, but also helpful to guide treatment and judge prognosis. The cerebral SPECT imaging could be complementary with CT and MRI. It also could act as an index of HBO comprehensive treatment for PVS and prognosis determination. K29 Therapeutic efficacy of hyperbaric oxygen on middle Jiexiang Pan, Weihua Chu, Fei Li, Hua Feng Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chengdu, China Objective: To evaluate the efficacy of hyperbaric oxygen (HBO) treatment on model of right middle cerebral artery occlusion (MCAO) in rabbits. Methods: Forty healthy rabbits were suffered MCAO using electragulation and were randomly divided into 4 groups. The rabbits in I group were treated with HBO immediately for 20 days after MCAO. The rabbits in D group were treated with HBO 7 days after MCAO for 13 days. The rabbits in C group were not treated with any therapy after MCAO. The methods of S group were similar to that of C group except no MCAO. The change of behavior, somatosensory evoked potential (SEP) and infarct volume in these rabbits was observed respectively for 10 days and 20 days after MCAO. Results: Ten days after MCAO, the mean score of behavior of I, D, C and S groups was respectively 8.6±1.2, 5.8±0.8, 5.6±1.6 and 12±0.0. The neurobehavioral impairment in I group relieved 3 significantly compared with that of D and C groups, (p , 3 3 3 214±19.7 mm , 229.4±25.5 mm and 0 mm for 10 days after MCAO, the infarct volume of I group was significantly 3 3 smaller than that of D and C groups (p , 203.4±12.7mm , 3 3 221.4±20.3mm and 0mm .The infarct volume of I group was significantly smaller than that of D and C groups (p<0.01). Conclusion: Early applications of HBO and repeated administration of HBO for 20 days have significant effects on the change of behavior, somatosensory evoked potential (SEP) and infarct volume of rabbits which suffering from MCAO. K30 The therapeutic efficacy of hyperbaric oxygen treatment for brain infraction was influenced by the onset time: micro dialysis study in rabbits Zhaopang Lai, Fei Li, Zhi Liu, Hua Feng Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chengdu, China Objectives: To observe if the therapeutic efficacy of hyperbaric oxygen treatment for brain infraction was influenced by the onset time after permanent middle cerebral artery occlusion (MCAO) in rabbits. Methods: 36 male rabbits were randomly divided into simple MCAO group (n=12) , MCAO+ HBO group (100% O2, 2.5 ATA, 1h / d, from 1 d after MCAO, n=12) and MCAO+DHBO group (100% O2, 2.5 ATA, 1h / d, from 7 d after MCAO, n=12). Behaviors and volumes of infarction were observed, microdialysis was applied to monitor the concentrations of glucose, lactate, pyruvate and glutamate around the infracted zone at 1,3 ,10and 30 d after permanent MCAO. Results: Behaviors’ score and volumes of infarction were lower in MCAO+ HBO group than the others (P<0.01). The lactate and pyruvate ratio increased after MCAO in three groups, but they were lower in the MCAO+ HBO group than in the others at Day 1 and Day 3(P<0.05). The glutamate concentration increased after MCAO, peaking at 10 d, but at day 1 and day 3 the glutamate concentration was lower in the MCAO+ HBO group (P<0.05). Conclusions: Hyperbaric oxygen treatment could protect the brain from infarction through improving the energy metabolism and decreasing the excitatory amino acids disorders around the infracted zone after MCAO in rabbits. In order to improve the therapeutic efficacy of hyperbaric oxygen, it should be performed as early as possible. K31 The expression of nestin was elevated by hyperbaric oxygen treatment in a model of right middle cerebral artery occlusion in rabbits Jiexiang Pan, Weihua Chu, Fei Li, Hua Feng Department of Neurosurgery, Southwest Hospital, Third Millitary Medical University, Chengdu, China Objectives: To evaluate the efficacy of hyperbaric oxygen (HBO) treatment on the expression of Nestin in a model of right middle cerebral artery occlusion (MCAO) in rabbits. Methods: 30 healthy rabbits were randomly divided into 3 groups: The rabbits in MCAO+HBO group were treated with HBO immediately for 20 days after MCAO, The rabbits in MCAO group were not treated with any therapy after MCAO, The methods of control was similar to that of MCAO group except no MCAO. Behaviors and volumes of infarction were observed, and the expression of Nestin was measure by immunocytochemistry at 10 and 20 days after MCAO. Results: Behaviors’ score and volumes of infarction were better in MCAO+ HBO group than the MCAO group (P<0.01).10 days after MCAO, the expression of Nestin of MCAO+ HBO group and MCAO group was respectively 15.88±1.2 and 6.63±1.6. 20 days after MCAO, the expression of Nestin of MCAO+ HBO group and MCAO group was respectively 20.03±1.6 and 6.82±0.8. The expression of Nestin in MCAO+HBO group relieved significantly higher compared with that of MCAO group (p<0.01). Conclusion: Early applications of HBO and repeated administration of HBO for 20 days have significant effects on the expression of Nestin of rabbits which suffering from MCAO. K32 Regional biochemical changes following ischemic brain injury in rabbits : microdialysis studies and effects of hyperbaric oxygen preconditioning Chongying Deng, Fei Li, Lijun Zhang, Hui Meng, Jiangkai Lin, Hua Feng Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chengdu, China Objectives: To observe the variations of regional biochemical changes around the infracted zone after permanent middle cerebral artery occlusion (MCAO) in rabbits and evaluate the effects of hyperbaric oxygen precongitioning (HBOP). Methods: 48 male rabbits were randomly divided into simple MCAO group (n=24) and HBOP+MCAO group (100% O2, 2.5 ATA, 1h / d, 5d, n=24) . Microdialysis was applied to monitor the concentrations of glucose, lactate, pyruvate and glutamate around the infracted zone at 1, 3, 10 and 20 d after permanent MCAO. Results: Glucose decreased at 1 d after MCAO in two groups, but in the preconditioning group glucose recovered to normal at 3 d, while in the simple MCAO group it still decreased at 20 d and significantly lower than the left (PP<0.05). Conclusions: 1, The variations of the components of the microdialysis interstitial fluid from the brain support the presence of “biochemical penumbra” around the infracted zone after MCAO;2, the mechanisms of HBOP maybe improving the energy metabolism and decreasing the excitatory amino acids disorders around the infracted zone after MCAO in rabbits . K33 Use hypenbaric oxygen( HBO) to treat 8 patients of viral meningitis Jun Meng, Jun Qu HuanHu Hospital, Tianjin, China Objective: Use hyperbaric oxygen (HBO) to treat viral meningitis. Method: Use hyperbaric oxygen (HBO) to treat 7 patients of viral meningitis and we will observe the change of hydrocephalus in medical image and the recovery of consciousness, language, limb strength. Result: All the patients have a good curative effect in what sides we observed. Conclusion: Use hyperbaric oxygen therapy to treat viral meningitis at the end of the course maybe beneficial to the recovery of the naval function. K34 Effect Analysis of early and delayed hyperbaric oxygen treatment on ischemic brain injury of rabbit Zhaopan Lai, Zhi Liu, Gaoyu Cui, Jiangkai Lin, Xianrong Wang, Hua Feng Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chengdu, China Objectives: To investigate the effect of early and delayed hyperbaric oxygen (HBO) treatment on local ischemic brain injury in rabbit. Method: 32 rabbits were randomly divided into 4 groups: control group(sham), middle cerebral artery obstruction (MCAO)group, MCAO+HBO group, and MACO+DHBO group(delayed HBO started at 7 days after MCAO). 2 atmosphere pressure HBO was applied for 1 h per day, and neurological score, TTC dyeing and pathomorphological observation were performed to evaluate the effect of early and delayed HBO treatment. Result: Neuroethological abnormalities could be observed in all experimental groups except control group. 30 d after obstruction, ethological score showed rabbits in MCAO+HBO group was better than MCAO+delayed HBO (P<0.05); TTC dyeing showed the infarct size of MCAO, MCAO+HBO and MCAO+delayed HBO were 378±35.6 mm3, 59±17.2 mm3 and 139±45.8 mm3, respectively, with a significant difference in MCAO+HBO group compared with other two groups (p<0.01). Neuron edema, degeneration and decrease in cell number were observed with HE staining, which was more server in MCAO group and indistinct in MCAO+HBO group. Conclusion: Early HBO treatment has an advantage on the local ischemic brain injury of rabbit compared with delayed HBO. K35 The effect of HBO on survival of the arterialized deep-venous flaps in a rat model Ying LONG, Junjun HE, Jiewen TAN, Xiaojun LI, Yulin NIE, Zhi YI 1. The Shenzhen Peoples Hospital, Shenzhen, China 2. The Second Affiliated Hospital of Sun Yat-sen University, Guangzhou, China 3. The Buji Peoples Hospital, Shenzhen, China Objectives: the effect of hyperbaric oxygen therapy (HBO) on survival of the arterialized deep-venous flaps and blood supply was studied in a rat model. Methods: In this study, the arterialized deep-venous flaps with pedicle were established and anastomosed by proximal end of external iliac artery with external iliac vein of flaps on the abdomen of rats. An experimental model was created in retrograde blood supplied to flaps from external iliac vein inferior and epigastric vein. The 45 of SD rats were randomly divided into three groups. The blood supply of flaps in Group I (Control, n=15) was anastomosed by end-to-end with arteries and venous respectively. 30 of 45 rats were anastomosed in arterialized deep-venous flaps of rat model(ADVF). 15 rats with ADVF (GroupII, HBO) were received by HBO treatment at 0.2MPa twice daily for 3 consecutive days after operation. Another 15 of ADVF(Group III , non-HBO) were received by conventional treatment after operation. Clinical survival assessments of flaps included perfusion monitored by observation of mass species with naked eye. The survival rate of flaps was calculated after operation. Result: 1.The edema of flaps in ADVF was reduced by HBO . The color of flaps after HBO was red in the similar to Group I. The Flaps in Group III were going to be black red from 2. day after operation and dying on 3.day after operation. 2.The survival of the flaps were respectively 60%, 66.7%, 0. Conclusion: This study indicates that it iseffectiveness of blood circulation in this arterialized deep-venous flaps can be enhanced by retrograde arteriali- zation in this animal model. HBO could improve blood supply of the flaps with ADVP and reduce edema after operation and increase flap survival with ADVP. K36 Cancelling the requirement of ventilation for hyperbaric chamber pressurized with oxygen Mao Fangguan Chinese Society of Hyperbaric Facility, Shanghai, China Objective: When the volume fraction of oxygen of gas in a chamber is reduced the potentiality of fire will decrease and the operational safety will increase for the hyperbaric chamber pressurized with oxygen. Methods: By means of analyses and calculations the maxima of oxygen patial pressure (pO2) and carbon dioxide partial pressure (pCO2) in the chamber can be determined under conditions of nonventilation. Results: In this situation the pO2 may be raised to 0.22 MPa, it can meet the demands of HBO conventional therapy and the maximum of pCO2 less than 3 kPa is safe on the human body. Conclusion: It is favorable and reasonable to cancel the requirement of ventilation for a hyperbaric chamber pressurized with oxygen. K37 Reports of 48 cases about hyperbaric oxygen approach in treating thromboangiitis obliterans Jinjun Pang, Fengjuan Long, Guihua Pan, Yafan Li First Affiliated Hospital, Guangxi Medical University, China Objective: To explore the effects of hyperbaric oxygen on thromboangiitis obliterans (TAO). Method: There are 48 cases in our study.8 cases in stageⅠ,18 cases in stage Ⅱ and 22 cases in stage Ⅲ .All cases were treated by hyperbaric oxygen. Medicine was applied to severe cases We compare the effects in different stage and course of treatment. Results: 37 cases were cured,10 cases were effective, The total effective rate was 97.9%.26 cases in stageⅠ or stage Ⅱ were completely cured, the cure rate was 100%.The cases the cure rate was only 50% in stage Ⅲ .36 cases accept 4 courses hyperbaric oxygen treatment, 33 cases were cured, the cure rate was 91.7%.12 cases were treated less than 4 courses; the cure rate was 25%. Conclusions: Hyperbaric oxygen has a notable curative effect on TAO. We can receive high cure rate if we adopt complete courses hyperbaric oxygen treatment in stageⅠ and stage Ⅱ. K38 Hyperbaric Oxygenation on Limb Dyskinesia after Intervention of intracranial Aneurysm and Its Effects on ADL among 32 Cases Yongjun Mai, Xuedong Li, Meiyin Lei, Hua Huang HOB center, the Fourth Affiliated Hospital, GuangXi Medical University, Liuzhou, China Objective: To determine the effects of early hyperbaric oxygenation (HBO) on the prognosis of motor function after intervention of intracranial aneurysm. Methods: 62 patients with dyskinesia after intervention of intracranial aneurysm were randomized into HBO treatment group and control group. Both group received the same routine th th medicine. In addition, HBO group started HBO at 7 –10 day after intervention. Defects of nerve function and ADL were evaluated with Fugl-Meyer Scale and Barthel Scale respectively. Results: Neurofunction defects and ADL were significantly improved 30 days after treatment in both groups. There was statistic significance compared with the conditions after interventions (P<0.01). The results of HBO group were much better than those of control group. There was statistic significance between the two groups (P<0.01). Conclusion: Early HBO can improve patients’ ADL and defects of nerve functions after intracranial aneurysm intervention, which enhances patients’ life quality. K39 The EEG analysis before and after of hyperbaric oxygen therapy in patients with cerebral infarctinon Ma YuJie No.1 Hospital, Qiqihaer, China Objective: Analysis and Comparison of patients with cerebral infarction in HBO treatment before and after the EEG changes, study the prognosis of the disease. HBO treatment can reduce the incidence of meaningful consequences. Methods: HBO group in the conventional treatment at the same time increase the HBO therapy. HBO use large cabin wearing oxygen masks in 30″×2, the middle cabin air suction, once a day, 10times for a course of treatment, 2-3 courses of treatment. Conventional treatment of the control group, using low-molecular-weight dextran 500ml and dan senate 14 ml; 5%glucose injection 250 ml and CDP- choline 0.5g intravenous drip, once a day, seven days for treatment, treatment 2-3 Courses. Results: HBO group EEG abnormalities before treatment to 79 percent, 51 percent after treatment, down 28%,compared before and after treatment were significantly different (P<0.05); The control group EEG abnormalities before and after the treatment rate of 80 percent, reduced to 66 percent, down 14 percent; no significant difference (P>0.05). Conclusions: HBO can improve the prognosis of cerebra infarction patients, whether from the clinical efficacy or EEG of recovery, the effect is very obvious that the lower incidence of sequelae and provide a reliable basis for the treatment. So routine treatment of patients with cerebral Infarction at the same time as soon as possible with HBO treatment. K40 Influence of hyperbaric oxygen to the immune function of cells in the patients with chronic obstructive pulmonary disease 1 2 1 1 Bing Meng , Yongxin Ma , Guohua Li , Guiping Wang , 1 Xiaorong Liang 1.Weifang asthma hospital, Shandong, China 2.Weifang people’s hospital, Shandong, China Objective: To Observe the level of immune cells in the patients with chronic obstructive pulmonary disease and the influence of hyperbaric oxygen therapy to the immune function of cells in the stability of patients with chronic obstructive pulmonary disease. Methods: Randomly selected patients with stable COPD 167 cases, of which 86 cases for the treatment group, 81 cases for the control group, Tiotropium inhalation aerosol solution, selected 33 cases of normal healthy people in the control group. Adoption of improved ABC method in the Observer Group targets immune cells, blood testing, pulmonary function, after a course of HBO treatment (12 times), to detect the above targets again, and then to give a comparative study analysis. Results: HBO inhalation drug therapy group and the control group compared with the normal group targets immune cells have different levels of reduced (P <0.001), the HBO treatment group after treatment, cell-mediated immunity in patients with various indicators were significantly increased (P <0.01) , and corrected the CO2 retention and hypoxia (P <0.01), improved lung function. Conclusion: the level of immune cells in the stability of patients with COPD is degraded in varying degrees, the reduction of HBO treatment can significantly improve the stability of the cell-mediated immunity in patients with COPD function, at the same time to correct hypoxia and CO2 retention and improve lung function in patients with COPD (P <0.01). K41 Effect of hyperbaric oxygen to inflammatory cytokine in patients with obstructive sleep apnea-hypopnea syndrome 1 2 2 Yongxin Ma , Nong Yu , Bing Meng 1.Weifang people’s hospital, Shandong, China 2.Weifang Asthma hospital, Shandong, China Objective: To observe the effect of hyperbaric oxygen(HBO) to inflammatory cytokine in patients with obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods: Thirty two patients with OSAHS were randomly divided into 2 groups: HBO therapy group and control group. The T lymphocyte + + + + subset,CD4 ,CD8 ,CD4 /CD8 and inflammatory cytokine,IL-6,IL-8as well as TNF-α,were assayed by flow cytometry after HBO exposure. Result: The level of CD4+ and CD4+/CD8+ ratio tended to increase after HBO exposure 7 times, while significantly decreased (P <0.001) after HBO exposure 14 times and 21times. The level of inflammatory cytokine,IL-6,IL-8 and TNF-αtended to decreased (P <0.005) after HBO exposure 7 times, and significantly decreased too (P <0.001) after HBO exposure 14 times and 21times. Conclusion: HBO therapy can not only adjust the balance of immune, + decreased the cytotoxic action of CD8 lymphocyte, but also significantly decrease the level of inflammatory cytokine in patients with OSAHS. K42 Effect of hyperbaric oxygen to inflammatory cytokine and pulmonary function in patients with Asthma 1 2 2 Yongxin Ma , Zhaoqiu Hu , nong Yu 1. Weifang Peoples Hospital, Shandong, China 2. Weifang Asthma Hospital, Shandong, China Objective: To observe the effect of hyperbaric oxygen(HBO) to inflammatory cytokineand pulmonary function in patients with asthma. Methods: ninety six patients with asthma were randomly divided into 2 groups: HBO therapy group and control group, and another thirty health cases as heath control group, the control group only accept regular therapy: To inhale Budesonide 200µg 2 times daily, and HBO group accept HBO therapy and regular therapy too. The inflammatory cytokine IL-5, IL-12, IL-13 as well as IL-18 were assayed by ELISA after HBO exposure. Result: The symptom and FEV1 were significantly improved after HBO exposure(P <0.005) ,the level of IL-5, IL-13 ,IL-18 were significantly decreased , the level of IL-12 was significantly increased. Conclusion: HBO therapy can ease the bronchial inflammation by adjust the inflammatory cytokine excretion, can significantly improve the patient’s pulmonary function. K43 The effect of HBO treatment on plateletm embrane glycoprotein Ma Linlin Beijing Chaoyang Hospital, Beijing, China Objective: Study the changes of HBO therapy on plateletm embrane glycoprotein, to further reveal the mechanism of HBO therapy and provide a theoretical basis with use anti-platelet aggregation in clinical. Methods: Through animal tests and clinical studies on the HBO treatment of common indications (Acute carbon monoxide poisoning and delayed encephalopathy, acute oxygen poisoning, decompression sickness, ischemic stroke, ischemia-reperfusion injury, SARS after avascular necrosis), the positive percentage of CD31, CD61, CD62p, CD63 and PAC-1 were measured by the flow cytometry (FCM). Results: HBO on platelet activation remains differences. Most studies show that HBO will reduce platelet glycoprotein expression, while a small number of studies have appeared that HBO can increase the expression of the plateletm embrane glycoprotein to The dual nature of HBO normal. Conclusions: treatment pends further study. HBO treatment with the pressure of time, intermittent, and the treatment of the disease itself? With further study of HBO on platelet glycoprotein, the exact mechanism will become more deeply clarified. K44 The influence of HBO on plasma vWF, serum IL-23 and IL-27 in cerebral ischemic-reperfusion rats Jiangjiang Lu, Chunjin Gao, Yajuan Li, Baosen Pang, Xiu xia Huang Beijing Chao Yang Hospital, Beijing, China Objective: By observing the influence of hyperbaric oxygen treatment on plasma vWF, serum IL-23 and IL-27 in cerebral ischemic-reperfusion rats, to explore possible mechanism of hyperbaric oxygen treatment on relieving ischemic-reperfusion flammatory reaction and to provide further experimental evidence for clinical HBO therapeutic method. Materials and Methods: 64 SD rats were randomly divided into 8 different groups: normal group (N), sham-o group, cerebral ischemic-reperfusion (IR) IR 24 hour’s group, IR 48 hour’s group, IR 72 hour’s group, HBO 24 hour’s group, HBO 48 hour’s group, HBO 72 hour’s group. Each group contained 8 rats. The cerebral ischemic-reperfusion models were established according to Pulsinelli’s methods of blocking four arteries. The normal group, sham-o group, cerebral ischemic-reperfusion (IR) group was placed in normal pressure atmosphere without hyperbaric oxygen treatment. The hyperbaric oxygen group started to accept hyperbaric oxygen treatment after surgery immediately, and once a day at the same time. HBO 24 hours group got once HBO treatment. HBO 48 hours group got twice HBO treatment. HBO 48 hours group got three times HBO treatment. Draw blood from the aorta abdominalis after operation at 24h, 48h, 72h respectively, then measure the content of vWF, IL-23 and IL-27 by using enzyme-linked immunosorbent assay (ELISA). Results: (1) The content of vWF in IR 24 hours group increases than that in sham-o group, the difference is significant, P in 24 hours group of IR increases than that in sham-o group, the difference is significant, P in 24 hours group, 72 hours group of HBO group decrease than those in IR groups at the same time group, the difference is significant, P in 24 hours group, 48 hours group, 72 hours group of HBO group decrease than those in IR groups at the same time group, but the difference is not significant, P>0.05. Conclusions: (1) By using hyperbaric oxygen, the content of vWF decreases at 24h, 48h and 72h, it shows that the hyperbaric oxygen has positive effect on relieving ischemic-reperfusion injury. The mechanism is to decrease the content of vWF. (2) By using hyperbaric oxygen, the content of IL-23 decreases at 24h and 72h, it shows that hyperbaric oxygen has positive effect on inhibiting inflammatory reaction and the mechanism of hyperbaric oxygen is to alleviate the IL-23 release.(3) In this experiment, by using hyperbaric oxygen, the content of IL-27 has the degressive trend, but has no significant meaning. It needs further study. K45 Effects of preconditioning with hyperbaric oxygen on neural cell apoptosis after spinal cord injury in rats Peigang Lu, Hua Feng, Yongzhi Xia, Guoqi Gong, Mei Li Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chengdu, China Objective: To study the effects of preconditioning with hyperbaric oxygen on neural cell apoptosis and expression of Caspase-3 after spinal cord injury in rats at different time. Methods: fifty-five adult Sprague-Dawley adult rats, weighing from 250 to 300g, were randomly divided into 3 groups, hyperbaric oxygen preconditional group(25,n=5) ,normal injury group(25,n=5)and control group(5,n=5). In the experimental groups, the rat spinal cord injury models were established by the way of , Allen s method , and morphological studied by hematoxylin and eosin staining, Cell apoptosis was detected by TUNEL method and the expression of Caspase-3 by immunohistochemistry at different time(1 day, 5 day, 7 day, 10day, 14day) were observed. Results: The apoptostic cells positive for TUNEL and Caspase-3 expression were detectable in both two experimental groups. In the preconditional group, the number of apoptotic cells and the expression of Caspase-3 were decreased and the neurofunction of the spinal cord improved as compared with those in the control group. There were statistically significant differences between the preconditional group and normal injury group especially the control group. Conclusion: Apoptosis of neural cells is an important morphological change in the secondary lesion period after spinal cord injury. HBO preconditioning can reduce the numbers of apoptotic cells and promote the nerve function recovery in rats after spinal cord injury. 1. Department of Pediatrics, the 3rd Xiangya Hospital of Central South University, Hunan, Changsha, China 2. Navy General Hospital, Beijing, China K46 Automatic and non-resistance and non-noise oxygen-supply-and-vent device Shutian Duan, Xianhua Zhang, Binsheng Ren People’s Hospital, Pingyao County, Shanxi, China Objective: To reduce resistance and noise and avoid cross infection in hyperbaric oxygen therapy. Method: Place the detector outside the cabin .Place the air sac and silencer in the cabin. Use the detector to detect whether the air sac is full or not in order to follow the human body breath, and supply or vent oxygen .Result: The resistance of breathing is largely reduced. The resistance of calm breathing can almost become zero. The noise is greatly reduced. This can avoid cross-infection. Conclusion: This kind of oxygen-supply-and-vent device can be used in hyperbaric oxygen therapy. K47 Determination of platelet membrane glycoprotein PAC-I and CD63 in patients with delayed ecefhalopathy after acute carbon monoxide poisoning Xiaomin Hou, Chunjin Gao, Huan Ge, Liming Zhao, Lianh ua Wu, Yi Zhang, Lin Yang, Zhuo Li, Yu Gao, Man Qi, Ch engqing Xia Beijing Chaoyang Hospital, Beijing, China Objective: To study platelet membrane glycoprotein PAC-I and CD63 in patients with delayed ecefhalopathy after acute carbon monoxidepoisoning in order to instruct the anti-platelet therapy of DE ACMP. Methods: There are DEACMP group and normal control group. The DEACMP group were draw blood in 7 days after they arrived at hospital. The blood of normal control group were drawn in the 8AM after an overnight fast. The positive percentage of PAC- I and CD63 were measured by the flow cytometry (FCM). Analysis of t-test was applied to analyse the expressions of platelet membrane glycoprotein PAC-I and CD63. Results: The expressions of platelet membrane glycoprotein PAC- I of the DEACMP group was higher than which in the normal control group (P<0.05). The expressions of platelet membrane glycoprotein CD63 of the DEACMP group was much higher than which in the normal control group (P<0.01). Conclusions: According to this study, the expression of PAC-I and CD63 is in a high level with delayed ecefhalopathy after acute carbon monoxidepoisoning. It indicates that the inhibition of platelet activation is needed with delayed ecefhalopathy after acute carbon monoxidepoisoning. K48 Effect of hyperbaric oxygenation to human nerve stem cell transplantation on hypoxic ischemic brain damage in vivo 1 1 2 Mingyan Hei , Mili Xiao , Zuo Luan Objectives: To observe the effect of Hyperbaric Oxygen (HBO) to Human Nerve Stem Cell (hNSCs) transplantation on hypoxic Ischemic Brain Damage (HIBD) on neonatal rats. Methods: Neonatal HIBD rat model was produced according to Rice method. Experimental rat pups were randomly divided into HIBD, HIBD+transplantation group, HIBD+HBO and HIBD+transplantation+HBO groups (n=10 in each group at each time point). On day 3 (d3) after HIBD, hNSCs were transplanted into the left ventricles by microinjection method. The first HBO treatment was administered within 15min after hNSCs transplantation and once daily for consecutively ten days. TUNEL staining was used for apoptotic study at d4, d5, d6, d13 after HIBD. Fluorescent immunohistochemical (FIHC) staining and confocal microscopy were used to observe the survival, migration, and differentiation of the implanted cells. Results: (1) On d4, d5, d6 and d13, TUNEL-positive cells could be observed in the injured cortex and hippocampus in all groups. The number of TUNEL-positive cells of HIBD+transplantation and HIBD+HBO groups were significantly less than that of HIBD group (P<0.05). While the number of TUNEL-positive cells of HIBD+transplantation+HBO group was very significantly less than that of HIBD group (P<0.01). (2) FIHC staining showed that on d13, the implanted hNSCs survived and extensively migrated from ventricles to periventricular brain parenchyma, and meanwhile differentiated to neurons and astrocytes. There was no significant difference about the cell migration style and distribution among HIBD+transplantation, HIBD+HBO and HIBD+transplantation+HBO groups. The number of total survived cells of HIBD+transplantation+HBO was significantly (P<0.01) more than that of HIBD+transplantation group or HIBD+HBO group. Conclusions: (1) After transplantation, hNSCs can survive, migrate and differentiate into neurons and astrocytes. (2) To some extent, hNSCs transplantation has neuroprotection to HIBD in neonatal rats. (3) HBO therapy may enhance the above neuroprotective effect via promoting graft cell survival rate, migration and differentiation. K49 Hyperbaric oxygen therapy for a case of gas gangrene in both feet He Xia Hyperbaric oxygen department of Chongqing Emergency Medical Center, Chongqing, China Objective: Through HBO therapy the gas gangrene. Methods: Air hyperbaric chamber, pressure: 2.5ATA compression time for 40minutes, inhal oxygen for 30 minutes, then 10 minutes’ break. After that, another 30 minutes’ oxygen inhalation. Further, 50 minutes for decompression with outing of chamber. During the above procedure, no uncomfortable sense wascomplained. Results: After3hours:T:39C,HR:140bpm,R:30/min,BP:128/58mmH g.After 12 hours, the patient happened tachypnea. T: 39.2 ℃HR: 157bpm, R: 35/min, BP:112/98 mmHg. The patient cough pink frothy sputum and the both base of lung had moist rale. Thoracic CT: ⑴ pneumocontusion and pneumonedema ⑵pulmonary infection⑶pleural effusion. Conclusion: HBO has therapeutic effect on gas gangrene pneumonedema. The condition of patient aggravate suddenly may have relation to these factors: ⑴The patient have no x –ray from admission-time to going to compartment. It unknown whether decompress conditional will induce reversion under the pneumonedema. ⑵The systemic inflammatory response x-ray of syndrome was obvious. ⑶ Chest pneumocontusion without clinical syndrome was regarded as contrary contraindecation abroad. The patient sustained trauma and change of lung x –ray. It can not exclude out pneumocontusion. K50 Effects of hyperbaric oxygen on expression of brain derived neurotrophic factor mRNA in hippocampus of mice after cerebral ischemia reperfusion Na Guo, Chunjin Gao, Guozhong Wang, Fujia Liu, Yuepi ng Lu Chaoyang Hospital, Beijing, China Objective: To investigate the effects of hyperbaric oxygen (HBO) on expression of brain derived neurotrophic factor (BDNF) mRNA in hippocampus of mice after cerebral ischemia reperfusion and explore the therapeutic mechanism of HBO from molecular level. Methods: The mice were randomly divided into a cerebral ischemia reperfusion group (IR group), a hyperbaric oxygen group (HBO group) and a sham–operation group (Sham group). The cerebral ischemia reperfusion models were established. The expression of BDNF mRNA in the hippocampus of mice was measured at 4 h, 12 h, 24 h, 48 h and 72 h respectively, after reperfusion by reverse transcription- polymerase chain reaction (RT–PCR). Results: 1) The expression of BDNF mRNA in hippocampus in HBO group was higher than those in the Sham group at 4 h, 12 h, 24 h, 48 h and 72 h (P0.05).3) The expression of BDNF mRNA in HBO group was lower than that in IR group at 4 h (P0.05). Conclusion: The expression of BDNF mRNA increased in hippocampus of mice after cerebral ischemia reperfusion. HBO treatment may effectively relieve the cerebral ischemia reperfusion injury through improving the expression of BDNF mRNA in hippocampus of mice after cerebral ischemia reperfusion. K51 The efficacy and nursing research of dysarthria’ therapy by hyperbaric oxygen Guo Junmei Second Hospital, Shenzhen, China stroke Objective: The efficacy of strocke dysarthria’ therapy by hyperbaric oxygen. Methods: from 2005 to 2006, 60 patients have divided into two groups.30 patients with the hyperbaric oxygen therapy is the observation group, the other is the control group. 60 patients with the implementation of conventional therapy, the Observation group have the hyperbaric oxygen therapy at the basic therapy. Results: The effective rate of observer Group is 90%, 53.33% control group. The therapeutic effect of the two groups was significant (P<0.05). Conclusion: hyperbaric oxygen therapy can improve stroke dysarthria efficient. K52 Hyperbaric oxygen treatment of persistent vegetative state 28 cases Experience Guo Guanghan Suqian City of Jiangsu Province Peoples Hospital, Suqian, China Objective: Study the effects of hyperbaric oxygen on the persistent vegetative state patient rehabilitation treatment. Methods: 2001-1/2007-12 Suqian City People's Hospital of hyperbaric oxygen treatment centre-patient treatment of 28 cases of pvs patients receiving hyperbaric oxygen rehabilitation treatment, using high-pressure air cabin, 0.2 mpa pressure, oxygen for 60 min, 10 min middle rest. Results: The rehabilitation of hyperbaric oxygen therapy, basic rehabilitation eight cases, for more then 80 times in 6 cases, treatment within 60 to two cases, in the course within 30d by hyperbaric oxygen therapy in 12 cases, the basic rehabilitation of six cases in the 60d via the high oxygen therapy the basic rehabilitation of two cases. 28 cases of cases of patients 12-40 years of age, the basic rehabilitation of six cases ,41-61-year-old with 10 cases, the basic rehabilitation of two cases, patients over of 61 years of age without basic rehabilitation. Conclusion: Hyperbaric oxygen therapy can be recovered in blood pressure, improve microcirculation, help improve persistent vegetative state patients awake and function to maintain life. K53 Using Hyperbaric Oxygen as an Adjuvant Method in Hypersensivisity Vasculitis Huan Ge, Chunjin Gao Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing, China Aim: We report a case who was suffered from hypersensivisity vasculitis. Using Hyperbaric Oxygen and corticosteroid to treat hypersensivisity vaasculitis. To the best of our knowledge, this is the first report that hyperbaric oxygen (HBO) served as an adjunctive therapy for hypersensitivity vasculitis. Method: A 58-year-old male patient was injected into his thumb of right hand because of tenosynovitis in local hospital. Half an hour later, he started to have pain and swelling in his distal upper extremity of right side. Some medicine were prescribed and for 4 hours without benefit.New lesions developed on the elbow, as well as on the hand. Palpable Purpura was involving anterior aspect of the left upper limb through to elbow. Darkening of the skin also were noted. That night patient was transferred to Beijing Chaoyang Hospital affiliated Capital University of Medical Science.Tolazoline 20mg im and Dextran 40 500ml iv were used to treat spasms of peripheral blood vessels and improve microcirculation by decreasing blood viscosity and impeding erythrocyte aggregation. Dexamethasone meanwhile intravenously 20mg was given. Two hours later the patient’s condition deteriorated and his lesions developed. HBO therapy (0.2Mpa) was used to alter condition of local hypoxia. After HBO therapy, the patient’s situation was improved obviously. His palpable purpura did not reappeared until 3 hour later. At the first 24 hours after admission, the patient was treated with HBO therapy twice. Subsequently, he received HBO therapy 12 sections (once a day). From the second day, he was orally given 40mg of prednisolone and 200 mg of Aspirin per day for 10 days. Result: The patient’s condition was getting better, and palpable purpura and darkening of the skin were also reduced gradually. Fifteen days after treatment with HBO and cortin, the patient’s symptoms and ultrasound finding were normalized. He have a decrease in the dose of prednisolone 30mg/d for 10 days, then 20mg/d until discharge. Conclusion: HBO therapy combine with small doses of corticosteroid is an effective and safe therapy for this patient, further studies are needed to evaluate whether HBO can be used as primary therapy for a group of patients suffering from hypersensitivity vasculitis. K54 Clinical effects of HBO treatment in Patients with Mental Disorder Caused by TBI using of BPRS and HDS and ADL 1 1 1 2 Zhaoming Ge , Ling Li , Hongbin Cai , Xudong Zhang , 1 Haijun Ren 1. Second Hospital of Lanzhou University, Lanzhou, China 2. Gansu Provincial Peoples Hospital, Lanzhou, China Background: To evaluate clinical effects of hyperbaric oxygen (HBO) treatment in patients with Mental Disorder arising from traumatic brain injury. Methods: One hundred and five patients with Mental Disorder following Traumatic Brain lnjury (TBI) were randomly divided into therapy group(55 cases), which was treated by hyperbaric oxygenation and medications ,and control group (50 cases) which was treated by medications. The scales included the Brief psychiatric rating scale (BPRS) and Hasegawa Dementia Scale (HDS) and Activity of Daily Living Scale (ADL).All patients were evaluated with BPRS and HDS and ADL before and after treatment. Results: Obvious significance in BPRS and HDS and ADL scores existed between two groups (after two course of treatment P <0.05, after the four course and three month P <0.01). Conclusion: The combination of HBO shows good therapeutic efficacy to patients with Mental Disorder caused by traumatic brain injury. K55 Effect of hyperbaric oxygen combined therapy on persistent vegetative state in 30 patients. Gao Yu, Gao Chunjin, Ge Huan Beijing Chaoyang Hospital, Beijing, China Objective: To evaluate effectiveness of hyperbaric oxygen combined therapy on persistent vegetative state and explore the best therapeutic regimen for it. Method: Thirty cases of persistent vegetative state treated with hyperbaric oxygen combined therapy from 1999 to 2005 were analyzed retrospectively. Including the effects of etiological factors and treatment times and treatment juncture on therapy. Result: The excellence rate and improvement rate were significantly higher in cerebral trauma group than those in no cerebral trauma group. And two groups in which the patients began to receive treatment when became persistent vegetative state for less 61 days recovered better than the other one in which the patients began to receive treatment when became persistent vegetative state for more 60 days. Conclusions: The effectiveness of hyperbaric oxygen on the patients with persistent vegetative state caused by cerebral trauma and the patients who just begin to receive hyperbaric oxygen treatment when having been ill for less 61 days better. K56 Efficacy of hyperbaric oxygenation therapy for diabetic foot Bi Zhumei Shandong Provincial Hospital, Jinan, China Objective: To study the efficacy of hyperbaric oxygenation therapy(HBO) on patients with diabetic foot. Methods: 42 patients were randomly divided into conventional therapy group and HBO therapy combined group, efficacy differences between the two groups was compared. Results: Cure rate and total effective rate was 68.2% and 86.4% in HBO combined group while it was 20.0% and 60.0% in the control group , differences were seen between the 2 groups obviously (P<0.05). Conclusion: HBO therapy augments the efficacy of conventional therapy. K57 Effects of comprehensive hyperbaric oxygen rehabilitation on function recovery for cerebralapoplexy patient NingQin Gao, XiaoPing Chen, Jun Shen, Ying Zhang, Ta oLi Wang, LiHua Huang, HaiPing Ge Xuhui Central Hospital, Shanghai, China Purpose: Discuss the effects of comprehensive hyperbaric oxygen rehabilitation on function recovery for cerebralapoplexy patient. Method: 50 cerebralapoplexy patients are divided into two groups, namely, hyperbaric oxygen and non-hyperbaric oxygen group. The routine treatment and rehabilitation is taken for both two groups and the additional hyperbaric oxygen treatment is provided for hyperbaric oxygen group. The functional independence measurer (FIM) of patient and simplified Fugl-Meyer motion function evaluation method can be used for evaluation. Results: The conclusion shows that the FIM and simplified Fugl-Meyer scoring difference between both two groups have the statistics significance after treatment and the hyperbaric oxygen group is superior to non-hyperbaric oxygen group. FIM is 100.92±15.76 after the patient in hyperbaric oxygen group is treated and FIM is 83.60±28.20 after the patient in non-hyperbaric oxygen group is treated. The comparison between two groups P±22.61 after the patient in hyperbaric oxygen group is treated and the simplified Fugl-Meyer is 36.64±24.26 after the patient in non-hyperbaric oxygen group is treated. The comparison between two groups P<0.01. The simplified Fugl-Meyer is 54.48±22.61 after the patient in hyperbaric oxygen group is treated and the simplified Fugl-Meyer is 36.64±24.26 after the patient in non-hyperbaric oxygen group is treated. The comparison between two groups P<0.01 Conclusions: The conclusion is that the hyperbaric oxygen treatment can improve the activities of daily living and motion function of cerebralapoplexy patients. K58 Systematic review of the effects of hyperbaric oxygen adjunctive therapy on brain injury Li Chu, Shilian Hu, Oyang Aiqun, Yaowu Ge, Wang Qiang The Second Affiliated Hospital of Anhui Medical University, Hefei, China Objective: To evaluate the effects of hyperbaric oxygen (HBO)combined therapy on the patients with brain injury. Methods: HBO, as a commonly-used adjuvant therapeutic method to treat the brain injury, is not unanimously accepted by the doctors yet. In this paper, we searched for the domestically published studies on the HBO combined therapy on brain injury and only those studies in accordance with the following inclusion criteria were reviewed systemically. ⑴ Randomized controlled trials (RCTs) and clinical controlled trials (CCTs) about the HBO combined therapy on brain injury without confounding factors. ⑵ Trials should contain control groups (medicine/operation combined with HBO) and treatment groups (treated with medicine/operation only). No less than 100 cases were needed in each treatment group and the case number in control group must meet the statistical requirements. ⑶ The age of each case should be between 9 to 75 years old. Statistical Treatment: The statistics software RevMan4.2 provided by Central Cochrane was applied to systematically review the effects of HBO combined therapy on brain injury. Odds Ratio (OR) was applied and 95% Confidence Intervals (95%CI) were calculated. Chi square test was also carried out to assess the heterogeneity among groups. Results: Up to March 2008, 623 papers about the effects of HBO combined therapy on brain injury were browsed and only 9 trials (involving 3916 cases) in accordance with the inclusion criteria were reviewed systemically. Among these 9 trials, total effective rates were compared in 8 trials, the scores of Glasgow Coma Scale (GCS) before treatment and one month after treatment were compared in 2 trials, and the mortality rates of the cases within 6 months’ follow-up study after treatment were compared in 2 trials. After the statistical treatment with the statistics software RevMan4.2, the following statistical outcome was obtained. ⑴ The total effective rate: Clinical effects were reported in 8 trials (involving 3688 cases), and the total effective rate of HBO combined treatment groups was markedly improved with statistical significance as compared with that of control groups (95.12% vs. 74.85%; OR 6.37; 95%CI 5.04,8.06; P<0.01). ⑵ The comparison of the GCS scores: The GCS scores of cases had no statistical significance among groups in 2 trials (involving 430 cases) before treatment and there was no heterogeneity among groups after Chi square test (P=0.22), but the combining GCS score of cases one month after treatment in treatment groups was 1.67 more than that in control groups one month after treatment and the difference had statistical significance (95%CI 1.2,2.14; P<0.01),. ⑶ The mortality rates of the cases 6 months after treatment: The mortality rates of cases within six months’ follow-up study after treatment were carried out in 2 trials with 420 cases involved and there was no heterogeneity among groups after Chi square test (P=0.13). It was found that the total mortality rate of cases in 6 months after treatment was 10.76%(24/223) in treatment groups, which was less than the total mortality rate (18.78%; 37/197) of cases in control groups with statistical significance (10.76% vs. 18.78%; OR 0.51; 95%CI 0.29,0.90; P<0.05),. And NNT(Number Needed to Treat) was 12.5,which suggests that one patient with brain injury could be avoided from death in 6 months among every 12.5 patients if adjunctively treated with HBO. Conclusion: After the systemic review of the studies of HBO combined therapy on brain injury, it could be found that the total effective rate significantly improved and the mortality rate obviously decreased after patients with brain injury had been adjunctively treated with HBO. So, HBO therapy is a desirable treatment measure for the patients with brain injury, for it proved to be of definite therapeutic effects and clinical significance. K59 Clinical study of hyperbaric oxygen treating in patients with developing cerebral infarction Du Yuqin Shantou University Medical College First Subsidiary Hospital, Shantou, China Objective: To explore the therapeutic effects and safety of Hyperbaric Oxygen treating in patients with developing cerebral infarction. Methods: 63 patients were randomly divided into two groups. The control group (n=30) was treated with Xue Shuan Tong and conventional therapy for ACI , and the treatment group (n=33) was treated with Hyperbaric Oxygen treatment combined with conventional therapy for ACI , general for two weeks. Results: After the above-mentioned therapy , the scores of Nervous Functional Deficiency were lower than before therapy and the parameters of blood viscosity were decreased in two groups , but were significantly progress and decreased in the treatment group compared with the control group (P<0.01or P<0.05). Conclusion: Hyperbaric Oxygen treatment is a safe and effective method in patients with developing cerebral infarction. K60 Nursing experience in treating h2s poisoning with high pressure oxygen Chen Sailian Department of HBO, the People’s Hospital of Tongling city, Anhui, China To treat H2S poisoning, high pressure oxygen therapy should be used as early as possible. High concentration oxygen inhalation; continuous positive pressure breathing, artificial sputum, avoiding respiratory tract obstruction are the key nurse steps. In the meantime, to change the histanoxia by applying the diutretics, control the pulmonary edema and encephaledema, use the antibiotic to treat secondary infection are also the effective measures. The author thinks it is important to use HBO at early stage and thoughtful nurse in treating H2S poisoning. K61 The reasons and how to prevent barotraumas of middle ear to the sudden deafness patients during hyperbaric oxygen treatment Lijuan Chen, Yan Jiang, Rongzhen Wang, Xiaohong Ding The First Affiliated Hospital, College of Medicine, Zhejiang University, China Object: To investigate how to prevent barotraumas of middle ear during hyperbaric oxygen (HBO) treatment to the sudden deafness patients. Methods: There were 1019 patients received HBO treatment in our hospital during Jan-04 to Dec-07 and 68 patients among them encountered barotraumas of middle ear. The 68 patients were divided into groups according to different reasons of barotraumas of middle ear, first or non-first time treatment and different educational background. And comparison were in progress inter-groups. Results: 6.64% of all 1019 patients encountered barotraumas of middle ear. Among them 87% (59 patients) were mild, 11% (7 patients) were middling, 2% (1 patient) was severe. The reasons of barotraumas were eustachian tube obstruct, inappropriately pressure adjust and faulty operation. There was significant difference in composition of these three reasons. The incidence rate of barotraumas was 5.1% in first time treatment patients, and was 1.6% in non-first time treatment patients. The difference was significant (P<0.01). There was also significant difference in different educational background patients (P<0.01). Conclusion: Many factors can cause barotraumas of middle ear during HBO treatment to the sudden deafness patients. So the operator must pay attention to the complication and take some things to reduce the incidence rate of barotraumas of middle ear. K62 Effect of different initiation time of hyperbaric oxygenation therapy on MCAO rats with learning and memory deficits Hao Chen, Zhumei Bi, Ning Cui, Handong Liu Department of Hyperbaric Oxygenation Treatment, Shandong Provincial Hospital, Jinan, Shandong, China Objective: To investigate the effect of initiation time of hyperbaric oxygenation (HBO) therapy on spatial learning and memory deficits of MCAO (middle cerebral artery occlusion) model rats. Method: MCAO rats model was induced. HBO treatment was administered at 6 or 24 hours after reperfusion respectively in earlier (EHBOT) or delayed therapy (DHBOT) groups. The spatial learning and memory abilities were evaluated by Morris water maze test. The infarct volume ratio of each group was measured by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining. Result: In EHBOT and DHBOT group, compared with that in ischemia-control group, the learning and memory abilities improved and the brain infarct volume ratio diminished markedly (all P<0.01). Conclusion: Both earlier and delayed HBO therapy can improve the learning and memory dysfunction of rats with ischemia-reperfusion brain injury. Hyperbaric oxygenation therapy shows neural protective effect in ischemia-reperfusion injury. K63 Hyperbaric oxygen and rehabilitative therapy on severe traumatic brain injury 196 cases Huiping Peng, Xiaoxin Lu, Yongjian Tang, Weihong Fang Fuzhou General Hospital, Fuzhou, China Objective: To investigate the effective usage of hyperbaric oxygen and rehabilitative therapy on severe traumatic brain injury. Methods: From March 2007 to April 2008, 196 patients of severe traumatic brain injury were treatment by hyperbaric oxygen treatment and rehabilitative therapy in our department, male 119, female 77, average 30.6±8.7years. All patients were severe traumatic brain injury, treated by hyperbaric oxygen treatment (HBOT) and rehabilitative therapy. HBOT pressure was 1.6-0.2Mpa, patients inhale oxygen with face mask for 60 minutes, A 5-minute break was taken to breath air inner cabin. HBOT was performed once a day, for 10 days as a treatment course. AT the meantime, rehabilitative therapy was performed once or two a day for every patient, the treatment time was 30-60 minutes, including arthrosis passivity movement, nerve muscle electricity stimulate, physics therapeutics, biofeedback. Result: The number of times of hyperbaric oxygen and rehabilitative therapy on patients was 20±4.5; the healing rate was 85.2% (167/196); the effective rate was 14.8 %( 29/196).There were no anyone break off treatment for unwell. Conclusion: Hyperbaric oxygen treatment and rehabilitative therapy have significantly effect on severe brain trauma patients, they are safety and useful. Mechanism of ischemic tolerance induced by hyperbaric oxygen preconditioning involves up-regulation of hypoxia-inducible factor-1α and erythropoietin in rats 1 1 1 YunPing Li , ZaoYun Peng , Gu Guo Jun , 1 1 1 1 JiaJun Xu , ZhiMin Kang , WeiGang Xu , HengYi Tao , 2 2 1 Robert Ostrowski , John H Zhang , XueJun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China K64 The curative effect of Hyperbaric Oxygenation treatment child brain damage and the influence of nursing Jian Bao, Dao-dong Liu The people’s hospital of Lu’an city, Anhui province, Lu’an, China Objective: We studied the effect of hyperbaric oxygen (HBO) preconditioning on the molecular mechanisms of neuroprotection in a rat focal cerebral ischemic model. Methods: Seventy two male Sprague–Dawley rats were pretreated with HBO (100% O2, 2 atmospheres absolute, 1 hour once every other day for five sessions) or with room air. In experiment 1, HBO preconditioned rats and matched room air controls were subjected to focal cerebral ischemia or sham surgery. Post-injury motor parameters and infarction volumes of HBO preconditioned rats were compared with those of controls. In experiment 2, HBO preconditioned rats and matched room air controls were killed at different time points. Brain levels of hypoxia-inducible factor 1a(HIF-1a) and its downstream target gene erythropoietin (EPO) analyzed by Western blotting and RT-PCR as well as HIF-1α DNA-binding and transcriptional activities were determined in the ipsilateral hemisphere. Results: HBO induced a marked increase in the protein expressions of HIF-1α and EPO and the activity of HIF-1a, as well as the expression of EPO mRNA. HBO preconditioning dramatically improved the neurobehavioral outcome at all time points (3.0±2.1 vs 5.6±1.5 at 4 h, 5.0±1.8 vs 8.8±1.4 at 8 h, 6.4±1.8 vs 9.7±1.3 at 24 h, P<0.01 respectively) and reduced infarction volumes (20.7±4.5% vs 12.5±3.6%, TTC staining) after cerebral ischemia. Conclusion: This observation indicates that the neuroprotection induced by HBO-preconditioning may be mediated by an upregulation of HIF-1a and its target gene EPO. Purpose: Discussion the curative effect of Hyperbaric Oxygenation treatment child brain damage and the influence of nursing. Method: In random take out 82 examples as observation group (n=82) from hospitalized child patient (October 2002 to October 2007), and take the same period 78 examples as compare group. The observation group was given conventional treatment add HBO treatment, the compare group treat only given conventional treatment. Observe the difference of curative effect in two groups’ treatment the child brain damage. Result: the cure and apparently effective rate of observation group be higher than compare group. Conclusion: The treatment of Hyperbaric Oxygenation can raise the effect in child brain damage. K65 Up-regulated HIF-1α is involved in the hypoxic tolerance induced by hyperbaric oxygen preconditioning 1 2 1 1 Zhaoyun Peng , ping Ren , Zhimin Kang , Jing Du , 1 1 1 1 Qinglin Lian , Yun Liu John H Zhang , Xuejun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical, Shanghai, China Objective: the present study was to examine the hypoxic tolerance induced by HBO-PC and to explore the role of hypoxia-inducible factor-1alpha (HIF-1alpha) in a global hypoxia model. Methods: Male mice received HBO-PC before hypoxia exposure and swimming. Results: HBO-PC significantly prolonged the survival time and the tolerance time of swimming under normobaric hypoxia. HBO-PC increased the protein content of HIF-1α and erythropoietin (EPO) in the cerebral cortex and hippocampus and prevented the changes of blood brain barrier (BBB) permeability and brain edema caused by hypoxia exposure. Conclusion: The results suggested that HBO-PC induced hypoxic tolerance in mice via up-regulating of HIF-1α and its downstream genes. K66 K67 Hyperbaric oxygen preconditioning attenuates motor neuron apoptosis after spinal cord ishchemia in rats: role of nitric oxide 1 2 1 2 Liping Wang , Xuejun Sun , Wenxian Li , Zhimin Kang , 2 2 3 Hengyi Tao , Weigang Xu , John H Zhang Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical, Shanghai, China Hyperbaric oxygen (HBO) preconditioning confers neuroprotection against subsequent ischemic insult by inhibition to neuronal apoptosis. In this study, we investigated whether nitric oxide (NO) was involved in HBO-induced ischemic tolerance and the underlying mechanisms in a rat model of spinal cord ischemia-reperfusion. HBO preconditioning, which significantly increased NO levels in spinal cord tissue, was produced by consecutive four times of 1-h HBO exposure (2.5ATA, 100%O2) at an interval of 12 h. At 24 h after the last pretreatment, rats underwent spinal cord ischemia for 9 min. Function recovery was evaluated by 15-point scale, and motor neuronal apoptosis was detected by TUNEL staining. Behavioral function was remarkably preserved and motor neuronal apoptosis was notably attenuated by HBO preconditioning (P<0.01). Intraperitoneal injection of L-nitroarginine-methy-ester (L-NAME, 10 mg/kg), a nonselective nitric oxide synthase (NOS) inhibitor at 20 min prior to each HBO preconditioning, abolished the beneficial effects of HBO preconditioning. The activities of caspase-3, -9, -8 and the expressions of mitochondrial passway anti-apoptotic mediators in the ischemic spinal lumbosacral tissue at 6, 12 and 24 h after reperfusion were evaluated in HBO preconditioned rats with or without L-NAME. NO protected neurons from apoptosis through attenuation of cytochrome c release and caspases cleavage along with upregulation of Bcl-2 and antioxidant enzymes. Intraperitoneal administration of thiol antioxidant N-acetyl-L-cysteine (NAC, 200 mg/kg) at 15 min before each HBO preconditioning also blocked the neuroprective effects of HBO by decreasing NO production. The abovementioned data indicate that NO produced by HBO may contribute to neuroprotection during the preconditioning. K68 When high pressure oxygen treatment prevents nursing experience which the middle ear gas crushes Gao Xiudong Victory oil field central hospital high pressure oxygen branch of Dongying, Shandong camp, China Objective: Discussion high pressure oxygen branch nursing to prevents the middle ear gas to crush the morbidity the influence. Methods: We carry on to each patient carefully nurse comprehensively, then, the careful observation, the record, summarizes, carries on the analysis. Results: Nurses earnestly after us, the patient middle ear gas crushes the disease incidence rate reduces obviously. Conclusion: When high pressure oxygen treatment, carries on carefully nurses comprehensively, but effectively reduces the disease incidence rate which the middle ear gas crushes. K69 Effect of hyperbaric oxygen on the rehabilitation of neurological function impairment and Ability of activity of daily living in patients with intracranial aneurysms after operation Dongjuan Li, Jinlong Liu, Xiaoning Si Department of Hyperbaric oxygen, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China Objective: To observe the influence of hyperbaric oxygen (HBO) combined with physical therapy and acupuncture on neurological function impairment (NFI) and ADL in patient with intracranal aneurysms. Methods: 80 cases with intracranial aneurysms were randomly divided into two groups treated with and without HBO therapy besides conventional treatment. The score of NFI and Barthel were evaluated before and after treatment. Results: The score of NFI after treatment was lower than before treatment in two groups. It was lower in HBO group than in control group after treatment. The score of ADL after treatment was higher significantly as compared with before treatment in HBO group and control group. After HBO therapy they were higher than those in control group. Clinical effect wasassociative with the day of beginning and Hunt-Hess grading system. Conclusions: HBO therapy and other rehabilitative training were actively used in patients of intracranial aneurysms in the early stage after operation, could improve neurological function and ADL and quality of life significantly. K70 Effect of hyperbaric oxygen therapy in ischemic stroke: :150 cases report Li Li, Jiali Zhang, Yue Yao, Huichun Zheng, Xiaoqin Du HBOT Center of Southwest Hospital, Third Military Medical University, Chongqing, China Objective: Observe the effect of hyperbaric oxygen therapy (HBOT) in patients with ischemic brain stroke. Methods: 150 cases of brain infarction patients, which performed HBOT, were analyzed retrospectively. Results: The symptoms of 54.0% patients with HBOT were improved significantly, but it is 44.0% in another 150 cases of brain infarction patients without HBOT during the same period. If HBOT could be initiated in 30 days after attacked, the ratio of patients with significant symptoms improvement is 69.7%, 57.5% in 31-60 days, higher than in 60-90 days (40.0%) and after 90 days (23.5%). The best outcome was occurred in patients with HBOT course of 21-30 days, 63.6% of which achieved significant improvement, followed by11-20 days (59.7%), less than 10 days (52.3%) and more than 30 days (31.8%). Conclusions: HBOT can do benefit to patients with brain infarction and it is beneficial to initiate HBOT as early as possible, and the course of HBOT should better not less than 20 days. K71 The use of Hyperbaric oxygen in infants external hydrocephalus comprehensive treatment Wu Xiuyun Department of Hyperbaric oxygen Taihe Hospital of Yunyang Medical College, Shiyan, Hubei, China Objectives: To investigate the role of hyperbaric oxygen treatment in infants and young children of the hydrocephalus and analysis the leading risk factors of external hydrocephalus. Methods: 100 cases of the children with hydrocephalus using Hyperbaric oxygen + nerve-brain-training physical rehabilitation treatment, infants with single oxygen chamber therapy a day, 12 days for a course of treatment, intermittent 20 days , A total of 2 to 3 course. Treatment of pressure 0 to-4months 1.6 ATA; 4-8months 1.7 ATA; 8-12months1.8 ATA; clinical follow-up from 6 months to 1 year. Results: 100 cases of children with the 2 to 3 course of treatment, clinical symptoms disappear, six months of follow-up review of 74 cases of head CT subarachnoid fluid decreased to normal, one-year follow-up of 26 cases of non-developmental disorders and nervous system abnormalities, The total effective rate was 90%. The risk factors of external hydrocephalus is the lack of oxygen in perinata, suffocation, encephalitis, trauma, such as the factors that injury the central nervous system. Conclusions: The external hydrocephalus children in the comprehensive treatment on the basis of early supplemented with high-pressure oxygen treatment, clinical prognosis is good for children with neural, mental development play a positive role in promoting. K72 The Nursing during the hyperbaric oxygen treatment after Skin grafting Wang Wenjie Tai He Hospital affiliated to Yunyang Medical College, Shiyan, Hubei, China Objective: Explore the relationship between the success rate of skin after transplantation and the nursing during the hyperbaric oxygen treatment after skin grafting. Methods: 40 patients were studied who took the reconstruction of skin grafting because of the trauma or the organizations after surgeries in our hospital since 2005. Conventional treatment, nursing and the hyperbaric oxygen treatment were carried out at the same time. single pure oxygen chamber treatment pressure 0.2 Mpa, or, decompression of the 25min, Regulators 40 min, in a small cabin air pressure, the pressure of 0.2 Mpa, oxygen 60 min (30'2 +10'), or, decompression of the 25 min. Results: The efficacy is closely related to the time between the transplant and the hyperbaric oxygen treatment. The time is shorter and the effect is more obvious. And the Special nursing during the Hyperbaric oxygen treatment has played a positive role in promoting and prevented the incidence of complications, the effective rate was 90%. Conclusions: The Hyperbaric oxygen treatment has a significant effect, and should be used earlier during the conventional treatment. K73 Significance of vascular endothelial growth factor in steroid-induced vascular necrosis of femoral head treated with hyperbaric oxygen Cui Cao Department of Orthopedics, Taihe Hospital of Yunyang Medical College, Shiyan, Hubei, China Objective: To investigate the stage-changes of vascular endothelial growth factor (VEGF) in the mode of steroid-induced avascular necrosis of femoral head and after treated with hyperbaric oxygen, and explore the pathogenesis. Methods: 60 adult Japanese rabbits were randomly divided into two groups: experiment group (42) and control group (18). As for experiment group, each one was two times per week, and as for control group, each one with 2ml of salt water, the experiment lasted for six weeks. Then, rabbits in experimental group were randomized to hyperbaric oxygen (HBO) group(16) and control group(16). The HBO group receive HBO treatment, but the control group was placed in the fresh air. At the end of 2, 4, 6, 8, 10, 12 weeks, the ratio of VEGF, pathological changes of femoral head in light microscope and electron nicroscope, imaging changes were observed. th Results: At the end of 6 week, a propotion of osteocytes decreased in volume and the nuclei shrunk. Many osteocytes underwent necrosis, dissolved and became fragments. The masculine expression of VEGF was slight. th At the end of 12 week, scattered osteoblast cells could be observed around the bone trabecula. Nascent bone cells and collagenous fibri could be found. The ratio of masculine cells of VEGF, which were mainly in the endangium, was increased obviously. At the same time, there were many newborn micrangium. Conclusion: HBO can accelerate the vascular developing and ossification by promoting the exudation of VEGF and improve bone repairing. K74 Nursing methods of respiratory tract in severe craniocerebral injury patients after tracheotomy who were treated with high pressure oxygen and combined therapy Ming Huang, Jing Bian Department of Neurosurgery, Taihe Hospital of Yunyang Medical College, Shiyan, China Objective: To discuss nursing method of respiratory tract after tracheotomy in patients with severe craniocerebral injury, who were treated with high pressure oxygen and combined therapy, and decrease the infection rate respiratory tract and improve the survival rate. Methods: 198 patients with severe craniocerebral injury were treated with tracheotomy and high pressure oxygen and combined therapy, all patients were given environmental nursing, postural nursing, sputum nursing, sputum culturing for germs, controlling the correct decannulation time and so on. The data was analyzed retrospectively. Results: All the patients were kept unobstructed of respiratory tract. Infection rate of respiratory tract was 24.9% and survival rate was 89.2%,survival quality was improved obviously and the rate of good was 74.5%. Conclusion: Timely and effective respiratory tract nursing for patients with severe craniocerebral injury who were performed with tracheotomy can decrease complication of respiratory tract infection effectively and make for the rehabilitation of patients. K75 Nursing experience of 26 cases with spinal cord jnjury treated with hyperbaric oxygen therapy Dongyun Zhang, Haiju Pi Department of spinal surgery, Taihe Hospital, Yunyang Medical College, Shiyan, Hubei, China Objective: To investigate the therapy effect of spinal fracture with spinal cord injury treated with spinal cord decompression and internal fixation and hyperbaric oxygen (HBO) therapy. Methods: From 2001 to 2003, 252 cases of spinal fracture with spinal cord injury were treated with spinal cord decompression and AF nail fixation in our hospital, after operations, 26 cases treated with hyperbaric oxygen (HBO) therapy, and the other 26 cases treated with routine therapy. The therapy effect was observed according to Frankel standard, and the further low back pain was also observed, the follow up period’s was one year. Results: The 26 cases treated with hyperbaric oxygen achieved better treatment effect than the other 26 cases. Conclusion: Spinal fracture with spinal cord injury treated with hyperbaric oxygen therapy can acquire more better treatment effect than treated only with operation. K76 Hyperbaric oxygen treating and caring 48 cases of severe brain injury and tracheotomy patients Jing Bian, HouCheng Li Taihe Hospital, Yunyang Medical College, Shiyan, Hubei, China Objective: To explore the nursing experience of tracheotomy and severe brain injury patients during hyperbaric oxygen therapy. Methods: As the 48 cases of severe brain injury and tracheotomy patients who admitted in our hospital in 2005 for the study, during the conventional surgical treatment and care, recovery supplemented by hyperbaric oxygen treatment, a single pure oxygen chamber treatment, pressure 0.1 Mpa, respectively increased pressure and decompression 25 minutes , maintain pressure 40 min, a small, air-pressurized module, the treatment pressure is 0.1 Mpa, oxygen 60 min, (30 * 2 +10), or, respectively increased pressure and decompression 25 minutes. Results: on the basis of clinical treatment, after vital signs Stability, no further bleeding tendency, as soon as possible to hyperbaric oxygen therapy, to promote the lives of comaawakening and improve the life function. Of 48 cases patients, cured 21 cases, markedly effective 13 cases, improvement 9 cases, 2 cases of invalid, 2 cases died, the total efficiency is 91.66 percent. Conclusions: as soon as possible safe and effective for hyperbaric oxygen treatment, while the care measures before and after hyperbaric oxygen treatment is particularly important, and actively deal with complications, can improve the prognosis of severe brain injury, has made significant effect. K77 Hyperbaric oxygen treatment and rehabilitation training in the United Feng-chi point of acupuncture Pseudobulbar palsy analysis of the clinical results HouCheng Li, HongMei Zhang, GuangJian Liu, JunHua Wang, ZhongMing Rao, Ming Zhu Tai He Hospital affiliated to Yunyang Medical College, Shiyan, Hubei, China Objective: To evaluate the clinical effects of hyperbaric oxygen treatment and rehabilitation training in the United Feng-chi point acupuncture treatment after a stroke pseudobulbar palsy. Methods: 90 patients were randomly divided into I (ABC). II (ABC) group, were given conventional treatment of cerebral vascular disease, and another to give I (B), II(B) group hyperbaric oxygen therapy, I (C), II (C) Group and swallowing function of rehabilitation training; II(ABC ) Group Feng-chi point of acupuncture treatment; to their own improved wa tian surname swallowing function classification standards in the treatment of various points in time before and after to evaluate the patients with swallowing function. Results: In addition to I A group, the score of the other five groups in eight points in time have significant differences (P <0.05, or P <0.001), the score differences between group I and II, therapy group in seven points in time had statistical Significance (P <=0.001); In addition to the three days treatment, I, II group at other times, the group score differences were statistically significant (P <0.05, or P <0.001). Conclusions: Comparison of clinical, hyperbaric oxygen treatment, more effective than conventional therapy group, rehabilitation training group is better than hyperbaric oxygen treatment group, the Joint Feng-chi point acupuncture treatment group is better than non-acupuncture treatment group. K78 Hyperbaric oxygen therapy for brain tumors, cerebral vascular tumor after clinical effectiveness analysis Houcheng Li, Ming Huang, Jing Bian, HongPing Ning, Xiu Yun Wu, Ming Zhu Shiyan Yunyang Medical College, Taihe, Hubei, China Objective: To analyze the clinical effect of Hyperbaric oxygen treatment of brain tumors, cerebral vascular tumor. Methods: Choose 96 patients of brain tumor, cerebral vascular tumor who have surgery Since December 2000 in our hospital's neurosurgical hospital, were randomly divided into two groups. 48 cases of hyperbaric oxygen in the conventional drug therapy group at the same time, supplemented by hyperbaric oxygen treatment. Of which 18 cases were single pure oxygen chamber treatment, pressure 0.2 Mpa, Regulators 40 min, upward and downward pressure each 25 minutes. 20 patients with small cabin air pressure, pressure 0.2 Mpa, oxygen 60 min (30 '× 2 +10'), the middle rest 10 min, upward and downward pressure each 25minutes. Once a day, 12 times for treatment. For the longest time, 68 times, the shortest are six times. The control group of 48 cases, conventional drug treatment. Results: HBO were cured 30 cases, markedly effective in 13 cases, improvement in two cases, invalid three cases, 93% efficient. The control group cured 16 cases, nine cases markedly effective, improved in 10 cases, 13 cases invalid. Group 2 cure rate and the total efficiency of the differences were statistically significant (P <0.05). Conclusion: In the premise of drug treatment, that the surgery patients of brain tumor, brain tumor blood vessels, supported by hyperbaric oxygen treatment, clinical treatment more effective than conventional drug group, and the sooner the better therapeutic effect. network structure upstream activating the function of the system, Is conducive to patients regained consciousness. Enhance the liver and kidney function, strengthen the poison of detoxification and excretion. K79 Nursing of the hyperbaric oxygen treatment to the reconstructed right hand after operation Guiping Hu, Qiong Zhang, Yan Quan Taihe Hospital of Yunyang Medical College, Hubei, China K81 Study of hyperbaric oxygen therapy on patients complicating with disordered brain function and incision of trachea Huijun Hu, Xiaowen Pan Hyperbaric Oxygen Center of PLA, Naval General Hospital, Beijing, China Objective: To investigate the contribution of hyperbaric oxygen treatment to operation achievement ratio of limbs transplantation and the effect on functional rehabilitation. Methods: A case of dumped hand, after the excision of the left upper extremity, was heterotopic transplanted to reconstruct the right hand. Besides the symptomatic treatment and supportive treatment of anticoagulation, dilat blood vessel, anti-inflammatory, analgesia. To carry out the hyperbaric oxygen treatment 6 hour after the operation. The pressure is 0.2Mpa(2ATA). The time of absorption oxygen is 60 min. Intermedial recess is 10 min. Both the process of boosting pressure and decompressing pressure are 25 min. Deploy seven treatments in the three days. Then one treatment per day. In the stage of therapy after operation, the specific nursing of keeping the affected extremity warm and raising the affected extremity, local proper fixation are very important. Results: The treatments promote the functional rehabilitation of affected extremity. Half year after of the operation, the follow up find that the recovery of the reconstructed right hand is satisfaction. The rotation function of the antebrachiu: pronate 70 °, supinate 70 ° the extension, flexion and prehension of fingers are normal. And the muscle force is IV grade. Conclusion: Prompt hyperbaric oxygen treatment and standard specific nursing after successful operation are the important measures that promote the functional recovery of the implanted extremity. K80 Hyperbaric oxygen treatment of toxic encephalopathy tetramine case Li Hongyan The Peoples Hospital HBO Departments of Qitaihe city Heilongjiang Province, China Objective: The implementation of high-pressure oxygen treatment, toxic encephalopathy and multiple organ failure patients regained consciousness as soon as possible, to language, physical function; to improve multiple organs. Methods: Case Analysis, Hyperbaric oxygen treatment. Results: After high-pressure oxygen treatment, the patient awareness of recovery, normal intelligence, language physical function returned to normal, liver and kidney function returned to normal. Conclusion: HBO can reduce intracranial pressure, improve cerebral edema. At the same time increase the vertebral - basilar artery blood flow system, thereby increasing the blood supply the brain stem, contribute to the restoration of the brain stem Objective: :To study the equipments, therapy opportunity, security and institution of hyperbaric oxygen (HBO) therapy on patients complicating with disordered brain function and incision of trachea. Methods: :Retrospective analysis was done on the patients who complicated with disordered brain function and incision of trachea from Jan. 1999 to Jun. 2007. Their data were summarized. Firstly, all kinds of equipments through which the patients after tracheotomy could inhale oxygen in HBO chamber were compared. Their structure, serviceable range, security, efficiency of inhaling oxygen and therapeutic efficacy were studied. So the problem on equipments for the patients was solved. Secondly, all kinds of sputum aspirators were compared, including their principle, structure, serviceable request and limitations. By using these sputum aspirators, the problem on aspirating sputum in HBO chamber was solved. So the security of patients was ensured. Thirdly, we proposed that the patients after tracheotomy should be administered HBO therapy earlier. However, the following factors must be considered, such as the severity of primary diseases, the severity of pulmonary infection, the type of HBO chamber, the equipment in HBO chamber, the diathesis and experience of medical personnel in HBO chamber. In addition, informed consent and institution about medical personnel in HBO chamber were very important. Especially for the severe patients, when administered HBO therapy, they must be accompanied by doctors or nurses. Results: :After the factors including equipment, medical treatment, nursing, institution and so on had been studied and summarized, we solved the problem that the patients complicating with disordered brain function and incision of trachea could be administered HBO therapy promptly and safely. Conclusion:Safety should be the most important premise. Besides, we should make the best of all means to start HBO therapy as early as possible, through which the patients complicating with disordered brain function and incision of trachea could get a better result. K82 The foreground of Lidocaine treatment for DCS Li Changchun Navy submarine academy of PLA, Qingdao, China With the further cognition to the DCS pathology, some pharmacologic agents raise the people’s interest. Lidocaine is one of the most promising pharmacologic agents because of the obvious treatment effect. Pathologic development of DCS: First, people considered DCS was result from simple physical injury of bubbles; however, following study show the pathology is complicated. It is believed that the body’s host defenses respond to bubbles as foreign bodies, leading to the activation of enzymes, complement and clotting factors, and the release of vasoactive substances .The activation of the body’s defense system initiates a vicious cycle the leads to multiple organ failure .To the series of inflammation reaction, pharmacologic treatment is very important. Pharmacology of lidocaine: Lidocaine is local anesthesia agent,since 1963, it has been used as antiarrhythmic agent for ventricular tachycardia and fibrillation. It begin to work within 15-30 seconds after intraveneous, and then rapidly distribute to heart, brain, lung, liver etc. Lidocaine can work on heart directly, but less effect on vegetable nerve. The present study of lidocaine to treat DCS: It is a tendency to use the lidocaine to treat serious DCS, these results from some animal experiments in vivo. In 1984, Evans found lidocaine can protect nerve system in animal experiment. This raises people’s interests to lidocaine as adjuvant treatment for DCS. Subsequence, many scientists also proof this view and then study its mechanism in rat and rabbit experiments, they found lower-dose lidocaine can preserve conduction in isolated nerves and inhibits cation leakage, and inhibit the adhesion of neutrophils to vascular endothelium, but the mechanism is unknown. However, regardless of the mechanism, lidocaine may offer protection by preventing leukocytes from adhering to damaged endothelium. Presently, the Adjuvant Treatments Committee of the Undersea and Hyperbaric Medical Society considers the use of lidocaine to be beneficial in cases of AGE presenting early for treatment. K83 The near and far-period effect of hyperbaric oxygenation on insomnia Kuang Aihua Cardiology Department of the Affiliated Hospital to Ningxia Medical College, Yinchuan, Ningxia, China Objective: To survey near and far-period healing efficacy of hyerbaric oxygenation (HPO) in patients with insomnia. Method: 84 patients with insomnia without organic disease were randomly devided into drug-group and oxygen-theapy group, and respectively were given drug theapy and HPO theary, Record Pittsburgh Sleep Quality Index (PSQI) of the two groups before and after treatment, and then record and compare/analysis average time of getting into sleeping and sleeping which is after one month and six months treatment. Result: The effect of HPO-theapy group obviously improve than drug-group, the effect of after one month treatment and six months treatment is similar. Conclusion: HPO can add to effectiveness of the conventional drug-treatment and has a reliable far-period effect. K84 Observation And Nursing Intervention Of Diabetic’s Hypoglycemia With Hyperbaric Oxygen Kong Lei Guangxi Zhuang Autonomous Region People’s Hospital, Nanning, China Objective: To probe into nursing intervention with diabetic’s hypoglycemia with hyperbaric oxygen. Method: The characteristics of diabetic’s hypoglycemia with hyperbaric oxygen were analyzed retrospectively and nursing countermeasures against it put forward. Result: Hypoglycemia of eight diabetic cases with hyperbaric oxygen got timely treatment, and with consequent remission, continued to take up oxygen till they got decompressed and discharged from the cabin; thus ensuring the HOB treatment. Conclusion: For diabetic’s hypoglycemia with hyperbaric oxygen, it is significant to give proper health education, dietary guide, medication instruction and warm-up direction. And it is necessary to understand the patient’s blood pressure, blood sugar, dieting, medication, metergasis of his liver and kidney in order to act on requirements. In the HOB treatment it is to observe strictly, check hypoglycemia and deal with it betimes, and following discharging, it is needed to find the cause of hypoglycemia for the purpose of avoiding recurring of it. K85 Clinical study of assistant treatment with hyperbaric oxygen in reflux esophagitis 1 1, 2 1 XU Li-min , KO Lei ZHOU Qing-nan , FENG Dao-rong , 1 FAN Qiu-ping 1. Department of Hyperbaric oxygen, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China 2. Department of Gastroenterology, People’s Hospital of Guangxi Zhuang Autonomous Region, Nanning, China Objective: To observe the clinical effects of using hyperbaric oxygen (HBO) to assist in treating 30 patients with reflux esophagitis. Methods: 60 patients with reflux esophagitis were divided averagely into the HBO group and conventional therapy group, both groups were given Omeprazole. Doperidone and L-Glutamine and Sodium Gualenate Granules, while the HBO group received HBO in addition to drugs for 8 weeks as a course. Then compare the improvement of clinical symptom and mucous membrane of esophagus, and compare the variation of clinical symptom at 6 month after treatment ending, to study the recrudescence rate. Results: The effective rate of clinical symptom and mucous membrane of esophagus were significantly higher inpatients of HBO group than that in conventional therapy group (p<0.05). Conclusion: Our data suggest that the assistant treatment with hyperbaric oxygen in reflux esophagitis may get better clinical results than conventional therapy and deserve to be widely accepted. K86 Effects of hyperbaric oxygen therapy 660 patients with craniocerebral injury Wenbo Jin, Min Li, Feng Xu, Ping Wan, Yusheng Ge Department of Hyperbaric Oxygen, Yijishan Hospital, Wannan Medical College, Wuhu, China Clinical information: 660 patients (465men and 195 women) with craniocerebral injury from Jannary 1994 to August 2007 were studied. The patients’ ages ranged from 5 to 72 year old. The course of disease ranged from 6 to 97 days. Causes resulting in Injury: Road accident 465, smash and hit accident 142, crash accident 53. The control group ,aged from 4 to 70 years old and with the course of disease ranged from 8 to 85 days, was 276 craniocerebral injury patients without undergoing hyperbaric oxygen therapy, No significant differences were observed in terms of Glasgow Coma Scale(GCS) for the age and brain contusion between the two groups. Methods and Results: The pressure was 0.2Mpa (2.0ATA) and pure oxygen was inhaled for 30min × 2 with 10min air break by mask. Severe cases with incision of trachea or low spontaneously breathing undertook first-class oxygen therapy using “humidification sterilization low-resistant device to inhale and discharge oxygen” developed by author. The hyperbaric oxygen therapy (HBO therapy) was carried out once a day (special cases twice a day), and 10 times as a course. The course of therapy ranged from 1 to 12 courses, with the average of 2.8 courses. The two groups undertook adjunctive therapy of dehydration, sufficient hormone, cell activator, correcting disequilibration of water and electrolyte, enforcing function training. The curative rates and total effective rates of HBO group were 70.45% and 94.32% , and were significantly higher than the control group 43.48% and 78.28% (u = 4.61,P < 0.01 ). Conclusions: HBO has become a commonly used therapeutic means for patients with craniocerebral injury, and its curative effect has been confirmed. Our research found that HBO therapy should got involved in before the peak of the cerebral edema. Severe cases with incision of trachea or low spontaneously breathing could obtain good therapeutic effect using “humidification sterilization low-resistant device to inhale and discharge oxygen” developed by author. Timely and sufficient treatment of HBO, and personalized oxygen inhalation means are the key to guarantee the curative effect of patiets with craniocerebral injury. K87 The role of hbot in regenerative medicine in anti-aging Joseph Ting Hi-Tech Hyperbaric Medical Centre, Kuala Lumpur, Malaysia Hyperbaric Oxygen Therapy (HBOT) has been proven to be of extreme importance in the Human Embryonic Stem-cell transplantation and Xeno-transplantation. There are different aspects of Regenerative Medicine in Anti-Aging. In this case the overview of future Medical treatments relies on New Scientific approaches like Nano-Medicine, Embryonic Stem Cell Transplantation, Chromosomal Gene Insertions and healthy life styles in adjunction with HBOT. Approach: The world is now experiencing climatic changes and extreme global warming not to mention air pollution and shortage of food production and escalating fuel prices. These in effect have presently reduced oxygen concentration at sea level in comparison to past decades. This is mainly due to the high level of carbon particulates in the air and contamination of drinking water and lesser arable land for farming. Consequently oxygen production level is greatly reduced. Conclusion: Future medicine inter-links closely with HBOT in Regenerative Anti-Aging Medicine. K88 The high pressure oxygen exposes repeatedly to organism function correlation influence discussion Jianping Jiang, Yanling Wang NO.254 Hospital of PLA, Tianjin, China Objective: For HBO repeated exposure to some of the relevant body to function in a study, for HBO to provide the scientific basis for treatment. Methods:High-pressure oxygen through clinical observation and animal experiments on blood coagulation, the brain erythropoietin content, liver function, brain trauma neurons ultrastructure of the immune function and the impact analysis. Results: Conduct clinical hyperbaric oxygen treatment indications in the correct choice under the premise of the implementation of rigorous scientific treatment, HBO treatment is satisfied with the results. However, long-HBO therapy on the bodys clotting, liver, and immune and brain functions, such as the impact of the ultrastructure was not obvious at present. Conclusion: How to make more safe and effective treatment of HBO, the volume - the validity of our research will need to resolve the issue. K89 Effect of related factors on development and the impact of delayed encephalopathyAfter acute Carbon monoxide poisoning Ji Yunping Tianjin Peoples Hospital, Tianjin, China CO poisoning delayed encephalopathy occurred in patients with acute poisoning has been sober a few days or a few months later. Objective: According by CO poisoning patients ‘the age, the degree of intoxication, whether complications, the first high-pressure oxygen treatment, treatment programmes, whether cerebral infarction history, and other relevant factors different on the incidence of delayed encephalopathy different. Method: I will return to the my hospital Gaoyayangke treated in the acute Moderate and severe carbon monoxide poisoning patients in 134 cases, both in the high-pressure oxygen treatment before the quantitative detection of oxygen hemoglobin > 30%.CT brain Show no hemorrhage and lesions. In the acute phase are different levels of coma.treatment: in a coma during the entire process under the pressure of 0.1 Mpa oxygen absorption 2 h. twice daily.After sober changed intermittent oxygen (30'x2 +10'). each Day 1. By age into three groups. A group of 26 cases. 60-year-old. Results: 1. A group of delayedencephalopathy in four cases (15%). B group, 10 cases of delayed encephalopathy (22%), C group, 18 cases of delayed encephalopathy (32%). two cases of death. 2. Delayed encephalopathy occurred with the extent of poisoning and hyperbaric oxygen treatment and the first time and whethe complications and whether cerebral infarction and Brain atrophy and the adequacy of the relationship between the show: 134 cases of recovered patients in 100 cases ,32 cases occurred late encephalopathy, two cases of death. Delayed recovery group Compared with that group encephalopathy ,the degree of light poisoning recovery group, with cerebral edema and cerebral infarction and cerebral atrophy less ,Attending the first time 4h of the 14 cases, high-pressure oxygen treatment time was insufficient. Conclusion: The greater the age, the incidence of delayed encephalopathy was higher;. level of CO poisoning is more serious, visit the time is nighter, the treatment time is not full, the more complications, particularly that patients with cerebral infarction and cerebral atrophy are the more prone to occur delayed encephalopathy. K90 A non-resistance absorbing oxygen access device Mingyi Ji, Yingying Liu, Meixiu Feng The second people hospital hyperbaric oxygen section, Shenzhen, China Objective: Improve the pipeline which is the second grade of oxygen pressure reducer in order to reduce the oxygen resistance. Methods: This device accesses oxygen storaging devices in the original pipeline which absorbs oxygen in the atmospheric with the second grade pressure reducer. Results: Accessing oxygen storaging devices almost can eliminate the additional resistance which produced by the second pressure reducer. Conclusion: The accessing devices fully meet the demand that people who is the weak breathing acess oxygen for oxygen therapy via the second grade pressure reducer, meantime, expand the scope of services and efficacy of the medical equipment. K91 GCS improvement after hyperbaric oxygen therapy in traumatic brain injury Yue Yao, Fei Li, Mei Li, Xiaoqin Du, Hua Feng HBOT Center of Southwest Hospital, Third Military Medical University Chongqing, China Objectives: To observe the effects of hyperbaric oxygen therapy (HBOT) on Glasgow coma scale (GCS) in patients with traumatic brain injury (TBI) and the influences of course and initiating time of HBOT on the therapeutic effects. Methods: 105 cases of TBI patients, which performed HBOT more than 30 days in HBOT Center of Southwest Hospital, were analyzed retrospectively. The GCS improvements were compared with 29 cases of TBI patients without HBOT during the same period. They were also compared between patients with different severity, initiating times and courses of HBOT. Results: The GCS improvement of patients with HBOT was 3.97±2.65, especially in severe TBI patients (5.22±2.49), Both were higher than that without HBOT (2.38±2.16) (P<0.01); The outcome was better in patients with HBOT course over 50 days (5.03±2.95) than that less than 50 days (3.32±2.27)(P<0.01); When HBOT could be initiated in 30 days it was 4.79±2.64, higher than initiated after 30 days (3.00±2.34) (P<0.01). Conclusions: HBOT can improve GCS of patients with TBI. It is beneficial to initiate HBOT as early as possible, and the course of HBOT should better not less than 30 days. K92 Hyperbaric oxygen therapy a case of cortical blindness after coronary angiography HouCheng Li, Yu Liu, HongMei Zhang, XiuYun Wu, HongPing Ning, Ming Zhu Tai He Hospital affiliated to Yunyang Medical College, Shiyan, Hubei, China A 65-year-old male, at 14:30 on November 27, 2007, because of "coronary atherosclerosis sclerosis", the femoral artery catheterization, coronary angiography (CAG) + cerebral angiography. No appeal of discomfort, returned to the sickroom after 1 h, the sense of dizziness, following a looking at things fuzzy, flu-gradually disappeared, binocular vision loss. Immediately to expand the blood vessels and lowering blood pressure and dealing with symptoms, rapid rehydration promote contrast agent excretion. Condition not improved, the eye fundus examination by urgent consultations "Bilateral ischemic optic disc lesions,bilateral retinal artery embolization incomplete." Immediately to hyperbaric oxygen therapy to improve the retina and optic nerve head ischemic changes, delaying the process of blinding. Treatment of pressure 0.2 Mpa (2ATA), oxygen absorption 60 min (30 〃 × 2 +10 〃), the middle rest 10 min. The second time after treatment in patients with eyes bright sense of self, in the third treatment, her eyes turning to the people, can clear five fingers.through 20 treatments, binocular vision for the inveatigation Vos1.2, Vod1.0,cured and discharged from hospital. HBO can quickly increase blood oxygen, extend the diffusion distance of the oxygen in the organization , quickly improve and rectify the the hypoxic state of eyes fundus organizations , rapid restoration of visual function, and saved the eyesight of the eyes. K93 The Summary of Sudden Deafness Treated By High Baric Oxygen Zhang Denghua Affiliated Hospital of Inner Mongolia Medical College, Huhehaote, China Objective: To understand the present condition of sudden deafness use of high baric oxygen in our country.And all treatment method. Evaluate its result. Method: Collection 200 articles (1999 -2008) about high baric oxygen treatment sudden deafness with computer In the period of january in. Reading about it, understand the method of high baric oxygen treatment sudden deafness.and revalue its quantity. Result: Introduced the new exhibition in recent 2 years: The sudden deafness is near concern to the hemal supply. high baric oxygen treatment can recover the cell function, and can be used as the first choice. The result is better after a week falling ill. Establish an animal model for suddcn-onsct sensorincural hearing loss(SSNH L). Administration of 3-NP the inner ear through the round window membrane can reproduce the clinical manifestation of SSNHL, and spiral ganglion damage is most prominent pathological change in this model. Emphasize the result of 3 thesises that announce recent 2 years, in those thesises, research objects are the patients each from of author’s hospital. The group of drugs to be for constract and the group of high baric oxygen and drugs to be for exprement. They use the standard diagnosis and treatment .And use to statistics . All the conclusions are positiv. Treating drugs choose from 200 thesises. 45kind drugs are divided into 5 types: The drugs of blood vessel expansion are 25 kind; The drugs lowering the blood’s glue are 6 kind; Other are 15 kind.Special treatments are 12 kinds. Conclusion: The data is dependable in 3 thesises; the case's number is enough, the method that handles the data is right. The conclusion is dependable therefore.It is importance for group of constract.The research using single drug is more reasonable than reunite of treatment. To choos the best method is one mission in the future. K94 Clinical Research on Treating Diabetic Foot with Hyperbaric Oxygen Combined with 654-2 Yang Jinhua the first Hospital of Shenyang, Liaoning, China Objective: To evaluate the curative effect of hyperbaric oxygen combined with 654-2 on diabetic foot and discuss the new effective therapy for treating diabetic foot. Methods: Divide349 cases of diabetic foot patients into treatment group and hyperbaric oxygen group,654-2 group and normal treatment group. The treatment group is treated with hyperbaric oxygen combined with 654-2 and compared with other groups. Results: The curative effect and examination index of the group treated by hyperbaric oxygen combined with 654-2 are significantly superior to that of other groups (p ﹤ 0.01) . cure rate and whole effective rate distinguish to 69.64%, 100%, 34.09%, 80.68%, 30.16%, 75.35%, 24.42%, 40.7%, Conclusion: The therapy of hyperbaric oxygen combined with 654-2 has distinct effect on treating diabetic foot, no reports regarding this new therapy have been published in our country or foreign countries. Therefore, further research, promotion and application should be made for the therapy. K95 The change and significance on the contents of serum interrelated kinases in patients with sever acute CO poisoning during the time of hyperbaric oxygen in treating myocardial damage Hongtu Zhou, Jianguo Yuan, Xuechun Zhang The Affiliated Hospital of Jiangsu University, Nanjing, China Objective: To observe the change of serum interrelated kinases in patients with severe acute carbon monoxide poisoning (ACOP) during the time of hyperbaric oxygen (HBO) treatment. To investigate the mechanism and the effect of HBO in treating myocardial damage. To probe the regular pattern of creatine kinase(CK),and its isoenzyme(CK—MB) during the time of HBO and to evaluate the therapeutic effect of HBO. Methods: The consciousness of 32 patients with severe ACOP was assessed with Glasgow scale 3-7,immediately after the 1,3,5,10st time HBO therapy. At the same time, these patients had a ECG examination. There were another 30 healthy volunteers as normal controls, the contents of serum kinases were measured. Results: With the HBO treatment time goes up, the patients’ ECG return to normal and the contents of serum CK,CK-MB were significant decrease(p<0.01). Conclusion: The myocardial damage of patients with severe ACOP can return to normal with HBO treatment. K96 Effects of hyperbaric oxygen on idiopathic sudden sensorineural hearing loss complicated by vertebral artery type of cervical spondylosis Hongtu Zhou, Xiaoping Guo, Wenjie Tan, Jiangguo Yuan, Xuechun Zhang Affiliated Hospital of Jiangsu University, Nanjing, China Objective: To investigate the clinical effect of the synthetic treatment of hyperbaric oxygen (HBO) by vertebral artery type of cervical spondylosis (VA-CS) resulted in idiopathic sudden sensorineural hearing loss (ISSNHL). Methods: 105 ISSNHL patients with VA-CS resulted in vertebrobasilar arterial insufficiency (VAI) weredivided into two groups, the firstgroup includes 59 patients of treatment of HBO and drug is contrast group, the second group includes 46 patients of treatment of HBO and cervical vertebra traction is HBO colligation treatment group. Results: The total effective rate of two groups are 91.5% and 97.8% (P﹥0.05) . The cure rate of two groups are 30.5% and 62.5% (P <0.01). Half year later, the recurrence rate of follow-up patients of two groups are 33.3% and 6.7% (P<0.05). Conclusions: HBO is one of effective methods to treat ISSNHL. HBO colligation treatment can increase the cure rate and decrease the recurrence rate. K97 Effects of cervical vertebra traction combined hyperbaric oxygen therapy on vertebral artery type of cervical spondylosis Hongtu Zhou, Wenjie Tan, Jianguo Yuan, Xuechun Zhan g, Tiecheng Shen Affiliated Hospital of Jiangsu University, Nanjing, China Objective: To investigate the clinical effect of hyperbaric oxygen (HBO) combined cervical vertebra traction treatment on vertebral artery type of cervical spondylosis (VA-CS). Methods: 168 patients with VA-CS weredivided randomlyinto three groups: cervical vertebra traction treatment group (group A), 62 cases; HBO treatment group (group B), 48 cases; and cervical vertebra traction combined HBO treatment group (group C), 58 cases. The patients in each group were treated according to designated protocols, and the therapeutic effects were compared among the groups. Results: The total effective rates of three groups were 80.6%, 93.8% and 97.8% respectively. The effective rate of group C was significantly better than that of group A (PPP<0.01). Conclusions: It is suggested that cervical vertebra traction combinedHBO therapy is an effective method for treatment of VA-CS. The general rehabilitation care can increase the cure rate and decrease the recurrence rate. K98 The analysis of clinical effect to hyperbaric oxygen treatment on 23 cases of acute osteofascial cornpartment syndrome. . Zhou Dun First Affiliated Hospital to Liaoning Medical University, Shenyang, China Objective: To analysis the clinical effect of the hyperbaric oxygen (HBO) treatment of acute osteofascial compartment syndmne (OFCS). Methods: 23 cases were recepted the HBO therapy. Results: The treatment effect was positive correlation with starting time ,the effect of starting treatment within 24 hour was better then beyond 24 hour(P<0.05). Conclusions: Some of cases, which had been treated by HBO therapy in time were avoided the fascial relief incision or amputation with satisfactory results. K99 Therapy on injury of brain by HBO together with acupuncture & healing course Ming Zhong, Xueqing Wang, Ping Li The Fifth Affiliated Hospital of Sun Yat-sen University, Guangzhou Objective: Figure out the clinical effect of therapy on injury of brain by HBO together with acupuncture & healing course. Methods: 48 cases of brain injury to patients were randomly divided into two groups with 22 in group A which was for comparison and 26 in group B which was for observation. The group A received high-pressure oxygen and drug treatment only, the Group B got acupuncture treatment and healing course besides the treatment of the group A. Inducted the Barthel index (MBI) to assess the basic ability in normal life as well as neurological defects and score Fugl-Meyer motor function score (MFA) before and after these four weeks. Results: After four weeks of treatment, MBI, neurological impairment and FMA of both two groups have improved, with significant differences (P <0.01). Compared group A with group B before and after four weeks, MBI, neurological deficit and physically FMA had a significant difference (P <0.05). After three weeks of treatment, total efficiency of group B was 92.3 percent, and that of group A was 81.8 percent, respectively, had a significant difference (P <0.05), the group B was more effective than the group A. Conclusion: It is worth further study in clinical application of therapy on injury of brain by HBO together with acupuncture & healing course basing on comprehensive analysis on the significant positive effect of neurological deficit, motor function and basic ability in normal life after this combined therapy. K100 The clinical observation and the experimental study of the effect of hyperbaric oxygen on peripheral blood stem cell 1 2 1 Chenggang Zheng , Yajing Zhu , Xiaohua Hang , 1 1 1 Yafei Pang , Hongjie Yi , Qingle Liu 1. Hyperbaric Oxygen Medical Center, The Faculty of Naval Medicine, Second Military Medical University, Shanghia, China 2. Shanghai Navy 411 Hospital, Shanghai, China Objective: To explore the effect of hyperbaric oxygen on peripheral blood stem cells in Chinese people; to explore the method in which HBO combined with colony stimulating factor is used to mobilize peripheral blood stem cells. Methods: 1. Employing routine hyperbaric oxygen treatment project, we observed the level of the + peripheral blood CD34 cells of eight patients who had received long-term hyperbaric oxygen treatment.We also + observed the level of the peripheral blood CD34 cells of eighteen patients who received hyperbaric oxygen treatment because of nervous system trauma, before and after they received hyperbaric oxygen treatment. 2. Thirty Balb/c mice were randomly and medially divided into three groups.In one group(HBO group) mice were exposed to HBO to mobilize peripheral blood stem cells. In another group (HGF group) mice were injected with granulocyte-colony stimulating factor (G-CSF) to mobilize peripheral blood stem cells. In the other group(HBO+HGF group) to mobilize peripheral blood stem cells mice that were injected with granulocyte-colony stimulating factor (G-CSF) at the same time were exposed to HBO.Before and after mobilization the gated cell Scal-1/CD34 dual-positive population was examined by flow cytometer. Results: 1. After seven times hyperbaric oxygen treatment,the absolute count of the peripheral blood + CD34 cells of the patients elevated from (1.87±1.08) 6 6 ×10 /L to (4.75±4.67) ×10 /L,2.54 times than before.After fourteen times hyperbaric oxygen treatment,the absolute + count of the peripheral blood CD34 cells of the patients is 6 (2.85±1.94) ×10 /L,1.52 times than before. After twenty times hyperbaric oxygen treatment, the absolute count of + the peripheral blood CD34 cells of the patients is 6 (3.26±3.49) ×10 /L, 1.74 times than before.Compared + with the absolute count of the peripheral blood CD34 cells of eighteen patients who did not receive hyperbaric oxygen treatment,the absolute count of the peripheral + blood CD34 cells of eight patients who had received long-term hyperbaric oxygen treatment did not show statistics difference. 2. In HBO group after mobilization the gated cell Scal-1/CD34 dual-positive population 2.01 times than before.In HGF group after mobilization the gated cell Scal-1/CD34 dual-positive population 2.66 times than before. In HBO+HGF group after mobilization the gated cell Scal-1/CD34 dual-positive population 3.76 times than before. Conclusions: Hyperbaric oxygen can mobilize peripheral blood stem cells.After seven times, fourteen times and twenty times hyperbaric oxygen + treatment, the absolute count of peripheral blood CD34 cells respectively elevates to 2.54 times, 1.52 times and 1.74 times than before.After long-term hyperbaric oxygen + exposure, the absolute count of peripheral blood CD34 cells does not elevate.HBO combined with hematopoietic growth factors could mobilize peripheral blood stem cells more efficiently. K101 Preliminary study on intratympanic dexamethasone injection to management of patients with profound sudden hearing loss 1 1 1 2 Hui Zhao , Tianyu Zhang , Jianghua Jing , Jining Luo 1. ENT Hospital, Fudan University, Shanghai, China 2. Public Health College, Fudan University Objective: to evaluate the effects of intratympanic dexamethasone injection on patients with profound sudden hearing loss. Materials and methods: All patients in the present study were profound sudden hearing loss, initial hearing loss was more than 90 dB, no previous interventions was conducted on all patients within 2 weeks onset of sudden hearing loss. Patients were assigned to 3 groups according to patients’ willness, Group I (local and general dexamethasone administration). 2. Group II (Intravenous dexamethasone injection ). 3..Group III (intratympanic dexamethasone injection). In addition, vessel dilation drugs, neurotrophy and hyperbaric oxygen therapy also conducted on all patients. Intratympanic dexamethasone (5mg/ml) injection was performed during 10 days (1 injection /2 days). Pure th th th tone test was conducted on 10 , 20 , and 30 day after intervention. Results: The factors may impact on the prognosis were matched in all three groups. The threshold improvement > 30 dB in group I was 81.82%, in group II was 83.3%, in group III was 88.64%, statistical study showed there was no significant different among 3 groups. th On the 30 day after intervention, pure tone threshold improvement was 41.36 dB in group I, 43.08 dB in group II, 51.70 dB in group III. Furthermore, pure tone threshold improvement among the 3 groups was no statistical different. Obvious hearing improvement was noted on the th 10 day after intervention, no further improvement showed after 20 day intervention. More hearing improvement was revealed in the low frequency, while in the high frequency, less hearing improvement was achieved. Conclusions: Comparison with intravenously dexamethasone injection, intratympanic dexamethasone injection did not provide more hearing improvement on patients with profound sudden hearing loss. K102 One-year efficacy of hyperbaric oxygen for the patients with acute cerebral infarction Yi Zhang, Chun-jin Gao, Huan Ge Beijing Chao-yang hospital, Beijing, China Objective: Observing one year to evaluate the efficacy of hyperbaric oxygen(HBO) for the patients with acute cerebral infarction. Methods: 192 patients with acute cerebral infarction were divided randomly into hyperbaric oxygen group and control group. The neurological impairment was scored before HBO therapy and after 20 days, 3 months, 6 months and 12 months. According to the severity of neurological impairment before therapy, each group was divided into three subgroups. Results: 1.Slight neurological impairment patients: neurological impairment scores of HBO groups were significantly lower than the scores of simultaneous control groups (P<0.05). 2. Moderate neurological impairment patients: neurological impairment scores of HBO groups after 20 days and 12 months were significantly lower than the scores of simultaneous control groups (P<0.05). 3. Sever neurological impairment patients: neurological impairment scores of the HBO group after 6 months and 12 months were significantly lower than the scores of simultaneous control groups (P<0.05). 4. Both one-year mortality and relapse rate were significantly lower in the HBO group than in control group (P<0.05). Conclusion: Early stage hyperbaric oxygen therapy can encourage neurological function recovery in one year after acute cerebral infarction and lower the one-year mortality and relapse rate. K103 Affect of the psychological intervention on parents in lower compliance with hyperbaric Yan ZHANG, Yun LIU, Gao-Gui HUANG The Children’s Hospital of Kunming, Kunming, China Objective: (HBOT) in infants and young children’s clinic. Methods: 67 parents of lower compliance in HBOT had psychological intervention. Measured with self-made compliance questionnaire, to compare the changes of before intervention and after. Results: The attitude of the parents before the intervention: 11 cases of hesitation, 34 cases of not accepting generally, 22 cases of resolutely leaving. The attitude after the intervention: 12 cases of willing to accept, 13 cases of generally accepting, 14 cases of hesitation, 12 cases of resolutely leaving. 2 (X =36.83,P<0.01). According to self-made compliance questionnaire,the score is 1.84±0.68 before intervention and 2.90±1.44 (t=-5.4454, P<0.01) after intervention. Conclusion: The psychological intervention on parents is effective to patients with the lower compliance in HBOT. To evaluate the effect of the psychological intervention on parents in the lower compliance with hyperbaric oxygen treatment. K104 Repetitive hyperbaric oxygen exposures enhance sensitivity to convulsion by upregulation of eNOS and nNOS Wenwu Liu, Kan Liu, Xuejun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China Objective: The purpose of this study was to investigate the mechanisms in increased sensitivity to convulsions and the role of nitric oxide (NO) and its synthases after repetitive HBO exposures. Methods: Mice were randomly assigned into three groups: HBO group; hyperbaric air (HBA) group and normobaric air (NBA) group. Mice in HBO or HBA group were exposed to hyperbaric oxygen or hyperbaric air respectively for 60 min twice daily for 3 consecutive days (2.5 atmosphere absolute [ATA]). 24 hours after the last exposure, mice were exposed to HBO (100% O2, 6 ATA). The latency of convulsions was recorded. In addition, the levels of NO, NADPH diaphorase, mRNA and protein expressions of NOS isoforms in hypothalamus and hippocampus were determined. Results: Latency to seizures was significantly shortened in mice after six HBO pre-exposures. The level of NO in hypothalamus in HBO group was increased. The number of NADPH-d positive cells and the levels of protein and mRNA of eNOS and nNOS in hypothalamus and hippocampus were increased. Conclusion: After repeated HBO exposures, elevated NO may enhance the sensitivity to convulsions and this may lead to seizures during the subsequent oxygen exposures. Prevention of seizures is needed when HBO is used as preconditioning method. K105 Effects of early stage hyperbaric oxygen treatment on prevention of complications in gravis type craniocerebral injury patients Zhang Ludi shanghai sixth peoples hospital Objective: to approach the effects of early stage hyperbaric oxygen treatment (HBOT) on prevention of complications in gravis type craniocerebral injury patients. Methods: total 326 cases of gravis type craniocerebral injury patients whose GCS score ≤8, among which, 244 cases were male, 82 cases were female, average age were 36.2±6.7.after consultation of HBO doctors, those who has indication for HBOT, and no counter indication for HBOT, were given HBOT simultaneously with conventional therapy, 126 cases patients who were given the first time HBOT within 2 weeks of admission or operation classed as early HBOT group. 108 cases patients who were given the first time HBO treatment after 2 weeks of admission or operation classed as late HBOT group. Among which, 92 cases patients who were not given HBOT because human factor or economy reason served as contrast group. three groups has no statistical significant difference in sex, age, and GCS score, the follow up time was within 8 weeks of admission or operation. Results: incidence rate of pulmonary infection of early HBOT group was significant lower thanlate HBOT 2 group X =13.78, P < 0.001.late HBOT group was significant lower thancontrast group, X =10.81, P < 0.005.incidence rate of gastric bleed of early HBOT group 2 was significant lower thanlate HBOT group X =7.32, P< 0.01.late HBOT group was lower than contrast group, but 2 no significant statistical difference, X =3.31, P > 0.05.incidence rate of renal function lesion of early HBOT 2 was significant lower than late HBOT group, X =7.39, P< 0.01.late HBOT group was lower than contrast group, but 2 no significant statistical difference.X =1.15,P > 0.05. Conclusions: earlier stage HBOT has significant preventive effects on complications of pulmonary infection, gastric bleed and renal function lesion in gravis type craniocerebral injury patients. 2 K106 Hyperbaric oxygen the application value which Resucitation to the cardio-pulmonary brian-A report of 136 cases Zhou Shurong 1st Affilitaed Hospital of Nanjing Medical Univerisity, Nanjing, China The hyperbaric oxygen (HBO) applies in the CPCR 136 cases, in eluding is drowing 23 cases, hanging the neck 49 cases, electric shock 3 cases, the narco-operation accident 17 cases, Adam-stoke's syndrome 1 case, the drug poisoning 6 cases, asphyxia 6 cases, cover-bedding syndrome 31 cases. Of 66 cases with cardiac arrest, 42 cases were cured, notable effective (2), improvement (1), no effect (21), and effective rate was 68.2%. Of 70 cases with no cardiac arrest, cures 64 cases, improvement (3), no effect (3) effective rate was 95.7%. Elaborated HBO treatment mechanism, HBO by its unique for oxygen way and unique mechanism, has other method of treatment the interchange ability in CPCR finally is not the success which the brain resucitation, regarding this HBO is playing the important treatment role. Reiterated in the treatment plan aspect authou before proposed about “the long treatment course HBO therapy may expect caudes some to consider in the past already is patient who hopeless decerebrate condition, so long as is not the genuine brain death, obtains the vitality” experience and idea. The CPCR case of illness suitably in the guardianshipe condition good, rescues in the well appointed large-scale HBO chamber to carry on the synthesis to treat and cure, completes accompanies the cabin work, the life symptom changes over to the stationary phase, may treat in the single pure oxygen cabin, must take the HBO in CPCR application, raises one batch to be good and under the HBO environment carrying on the rescue work the medical troops. K107 Research on the disinfection of the object surfaces in which is inside of the hyperbaric oxygen chamber and the inner surfaces of its oxygen venting tube Zhan Hechun Daqing Petrochemical Company employee hospital, China Objective: To explore an individualized omni-bearing circulating-target technology on the disinfection of the object surfaces of the hyperbaric oxygen chamber and the inner surfaces of it’s oxygen delivery the tube to eliminate the possibility of the cross-infection it has been brought by the connection ends of the oxygen of the delivery branch tube. Methods: To use the innovative process of independently delivering oxygen in the multifunctional chamber and th-30 ozone disinfection device, which is indirectly to integrate the process disinfection technology. Under the atmospheric pressure in which is properly close the disinfected chamber’s door, shut off the inlet control valve for oxygen delivery in process flow, open the functional isolation valve of the bypass in process flow, shut off the control valve in the process flow of oxygen delivery, and start the ozone disinfunction device and oxygen delivery power device. Results: This integrated disinfection technology have reached the requirement and purpose of the target design for both the object surface in the chamber and the inner surface of oxygen venting process tube. The research shows that the integrated process disinfection technology can make unconditioned omni-bearing disinfection to the environment inside of the chamber and to the closed loop of oxygen venting tube, it’s safe and reliable, has the efficacy of the individualized disinfection, and no secondary contamination source will be produced in the chamber after disinfection. Conclusions: In the process flow of the oxygen directly delivered in the chamber, and the ozone disinfection device can not be individually used, because the process flow has no oxygen delivery power device to be equipped, so it’s difficult to have the function of the target disinfection to the inner surface of the oxygen delivery tube. In this case, although the disposable sanitary appliances for oxygen delivery are used, the occurrence of cross-infection still can’t be prevented effectively. Using this technology, a new de-bottle-necking means is equipped to the oxygen chamber project; the unconditioned and zero-risk control of cross-infection in the chamber is realized during the whole process of the treatment. K108 Evaluation of stoke with intellect and memory curative effect 1 Xuming Zhou , 1 1 1 1 Qun Cai , Xiuqing Li , Liyan Yan , Hong Li , DanHong So 2 ng 1. The Frist Peoples Hospital of Harbin, Ha’erbin, China 2. The second Peoples Hospital of Harbin, Ha’erbin, China Purpose: Detection clinic curative effect of stoke with intellect and memory for HBO. Method: There are 2 groups 132 cases stoke of intellectual deficit and hypomnesia. Comparison group adopt routine medication treatment. Except HBO group routine medication treatment under 0.25mpa absorb pure oxygen 60 mins (break 10 mins), total 20 days, checking memory quotient (MQ) and hastgama dementia scale (HDS) 2-group comparison. Between 2 groups comparison show design data of analysis of variance. Result: after 20 days treatment, HBO group and comparison group MQ value increased. Diversity is obviously. HBO group got score more than comparison group. Both of them whether before or after, diversity is significance of statistics. Conclusion: HBO can increase dispersion and tension of oxygen in blood which improve cerebral tissue and urge cerebral tissue recovery. There are protection for white matter and grey matter. After stoke intellect and memory is obvious curative effect. K109 Exploring on the management experience of hyperbaric oxygen department Shaoxia Zeng, Tao Liu, Liusi Wu, Aiqiong Feng Department of hyperbaric oxygen, the first Peoples hospital of Zhaoqing, Zhaoqing, China Objective: To explore the management work of hyperbaric oxygen department. Methods: Making and implementing various management measures of hyperbaric oxygen. Results: The general safety of medical hyperbaric oxygen therapy was component through three aspects: equipment operation safety, operating cabin safety and therapy safety; every aspect safety need the corresponding scientific management measure. Conclusion: Only the equipment operation safety, operating cabin safety and therapy safety can ensure the successfully developing of safety work on the department of hyperbaric oxygen. K110 The rational selection of equipments of breathing in oxygen on patients after Tracheotomy influencing effectiveness of hyperbaric oxygen treatment Yu Daoyuan Department of Hyperbaric Oxygeon,Jingzhou Hospital,Tongji Medical College, China Objective: To explore the rational selection of equipments of breathing in oxygen on patients after Tracheotomy with hyperbaric oxygen (HBO) treatment. Methods: 300 patients randomly divided into 2 groups: head cover group (n=150) and connected tube group (n=150) were given treatment with head cover and connected tube equipments, respectively. 209 patients who have successfully finished two periods of treatment been conducted the GCS evaluations. Results: The rates of success of finishing treatment were 99.3% in head cover group, and 59.3% in connected tube group, respectively. There was a significant statistical difference in the two groups. The GCS score in connected tube group was significantly higher than that in head cover group. Conclusions: For the patients after Tracheotomy with HBO treatment, the curative effect of selecting connected tube is better than that of using head cover. They should choose to use connected tube to absorb oxygen first, and they may choose using head cover only if they can not finish the treatment. K111 Effects of early hyperbaric oxygen therapy on function recovery in patients with incomplete cervical spinal cord injury Yu Youjie Department of Hyperbaric oxygen, People’s Hospital of Guangdong Province, Guangzhou, China Objective: To investigate the effect of early hyperbaric oxygen therapy on function recovery in cervical spinal cord injury patients. Method: 72 patients were randomly divided into early hyperbaric oxygen therapy group (E, 36 cases) and late hyperbaric oxygen therapy group (L,36 cases).The patients in both groups received the similar rehabilitation and medicine treatment. The effects were assessed by the American Spine Injury Association (ASIA) motor scores, sensory scores and somatosensory evoked potentials (SEP). Result: There was no difference between two groups before treatment (P>0 05), and the ASIA motor scores improved significantly after treatment (group E P<0.001, group L P<0.05), but the scores of the group E was significantly higher than that of the group L (P<0.01). The ASIA sensory scores improved significantly after treatment (group E P<0.005, group L P<0.05), but the scores of the group E was significantly higher than that of the group L (P<0.05). The SEP of the group E improved significantly than that of the group L (P<0.05). Conclusion: Hyperbaric oxygen therapy can facilitate the function recovery, and it is better to interfere early. K112 Curative effects of hyperbaric oxygen (HBO) combined with manipulative therapies on limb dysfunction after traumatic head injury Ning Yu, Jian Lu Department of Hyperbaric Oxygen, The Second People’s hospital of Nangning, Guangxi, China Objective: To investigate curative effects of hyperbaric oxygen (HBO)combined with manipulative therapies on limb dysfunction after traumatic head injury. Methods: 160 patients were randomly divided into two groups according to time of admission: therapy group and control group. The therapy group were treated with HBO and manipulative therapies , the control group were treated with only HBO. Fugl-Meye scores and Brunnstrom grades were performed before treatment, as well as after 4 and 8 courses of treatment. Results: The Fugl-Meye scores and Brunnstrom grades of therapy group are obviously higher than that of the control group. There were significant differences between two groups ( p<0.05.).Conclusions: The curative effects of HBO combined with manipulative therapies on limb dysfunction after traumatic head injury are better. K113 Effect of hyperbaric oxygen on the MetHb concentration in patients with acute carbon monoxide poisoning 1 2 3 2 Shifu Yin , Chunjin Gao , Peisong Wang , Huan Ge , Lin 2 1 1 Yang , Yongping Xie , Ruquan Jin , 1 Jianmin Liu 1. Gaomi peoples hospital, Shandong, China 2. Beijing Chaoyang Hospital; Capital University of Medical Science, Beijing, China 3. Department of HBO; Qingdao University Affiliated Hospital, China Objectives: To study the relationship between acute carbon monoxide poisoning g and methemoglobin and the influence of hyperbaric oxygen (HBO) on them, and to approach the mechanism of acute carbon monoxide poisoning. At the same time, it gives the new way to the clinical treatment of ACOP. Methods: The ACOP group contains 195 patients, divided into the normobaric oxygen (NBO) group and the HBO group. The NBO group contains 97 patients, including 66 mild poisoning patients, 21 midrange poisoning patient s and 10 severe poisoning patients; The HBO group contains 98 patients, including 63 mild poisoning patients, 23 midrange poisoning patients and 12 severe poisoning patients. The Normal control group contains 191 health adults. Detect the MetHb and COHb concentrations both before treatment and after treatment in each group and further restriction analysis were performed. Results: The MetHb concentration is much higher in ACOP group than that in normal control group (P <0.01). There is dependability between COHb concentration and MetHb concentration in ACOP group before treatment (R =0.418, P <0.01). The MetHb concentration was much lower after HBO treatment than before HBO treatment in ACOP group (P <0.01).To mild and midrange ACOP patients, the MetHb concentration decrease d more significantly in HBO group than that in NBO group (P <0.05). Conclusions: The MetHb is probably one of the most important mechanisms to result in ACOP and makes it serious. HBO has significant curative effect on decreasing MetHb concentration. K114 The nervous system of children infected with the recovery of hyperbaric oxygen therapy clinical observation Yang Zhen Tianjin Children Hospital, Tianjin, China Objective: To observe the high-pressure oxygen treatment on the nervous system in children infected with the clinical significance. Method: 53 cases of the nervous system of children infected with hyperbaric oxygen therapy, the use of hyperbaric oxygen therapy at the same time to give anti-infection, nerve cell activity vasodilative drugs and anti-virus drugs symptomatic treatment. Pressure to 0.06-0.1 Mpa, Regulators 30 minutes each for one hour, day, 10 times for treatment, a total of three treatments, oxygen concentration in more than 80 percent. Results: high-pressure oxygen treatment of viral encephalitis after the cure rate is 64.10 percent with 25.64 percent efficiency of 10.25 percent efficiency rate of 83.33 percent of cerebral infarction recovered 16.66 percent efficient brain trauma recovery rate was 75% 25% efficiency of high-pressure oxygen treatment of the nervous system The total infection rate was 97.34 percent. Conclusion: The nervous system infection in children is common in pediatric clinical disease, cerebral vascular disease by the virus or the disease directly caused by brain injury with diffuse inflammation and vascular damage, resulting in brain tissue cycle of obstacles and edema, increased intracranial pressure So that the brain tissue of oxygen and blood supply for the anomaly, a serious disease can be accompanied by a coma. Thus leading to its dominant regional campaign, feeling the loss of function and language, intellectual development have tremendous impact. Through high-pressure oxygen treatment of the nervous system infections in the clinical observation of clinical symptoms improved significantly shorten the duration and reduce the rate of invalidity, the resumption of intelligence, thereby enhancing their quality of life, high-pressure oxygen can be used as the nervous system in children infected with an effective Treatment. K115 8 age,male,traffic accident resulted in primary brain stem infury. Glasgow grade 5. Revivaled after hyperbaric oxygen treatment. Clinic materials: 1. Case introduction: The cases involved burn inpatients in our hospital from Mar 2006 to Aug 2007. Among them, there are 36 male and 20 female with the age range from 1-13 years old and average 3.6±2.8 years old. The percentage of burn area to total area is between 10-40 and the average percentage is 15.1±6.9. They are all healthy before encountering wound and have not aspiration injury. 2. Therapeutic methods: The 56 patients are randomly divided into two groups: the treatment group (A group n=28) and control group (B group n=28). The patients of control group are treated only by locally applying Fulikang ointment while those of treatment group accepted the treatment of local Fulikang ointment plus hyperbaric oxygen (HBO). 3. HBO treatment: Patients of A group accept 100% oxygen breathing by masks for 80min, once or twice a day. We stimulated 10d as a therapeutic period and patients were arranged therapy according to the healing condition of wound surface. Normally, one or two therapeutic period were needed. 4. Assessment Indicator: The information involving the average healing time of wound surface, average inpatient day, the size, thick, rigidity and color of scar, the symptom of patients and the number of patients who needed operation were collected as the assessment indicator. 5. Statistical analysis: All the data were analyzed by t test and P<0.05 was considered to be statistically significant. Result: According to the clinic observation, in comparison to B group, the scars of A group were rosiness or white, soften, thin, smooth surface and few pain and itch. And also our findings showed accelerated healing of wound surface and reduced average inpatient day of group A. Only 2 patients of group A needed flap operation and have achieved the success in the first operation, while 9 cases needed operation in B group and among them, the operation of 2 patients were failing. The second operation was successful under the help of 10 times HBO therapy. Discussion: HBO has the following therapeutic effect according to pervious study: 1) Increasing the local blood oxygen pressure, relieving or even rectifying tissue hypoxia, reducing edema and improving blood flow; 2) HBO is conducive to abating flap necrosis and enhancing flap survival; 3) In terms of scar formation, the HBO-treated skins represent light-color, soft texture and few pain and itch; 4) Curbing the growth of some kinds of bacteria. To sum up, HBO is beneficial to the healing of second-degree burn wound surface in the respect of few usage of plasma and albumin, low occurrence of shock and scar formation, reduced tissue necrosism, edema, wound infection and blood poisoning, average inpatient day and the total expense, accelerated wound healing and operative success rate. K116 Clinic Observation of Hyperbaric Oxygen Promoting the Healing of Wound Surface of Second-degree Burn Patients 1 2 X-L Yang , Y-J Deng 1. the Department of Hyperbaric Oxygen, Ganzhou Municipal Hospital, Ganzhou, Jiangxi province, China 2. the Department of Burn, Ganzhou Municipal Hospital, Ganzhou, Jiangxi province, China K117 Hyperbaric oxygen treatment pontine brain contusion and a case of dissolution of myelin Yang Wenping Huai’an Second People’s Hospital, Jiangsu, China Patient: male, 52-year-old, riding on bicycle, the patient accidentally fell down and lead to brain contusion and Obstructive hydrocephalus. The local hospital committed after the effects of poor drainage ventricle and complicated by lung infection. On October 31, 2006 the patient was transferred to our hospital. Through physical examination, the body temperature was 37.8°, unconscious, vertical eyes open, body activities disappeared, mouth activities restricted, lung large number of Romanian-moist, having heart rate, limb extension reducing, muscle strength 0, limb tendon hyperre flexia, Bilateral pathological levy negative, liver damage, blood being in lower potassium, sodium, chlorine. The right lower chest film pneumonia, head CT right frontal lobe brain damage, hydrocephalus, low-density pontine lesions. Through 10-days anti-infection treatment, to dehydration, lung infection was under control, but the nervous system symptoms had not improved. The MRI inspection pontine basement of T1 and T2-signal, the patient had 15-years drinking habit, he drunk about 1000 ML every day. Considering chronic alcoholism liver and brain damage after myelin lead to the dissolution of the CPM, the patient was immediately cured by high-pressure oxygen treatment.0.2 ~ 0.23MPa O2 30’×2+10’. During high-pressure oxygen treatment, first three days, twice a day, then once a day, ten days treatment for one course. After the first time of high-pressure oxygen treatment, the patient was conscious and could eyes could open and committed activities as soon as the patient went out of the capsule. But 2 days later the patient went unconscious yet till one week later he went back conscious again. After 15-times high-pressure oxygen treatment, the patient could nodded to his family members. After 22-times treatment, the patient could communicate with his family members in simple speech removing of the trachea, taking in flowing food; the right upper limb muscle strength reached 1 level. Since then the treatment method was changed into a single-capsule pure oxygen chamber. After 4 treatment courses, four limbs muscle tension increased and muscle strength reached 2 level and liver function was normal. After 6 treatment courses, with the help of others, the patient could walk by himself, self-consumption, muscle strength reached 4 level, MRI basically normal, after six months out of the hospital, the patient fully recovered and could go back to work. From this case we have made the conclusion that high-pressure oxygen treatment can not only have the effective in the treatment of brain injury and also have the effective for recovery of CPM treatment. High-pressure oxygen treatment can be used as an effective means and recommended for promoting in clinical practice. K118 Nursing care of cerebrovascular disease patient with hyperbaric oxygen treatment Yang Qunfang Wuhan Union Hospital, Wuhan, China Objective: To observe the nursing effect of the cerebrovascular disease patients with treatment of hyperbaric oxygen (HBO). Methods: 150 cases receiving drug therapy were treated with HBO. With the measures of comprehensive care, observing during HBO treatment and uninterrupted treatment, so to enhance the effect. Results: Cured 19 cases, obviously effective 45 cases, effective 73 cases, invalid 13 cases. The total effective rate is 91.3%. Conclusion: Under the effective nursing, there is obvious effect of cerebrovascular disease patients with treatment of HBO. K119 The effect of hyperbaric oxygen treatment on the coagulation-fibrinolytic system in the patients of ischemic strok 1 2 1 1 Lin Yang , Wei Wang , Chunjin Gao , Baosen Pang , 1 Zhuo Li 1. Beijing Chao Yang Hospital, Beijing, China 2. The Third Hospital of Hebei Medical University, Shijiazhuang, China Objective To investigate the effects of hyperbaric oxygen treatment on the Coagulation-Fibrinolytic System in the patients of ischemic stroke. Methods 137 patients with acute ischemic stroke were divided randomly into routine therapy group(routine group) ,hyperbaric oxygen therapygroup(HBO group). There were 27 healthy volunteers in control group (control group). We measured the plasm concentration of AT-III, TM, uPA and uPAR respectively in the patients with ischemic stroke on the 1stand 11thday after admission. Results Compared with the control group , the plasm concentration of the routine group on the 1st day, the 11th day of AT-III decreased,TM and uPAR increased;the plasm concentration of the HBO group on the 1st day of AT-III decreased , the plasm concentration of TM, uPAR of the HBO group on the 1st day, the 11th day increased (P<0.01) ,TM decreased (P<0.05) .Conclusion In the patients of acute ischemic stroke, hyperbaric oxygen treatment can increase the plasm level of AT-III, and decrease the plasm level of TM and uPAR. Thus hyperbaric oxygen treatment can effectively improve the function of coagulation-fibrinolytic system in the patients with ischemic stroke, and may ameliorate therapeutic effect. K120 The Clinical Analysis of the Hyperbaric Oxygen Therapy in the Patients with Acute Cerebral Infarction Lin Yang Chunjin Gao Huan Ge Lianhua Wu Liming Zhao Beijing Chao Yang Hospital Objective To investigate the effect of hyperbaric oxygen therapy (HBOT) on the patients contracting acute cerebral infarction(ACI) and to proceed the clinical analysis. Methods Retrospective study was done in 466 hospitalized patients suffered from ACI from Jan. of 2000 to Feb. of 2005.The patients was divided into HBOT plus drug therapy group (HBO group ):303 cases and drug therapy group (control group ):163 cases. By using “The European Stroke Scale” (ESS) to score the patients of HBO group before and after HBOT and to score the patients of control group after hospitalization and before discharge. Then HBO group was compared with control group. Results For the severe and the moderate ACI, the score difference of HBO group being compared with control group were considerably significant (P10) being compared with control group was significant (P<0.05) .Conclusion Clearly HBOT had a certain effect on severe,moderate ACI and vertebra-arteria basilaris ACI which were better than drug therapy. The effect on treatment times of HBOT >10 was better than that of treatment times ≤10. K121 Influence of hyperbaric oxygen on the value of memory quotient and Hastgawa dementia scale in patients with radiation encephalopathy Yuan Jing The people’s hospital of zhangjiajie, Hunan, China Objective: To evaluate the effect of hyperbaric oxygen treatment on patient with radiation encephalopathy. To study the changes of the value memory quotient (MQ) and Hastgawa dementia scale (HDS) in patients with radiation encephalopathy pre-and post hyperbaric oxygen treatment and its value. Method : 60 patients with radiation encephalopathy were divided into two groups randomely, hyperbaric oxygen treatment group and control group. The values of MQ, HDS in 60 patients were measured pre-and post three courses of treament. Result : The total effective rate of hyperbaric oxygen treatment groups was 86.6% that of control group was 60.0%, hyperbaric oxygen treatment group had a good recovery. After three courses of treatment, the scale of MQ, HDS was increased in both groups, but there was significant difference between two groups (P<0.05), hyperbaric oxygen treatment group was obvious higher than control group. Conclusion: :The treating effect of hyperbaric oxygen combined with drug is much better than that of drug only and hyperbaric oxygen can further increase the value of MQ, HDS, HBO may be of use in the clinical treatment of RE patients and would benefit from further study. carbon monoxide poisoning; pregnant; hypokalemia; hepatitis B virus carriers. Glycerol fructose, Cerebrolysin Vial and hyperbaric oxygen therapy were given. treatment plan of HBO: pressure of 0.2 Mpa (2.0ATA), oxygen 30 min × 2 + air 10 min, time of therapy is 110 min, which boost 20 min, deboost 20 min.in the first three days ,2 / day. Later it changed to 1 / days. In the end it took 22 times. on May 1 the patients recovered and were discharged cesarean a healthy boy. 2 Discussion Whether pregnant woman after carbon monoxide poisoning can receive hyperbaric oxygen therapy is still remaining disputes. We believe it should be done . The mechanism may be in: HBO can increase the oxygen concentration and blood oxygen tension.It can correct hypoxia, and promote increasing of amniotic fluid, improve foetus development and metabolism. HBO can improve uterine blood supply and delay of blood flow so that enhancing the mother-child functional system and placental function. HBO promote gonadal hormones, the formation of the placenta villi blood vessels and the function of adrenaline. It conducive to development of the placentai.The mother’s functions of vital organs can be also improved. It should be noted: hyperbaric oxygen therapy must be done in time, combined therapy is important. to observe the condition changes intimately. Essential exam must be done before and after HBO therapy and Good record must be done. B-monitoring should be monitored. premature babies to high-pressure oxygen therapy can occur eyes of oxygen poisoning. Therefore hyperbaric oxygen therapy treatment to late trimester of pregnancy should not be too long and should be controlled within 1-2 courses. K123 Comparison of therapeutic effects of HBOT on Severe Brain Injury under 0.15MPa and 0.2MPa Chen Jian-hui Zhongshan City People's Hospital, Affiliated Zhongshan Hospital of Zhongshan University, Zhongshan, Guangdong Province, China K122 Hyperbaric oxygen treatment in late pregnancy of acute carbon monoxide poisoning PENG Ya, YANG Yulan Guilin, Guangxi NO181 People's Liberation Army Hospital Hyperbaric Oxygen Center March 2008, one case we treated successfully of acute carbon monoxide poisoning in late pregnancy, are reported as follows: 1、Case record, F, 23, were unconsciousness after bath a day before hospitalized. Physical exam: T:36.7 , HR:90 cpm, RR: 20 cpm, BP: 110/78 mmHg. Pregnant for 7 months. Auxiliary examination: obstetric B-ultrasound showed: fetal heart rate 158 cpm, good movements. ALT (26 u / l), GOT (46 u / l), HBsAg(+),potassium (3.27 mmol / l) other routine examinations were normal. Admission diagnosis: Objective: To compare the efficacy of hyperbaric oxygen at various pressure on severe brain injury,and to choose the most reasonable protocol for this desease. Methods: The 133 cases of severe brain injury were divided into two groups randomly, and they were treated once every day by the monoplace chamber. One session a day, ten sessions for one course, all together 30 sesssions for one patient. But the group A (67 cases) was treated at 0.15MPa for 60~70 minutes, and the group B (66 cases) was treated at 0.2MPa for 80~90 minutes. We explored the consciousness and reactions of these patients when they were treated, and reexamine head CT and pass judgment on GCS after each course of treatment is finished. Results: There were no significant difference between group A and group B in the duration of unconsciousness, aphasia and Absorption of intracranial K125 Development of a new inhalation model in hyperbaric oxygen chamber, An Cui, Peisong Wang Linyi City People's Hospital, HBO department Qingdao Medical College Hospital, HBO department hematoma. Conclusions: There were no significant difference in the efficacy of HBOT on severe brain injury between the protocols at 0.15MPa and 0.2MPa. So considering the shorter duration of treatment and the less therapeutic cost we think the lower-pressure protocol is better which can treat more patients with the limited resourcs. K124 Hyperbaric oxygen rescue a case of pulmonary embolism Li Lingfang Hyperbaric oxygen chamber,Liaoning Provincial General Hospital of Fushun Mining Bureau A 67-year-old female Patient suddenly occured difficulty in breathing, obvious cyanosis, pale face, mydriasis, state-dead in the second day after cholecystectomy. Multi-parameter monitoring showed that: BP60/40mmHg, P139 per minute, R30 per minute, So258%. Electrocardiogram showed: sinus tachycardia, atrial premature, imperfect right bundle branch block. X chest film: the thinning of the texture in the inferior lobe of right lung . The patient was diagnosed as acute pulmonary embolism, the vital signs were stable after rescue. But from December 20 to December 23, the patient was in a coma, on ventilator to maintain vital signs stable. The first hyperbaric oxygen treatment was given in the first 10 days after onset. The pressure was 1.8 ATA, 15 minutes for compression, oxygen inhalation (monoplace champer) for 50 minutes, intercalary washing for five minutes, decompression for 20 minutes. After one session of HBO, the patient can open her eyes by calling. After more than 40 times HBO, the patient was consciousness, not only can open eyes and speak, but also can answer simple questions. Discussion: HBO can decrease blood viscosity, improve ischemia in embolized regional, and reduce pulmonary avascular necrosis of embolism organizations, and can reduce pulmonary edema and improve the organs of the state of hypoxia, control the occurrence of shock, can reduce brain swelling and the brain tissue hypoxia damage, improve function of the network structure . The HBO therapy promote comatose patients to regain consciousness . The HBO therapy plays an important role in the rescue of patients with pulmonary embolism. The authors triturate a simple breathing patterns in HBO champer for adults to inhale oxygen and exhale own carbon dioxide at the same time. See attached map. Principle: Setting that the alveolar ventilation is 350 ml. connecting a hard hollow plastic ball , diameter 8.3 cm and volume 300 ml(including the space between mouth and nose mask) ,between the original oxygen masks and Y-piece. Patients wear oxygen masks for absorption Less than 200 kpa, at the end of each exhalation there is 300 ml alveolar gas for next inhalation within the hollow ball. The carbon dioxide concentration of alveolar gas is 2.5 percent in the 200 kpa, the carbon dioxide concentration of inhalation alveolar gas = 300 × 2.5% ÷ 350 = 2%. Due to oxygen consumption, oxygen in the hollow ball is less than 200 kpa, while hollow ball volume is less than the volume of alveolar ventilation, so when inhale , the oxygen through the pipeline influx into the hollow ball beacuse of difference of partial pressure of oxygen and in order to maintain enough alveolar ventilation, on the end of inhale the oxygen concentration reached 98 percent. Unless the alveolar ventilation is on big changes, we can maintain the relative stability of the concentration of oxygen and carbon dioxide concentration. That is, when the oxygen content increasing, the reinhalation of carbon dioxide can increase blood flow to further improve hypoxia. Comparising the new and old breathing patterns by simulation experiments, there is no obviously difference. K126 Non-resistance oxygen therapy device in mulitplace oxygen chamber Yu Xuelai department of hyperbaric oxygen Nanjing Zijin Hospital The principle of non- resistance device for oxygen therapy used gradient pressure for inhale and exhale oxygen. Oxygen pathway: gas source -control board -humidification bottles -flow meter - Simulation of the lung - masks (the trigeminal) - patients - oxygen pipeline outdoors. The patients suitable for non-resistance device for oxygen therapy are including : 1.The patients can breath without ventilator. The patients whose Respiratory function were relatively poor .2. The high paraplegia patients can breath spontaneously whose respiratory function were relatively poor.3. Coma patients can breath spontaneously.4 . patients whose respiratory center is damaged can breath spontaneously. 5 the patients with fractures of the ribs .6 coma patients with tracheotomy and the patients can move by order .7 the patients can use luge type ventilator. The advantage is: easy to operate. Oxygen without resistance. Patient can inhale pure oxygen. Cabin oxygen concentration is not raised. The steps to opreat non-resistance oxygen therapy device: 1. Redeploye the pressure of the gas source to 4.0-6.0 Mp. 2. open the oxygen valve. 3. guide the accompanying staff to open flowmeter the flow to 400-600 ml, the flow of children is depended on the tidal volume. 4. accompanying staff link oxygen masks and bellows (trigeminal tube) to the patient. The gas path of non-resistance device for oxygen therapy is sealed so the gas is pure oxygen. The first class oxygen concentration is 21% +4 × flow / L. treatment. Control group (B group n=21): the course of disease was above ten days, the patients’ condition was rather stable and their vital sign was normal. The course of their disease was the stage of rehabilitation. Contrast the two groups’ effect. Result: The effective rate of A group is significantly higher than that of B group.(p<0.05) Conclusion: Earlier and multi-course of hyperbaric oxygen treatment can shorten awake time, improve conscious disturbance, elevate healing rate, lower disability of disease and raise patient’s quality of life. K127 HBO cured a case of amnesia PAN Lin HBO department of Tianjin Hexi Hospital K129 hyperbaric oxygen treatment on 3 cases of anesthetic accident coma Maoxing Yan The department of hyperbaric oxygen, the hospital affiliated to neimenggu medical college 300202 The patients is male, 21 years old. memory loss because of losing his love.He had severe insomnia, did not know his family members and classmates, who did not know where he is, did not remember the address, the skull. His MRI is normal, so he was diagnosed reactive disorder. Neither western medicine nor traditional Chinese medicine took effect. So he came to our hospital and tried hyperbaric oxygen therapy. two days later, his sleep improved markedly, and his memory recovered.10 days after the full restoration he returned normal and went back to school. Principle of hyperbaric oxygen treatment: high-pressure of oxygen can increase the blood flow of vertebral artery ,and increase the relative oxygen partial pressure of the brainstem reticular activating system. It can activate neural activity, increase excitatory in EEG and the number of fast wave , and extent of frequency.in 0.25 Mpa ,HBO improve the activities of cytochrome oxidase and Na +-K +-ATP ,at the same time, it keep the balance of Na + / Ca2 +, reducing the flow of intracellular, reducing intracellular calcium overload.It normalizes the cellular membrane’s function . HBO improves metabolism in sugar, fats, amino acid and water, keep electrolyte and acid-base balances, increases the target cells number and functions of insulin receptors. K128 The hyperbaric oxygen treatment in diffuse axonal injury Yuanbi Yang, Zhuan Wang Hyperbaric oxygen chamber, Department of neurosurgery, The hospital affiliated to Luzhou medical college Objective: Observe the clinical effect of hyperbaric oxygen treatment on diffuse axonal injury, approach the suitable therapy opportunity and method. Method: According to patient's condition and course of disease, Forty-two patients with diffuse axonal injury were randomly divided into two groups: Earlier hyperbaric oxygen treatment group(A group n=21): the course of disease was from three to seven days, the patients separated themselves from life danger under drug control or post-operation, then they accepted hyperbaric oxygen 3 patients with anesthetic accident coma accepted hyperbaric oxygen treatment combined with drug treatment from the year of 2005 to 2006, they were cured and discharged. 1.clinical dates: The first patient was twenty-seven year female, she accepted appendectomy under general anesthesia in April, 2005, on the way to ward, she was found respiratory arrest and immediately received cardiorespiratory resuscitation, ten minutes later, she recovered spontaneously breathing but had been deep coma state, twelve hours later, she was transferred to our hospital and immediately accepted hyperbaric oxygen treatment, the therapy pressure was 0.25Mpa, oxygen inhale 30min×2,one time per day, three days later, she was gradually clear, one weeks later, she was completely clear, two weeks later, she was cured and discharged, her brain MRI image was normal. Both the second and third patients were four year girls, they have been coma because of congenital heart disease and started to accepted hyperbaric oxygen treatment on the third day and the seventh day post-operation respectively, the therapy pressure was 0.25Mpa, oxygen inhale 30min×2, one time per day, three weeks and eight weeks respectively, one person was cured and discharged, the other was clear but remained intellectual disorder and growth retardation. 2. Discussion: Anesthetic accident primarily damages the brain and can make the brain hypoxia and edema. Hyperbaric oxygen treatment can quickly raise the pressure of blood oxygen, improve the brain hypoxia and control the development of the infernal circle of brain edema. The two patients our discussed accepted hyperbaric oxygen treatment rather earlier and got a better prognosis, two-three weeks later, they were cured and discharged. The other patient accepted hyperbaric oxygen treatment rather later and got a bad prognosis. Therefore, when we encounter the anesthetic accident, we should apply hyperbaric oxygen treatment on the patients as early as possible, which can reduce the course of disease and avoid the occurrence of the residual. Concerning the regimen of hyperbaric oxygen treatment, we all used atmosphere compression chamber in our text, the pressure is 0.20-0.25Mpa, the time of oxygen inhale is 30min×2, which can get satisfactory effect and avoid side effects. K130 Effect of Hyperbaric oxygen therapy on 210 cases of cerebral trauma Chunfang Li, Yingyu Pan People's Hospital of Haikou City 570208 Objective: To study the clinical effects of hyperbaric oxygen treatment on patients of cerebral trauma. Method: patients of cerebral trauma were divided into four groups, including: 30 cases of acute brain injury, 5 cases of persistent vegetative state, 55 cases of convalescence stage, 120 cases of sequelae stage . Results: after treatment 38 patients were cured, 110 cases were markedly effective, 50 cases improved, 12 cases had no effect, and the total efficiency was 94.3%. Conclusion:In the patients of cerebral trauma, hyperbaric oxygen therapy can promote the recovery of consciousness and reduce the sequelae. In the patients of long-term coma, persistent vegetative state and serious nerve damage, Long course of hyperbaric oxygen therapy can significantly improve the effect and prognosis. Additionly, It is most difficult to deal with the patients of severe brain injury and brain hematoma, as it frequently accompanying vicious increased intracranial pressure, the prognosis of patients with cerebral hypoxia was also poor, the early hyperbaric oxygen therapy can increase oxygen content in time to prevent the occurrence of malignant hypoxia ischemia, providing the possibility of the recovery of neurological function. Therefore the patients of cerebral trauma should be given hyperbaric oxygen therapy as early as possible, to reduce brain injury mortality and morbidity, to improve the quality of life of patients. In the 210 cases of cerebral trauma, the patients who had obvious effects after hyperbaric oxygen treatment mostly were early onset of illness and not serous condition. K131 Intelligence Deciding the Therapetic Period Neonatal Hypoxic-Ischemic Encephalopathy of the relationship either between therapeutic period and effect or between therapeutic period and the rehabilitation of intelligence. In this regard, combined with the department of pediatrics, we observed the cases of HIE since 2001 consecutively. The protocol of HBO therapy is 0.03 Mpa pressure, 20min for 100% oxygen breathing, 40min total therapeutic time with twice washing chamber, once/d and ten times for a period in a single-person, pure-oxygen chamber. K132 Experience of applying the multi-parameter ECG monitor in hyperbaric oxygen chamber peiyun Li, mingzh Ma People's Hospital of Haikou City With the development of medical science, high-tech medical equipment has been used more and mor extensively in hospitals. Having the advantage of promptness, accuracy and visulization, ECG monitor play an important role in the diagnosis and treatment of cardiovascular patients and critically ill patients after surgery. It is common to use multi-parameter ECG monitor in some clinical departments, but the application of this devices in hyperbaric oxygen chamber has been rarely reported. From November 2007 to April 2008, we used PM-7000 multi-parameter ECG Monitor to observe 159 cases of critically ill patients in the hyperbaric oxygen chamber of YCQ3230-37,we have achieved good results. All the equipment are of type PM-7000 made by Shenzhen Mairui company, the monitoring procedure has been strictly followed and all the equipment components have been checked to make sure they work well, we observed and record the electrocardiogram changes. The application of ECG monitor outside the chamber give critically ill patients more oppptunity for hyperbaric oxygen treatment, expanded the scope of HBOT and improve the safety of patients in the chamber, moreover it is convinent for the medical staff to observe the patients in the chamber which is good for the treatment. W-Q Fan HaiKou People’s Hospital 570208 Neonatal hypoxic-ischemic encephalopathy (HIE), the brain damage taking place in the prenatal period, is the normal disease of pediatrics, featured by the high incidence. Destitute of immediate therapy, severe neonatal brain can lead to death, irreversible sequelae and ensuing heavy affliction to family members, increased social burden and negative effect to the population quality in our country. The treatment of HIE by hyperbaric oxygen (HBO) has been prevailing clinically and achieved better effect nowadays. However, it is still necessary to probe K133 Clinical observation of hyperbaric oxygen treatment on sixty case of neurasthenia ping yang, guiying he Kelamayi Central Hospital, Xinjiang, China Sixty patients have accepted hyperbaric oxygen treatment in our department since the year of 1991, they got distinguished effect. We report it as follow: 1 Clinical dates 1.1 General dates: 60 patients between 29 and 66 years old were included, 20 of them are male, the remains are female, the mean age of them is 47.5 year. The course of disease is between 15 days and 21 years. 1.2 clinical manifestations: easy to excited, feeling weary, sentiment, headache, wakefulness, tension, agitated, the decrease of memory, as well ad impaired concentration. EEG shows that the enhanced excitability of cortex and double side symmetry lower amplitude fast wave. 1.3 Hyperbaric oxygen treatment: The therapy pressure was 2.0 ~ 2.4ATA, the patients accepted hyperbaric oxygen treatment one time per day, oxygen inhale30/×2+5/ per time, one course of treatment was ten days. 1.4 The standard of therapeutic effect 1.4.1 Curing: The psychiatric symptom and somato-symptom of patients completely disappeared, the patients feel well and their occupation and viability can recover to anterior sickness. 1.4.2 Improvement: The psychiatric symptom and somato-symptom of patients generally disappeared, the patients can be engaged in mental and physical work. 1.4.3 Invalid: The psychiatric symptom and somato-symptom of patients remained unchanged. 1.5 Result: After 4-33 times of hyperbaric oxygen treatment,14 patients’ neurasthenia were cured,44 patients’ condition were improved, 2 patients’ condition weren’t improved, total effective rate was 96.7 percent. 2. Discussion Hyperbaric oxygen treatment can make the brain tissue obtain sufficient oxygen, improve the metabolic function of neurocyte and lower the excitability of neurocyte, which make the physiological activity of cerebral cortex gradually recover. Hyperbaric oxygen treatment can make the blood flow of vertebral artery increase, the pressure of oxygen of brain network and brain stem relatively increase, which can effectively improve the attenuation condition of the process of inhibition in cerebral cortex, also can strengthen the function of its regulating and controlling subcortex autonomic nervous system, relieve the symptom of autonomic nervous functional disorder. Hyperbaric oxygen treatment can lower the heart rate of the patients who have the symptom of cardiopalmus and pyknocardia, improve the sleep quality of the patients who have the sleep disorder, improve the senior activity of nervous system and raise psychological ability, physical capacity, intellectual ability, as well as work ability. We also discover the effect of hyperbaric oxygen treatment on man is better than woman, the short course of disease is better than the long course, the patients who accepted hyperbaric oxygen treatment combined with psychological treatment can obtain better effect. In order to help the neurasthenia patients early rehabilitate and decrease the complaints, in addition to drug treatment, we can extend and apply hyperbaric oxygen treatment on these patients. K134 high pressure oxygen treat pig streptococcicosis,one case report rongzhen wang xiaohong ding the First Affiliated Hospital, College of Medicine,Zhejiang University Case information: the patient was male, 47 years old, repeating fever for four days, with unconsciousness and seizure for two days before admission, accompanying the symptom of nausea and vomiting, head CT showed density of cerebral longitudinal fissure was high , bleeding could not be ruled out , then he was transfered to our hospital. Physical examination: temperature: 39.4 ℃, coma, and uneasy, stiff neck, muscular tension of four limbs was high, Babinski sign of two sides were suspicious positive,there were ecchymosis in four limbs. 9 Blood white blood cell count showed 19.3 × 10 / l, neutrophil leukocytes accounted for 93.5 percent, hemoculture found type 2 Streptococcus suis, confirmed Streptococcus suis disease, meningoencephalitis type. He was given dehydration, anti-inflammatory and rehydration treatment.He was still unclear after 10 days, then he received hyperbaric oxygen therapy, once every day, 80 minutes of oxygen inhalation each time, the middle rest of l0 minutes, the absolute pressure was 2.2 ATA, he was in the dim awareness after five days, he had reaction to question and was agitated; his consciousness recovered after treatment of 11 days, brain MRI scan had no obvious signs of abnormality, hyperbaric oxygen therapy continued, the patient can walk freely after treatment of 35 days. Discussion: This case was acute and had symptom of fever, chills, general discomfort, headache, nausea, vomiting, unconsciousness, seizure, skin ecchymosis, meningeal irritation sign positive, WBC and neutrophil ratio increased, CSF showed Septic change, blood culture found type 2 Streptococcus suis, diagnosis of pig-borne disease was confirmed. on the basis of comprehensive treatment, the patient was given a daily hyperbaric oxygen treatment, after HBOT of 11 times, the patient was awake in a stable condition. HBO, a non-drug treatment, played an important role in the treatment of this case of human infected with pig Streptococcus suis. HBO improves the supply of oxygen to the whole brain or the regional lesions, help repair damaged cells; hyperbaric oxygen may also break the vicious cycle of inflammatory - hypoxia cerebral edema - increased intracranial pressure , at the same time , network activation system has relatively high oxygen pressure, it accelerates the patient’s recovery from coma. K135 Hyperbaric oxygenation and facilitation technique combination treatment of a brain diffuse atonal injury Kunru Zhou, Zhihua Yang, Xiuzhen Wang, Jinbo Wang, Shaoxiong Xu Guang Dong Shen Zhen Bu Ji Peoples Hospital, Shenzhen, China Objective: For the sake of study the therapeutic effect of Hyperbaric oxygenation and facilitation technique cure a brain diffuse atonal injury, my hospital carried on the close observation into 60 cases of brain diffuse atonal injury patients from 2003 to 2007. Method: 60 cases of brain diffuse atonal injury patients are randomly divided into 2 sets. Contrast group (24 cases) was pure to given combined therapy of taking normal regulations medicine: Dehydrating agent depress encephalic pressure; adrenocortical hormones activated reticular formation for awakened cerebrum; correct electrolyte maladjustment; medicine nourish brain cell supply energy; acupuncture and manipulation; HBO group (36 cases) was given combined therapy of taking normal regulations medicine and hyperbaric oxygenation and facilitation technique, started on the sixth day after the patient hospitalized. Result: The treatment set cures 25, show effect 7, valid 3, invalid 1, total efficient 97.5%. The Contrast set cures 8, show effect 4, valid 5, invalid 7, total efficient 70.8%. Treatment set efficient is obviously better than the contrast set ;( p<0.05) Reply to diagnose after a year or the telephone track, the treatment set linger effect incidence rate is 11.1%. The Contrast set linger effect incidence rate is 58.4%, 2 sets relatively have obvious difference. (p<0.01). Conclusion: Hyperbaric oxygenation and facilitation technique cure a brain diffuse atonal injury earlier, recover quicker, cure effect better. Namely educed disability rate, also reduced death rate. Promote the patient of the function recover, make the patient be able to return to a society as early as possible. K136 The Effect of Hyperbaric Oxygen Therapy on cerebral infarction Pan xiaorong, Fan qiuping People's Hospital of Guangxi Zhuang Autonomous Region Our department use hyperbaric oxygen therapy to treat 120 patients with cerebral infarction supplemented with drug treatment since March 1996 to March 2006, with the same period 120 cases of conventional drug therapy in patients with cerebral infarction contrast, have made significant effect, the report are as follows: 1 information and methods 1.1 general information: 240 cases of cerebral infarction patients, 154 mailes, 86 females, ages 45 to 77 , an average of 63.5 years old, the duration of suffering is from one day to two and a half years, of which 181 cases of basal ganglia infarction, 22 cases of multiple infarction (Infarction lesions in the three above), lacunar infarction in 37 cases. Randomly divided into two groups: ⑴ HBO therapy and conventional drug treatment group ,120 cases (integrated group); ⑵ conventional drug therapy group of 120 cases (the control group). According to "stroke in patients with clinical neurological impairment score standards" (1995) [2] score. The two groups by age, sex and treatment of nerve impairment and there was no significant difference. 1.2 treatment: two groups of patients using conventional dehydration drugs decreasing intracranial pressure, blood vessel activation of nerve agents and expansion of vitamin E, and so on. Hyperbaric oxygen treatment: treatment of pressure 0.2 Mpa, wearing oxygen masks inhale pure oxygen of 30 minutes, rest for five minutes to inhale the cabin air, and then inhale pure oxygen for 30 minutes.Patients got HBOT Once a day of every 10 times for a course of treatment. A total of 2 to 10 courses, follow-up 1 year, then statistic further recurrence rate of cerebral infarction. Results Two patients with cerebral infarction treatment comparison in table 1. The course of integrated group and effects of table 2. Table 1 Comparison therapeutic effect of the two groups cured markedlytotal Numb effective effective failed effecti er ve rate number of of (%) cases cases % cases% cases % c ases % integrated group 120 96 80.0 12 10.0 9 7.5 3 2. 5 97.5 Control group 120 48 40.0 36 30.0 21 7.5 15 12.5 87.5 Compared with the control group x2=10.4, P<0.01 Table 2 :The course of integrated group with the effects of disease course Number cured Markedly effective failed total of effective effective cases rate(%) 21 15 4 0 100 1 ~40 28 7 13 8 0 100 30days 32 18 13 1 96.87 31 ~20 4 14 2 90 60days 61 ~ 90days 91days ~ 2.5years Differences between the two groups have a very significant (P <0.01), shows that integrated group relapse rate lower than the control group. 3 discussion hyperbaric oxygen,① blood oxygen content increase, blood oxygen pressure increase. Oxygen diffusing capacity and the diffusion distance increase, reducing brain cell degeneration and necrosis due to asphyxia, the effective restoration of ischemia " penumbral regions" cell function. ② enhanced aerobic metabolism, reduce anaerobic glycolysis, reducing brain lactate concentration, and thereby redress acid poisoning, improved the brain environment. ③ contraction of blood vessels, reducing cerebral edema and reduce intracranial pressure. ④ promote the formation of collateral circulation. ⑤ increase vertebral - basal blood flow and is conducive to the unconscious patients restoration of consciousness. ⑥ lower blood viscosity, promote thrombolisis and absorption. ⑦ reduce reperfusion injury to the brain. Not only hyperbaric oxygen therapy can be used in cerebral infarction but also can prevent the cerebral infarction recurrence again, it is an effective, safe and reliable rehabilitation measures, have important clinical significance, it is worth promoting. In view of oxygen under high pressure oxygen from the dispersion is still limited, the choice of cases with small lesions will have better effect. K137 Effects of hyperbaric oxygen on sports ability in female middle- long distance athletes before matches 1 2 Jian Zhang , Lunying Sun 1. HBO Department of Shandong Qianfoshan Hospital, Shandong, China 2. PE College of Shandong economic college, Shandong, China Objective: To explore the effects of hyperbaric oxygen (HBO) on sports ability in female middle- long distance athletes before matches. Methods: Twenty-three female 1500 meter athletes were randomly divided into hyperbaric oxygen group (HBO group, 11 cases) and normal pressure air group (NPA group, 12 cases). Before matches, eleven athletes (HBO group) were exposed to a hyperbaric environment of 0.2MPa (2.0ATA) to accept a treatment of hyperbaric oxygen. The time of rising pressure was 20 min.the athletes inhale pure oxygen for 60 min, taking a rest for 10 min to breathe air among inhaling oxygen. The time of reducing pressure was 30 min. The athletes in NPA group were exposed to a ordinary pressure cabin for 120 min, breathing air. Their quiet heart rate (HR), fatigue level, and the results of 1500 meter were determined respectively before and after experiment. Results: Before experiment, all indexes of two groups were not significantly different .After experiment, the HR of athletes in HBO group were average lower 3.08±0.83 beats each minute than before experiment ,and also the feeling of fatigue and the results of 1500m(female) were obviously improved as compaired with before experiment. All indexes in HBO group were much more improvement than those in NPA group. Conclution: Before matches, HBO treatment can increase the content of oxygen in blood and tissues , reducing the heart rate, lightening fatigue, adjusting the function of brain cortex ,and boosting female middle- long distance athletes the motor excitability . K138 the Influence of HBO to the Serous Endothelin in Patients of Serebral Infarction H-K Pan the First Hospital affiliated to ZhongShan University 510060 Objective: The study was designed to probe the influence of hperbaric oxygen (HBO) to the serous endothelin in patients of cerebral infarction. Methods: Assessing the relationship between the concentration of serous endothelin and therapeutic effect to 64 patients of cerebral infarction treated by HBO. Results: the patients within 2w sick have the significantly increased serous endothelin compared with pretreatment (P<0.05), while patients with beyond 2w sick have significantly abating serous endothelin ( P<0.05 ) . In comparison to the a bit of enhancement of control groups, the patients treated by HBO showed great climbing serous endothelin, especially those within 2w sick (P<0.05). Conclusion: According to our study, the beneficial effect of HBO to cerebral infarction has nothing to do with the decreased serous endothelin and possible related approaches need to be further explored. K139 A Case Report: the treatment of Hyperbaric Oxygen to osteomyelitis haibin xiang, rong xie Shanghai Punan hospital 200125 A female, 8 years old patient went to some hospital in ShangHai for the suddenly occurred weakness of low limbs and ensuing walking hardly accompanied with disabled urinary and fecal discharge. Physical examination: Reflex of patellar tendon of both sides does not exist. The muscular tension is low and muscle force of the low limbs is level O-Ⅰwith negative Babinski Sign. The patient was diagnosed as osteomyelitis preliminarily and hospitalized. Inpatient examination: oligoclonal antibody of CSF indicated the damaged blood-brain barrier and disproportionated increased ratio of IgG. Spine MRI showed the abnormal signals(T4 - T11). Treatment: 200mg methylprednisolone ivgtt for the first day, 250mg/d for the second and third day and following prednisone 40mg/d P0 adding the use of γ-Globulin and ATP. On the third day, she restored urinary discharge and on the ninth day, she had the ability of fecal discharge with still existing weak low limbs. HBO therapy began with on the tenth day of hospitalization. After the first period of HBO therapy, patient showed restored urinary and fecal discharge completely, enhanced muscle force to level Ⅲ -Ⅳ, increased muscle tension, rehabilitated reflex of patellar tendon, positive pathological reflex and she could walk supported by others. The progress after the second therapeutic period involved walking by herself, the asymmetrically induced reflex of patellar tendon and promoted muscle force to level Ⅳ—Ⅴ. For the ineffective normal treatment, we apply her HBO treatment timely and the significantly increased muscle force in low limbs suggested the nice synergic function of HBO and normal treatment. The possible effect that HBO treatment have in the case as following: increasing the oxygen pressure and concentration of bone marrow and enhancing the oxygen extension, which accelerating the rectification of local hypoxia condition; reducing the spinal cord edema; ameliorating the function of blood-spinal cord barrier; abating the tissue adherence after local infection; prolonging the reproduction period of damaged neural cells and protecting the irreversibly damaged neural tissue which contribute to the rehabilitation of neural function; decreasing the occurrence of delayed paralysis given rise to by the dysfunctional blood flow of the spinal cord. K140 The discussion of usage of electronic medical equipments in hyperbaric oxygen chambers Zhu JianMing Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China When hyperbaric oxygen chamber works, it is a confined manned pressure vessel, so it is a very important issue that the proper usage of electronic medical equipments in the cabin, which is related to the guarantee of the safety and effectiveness of the treatment. When the various equipment in the cabin are in an oxygen-rich environment and play the redox reactions, so the board can not have a monitor within the EDM, voltage can not exceed 24 V, which is order to prevent high-pressure environment from the impact and interference, and accurately monitor patients’ various and real-time physiological information who are inside the cabin for a long time. Health-care workers can observe them convenient inside or outside the cabin, and set and adjust parameters of change at any time. Multi-parameter monitor is composed of two parts: multiple physiological parameters box which is general at the oxygen chamber and is used to measure the patient's ECG, SpO2, NIBP, TEMP, and the physiological parameter of the end of breathing carbon dioxide. Through the standard RS232 socket and data transmission lines, the patient's information can be easily delivered to the computer workstations outside the hyperbaric oxygen chamber whose general operating voltage is DC 12 V and can be safely used in the oxygen-rich environment. The purpose of usage of computer workstations is to read the patient information for analysis, storage, processing and link to HIS systems in hospitals to share resources. LCD displays are generally used in the oxygen chamber, and LCD is generally divided into two main materials which are called LCD and TFT respectively. The LCD screen usually needs LED lights background, and also need high-voltage lights which can light background lights. So the LCD is liquid crystal display of the power supply DC 12 V, but in order to supply background lights around 300 ~ 100 V high-pressure, it needs a inverter power supply. It is precisely this power of the high-voltage inverter, which brings about the hidden dangers to patients who use the LCD screen of multi-parameter monitors in the hyperbaric oxygen chamber. When the oxygen concentration in the high-pressure oxygen chamber is beyond the standard, the high pressure about 300 ~ 100 V will produce "tinder" phenomenon, and it is easy to bring about burning accidents. The TFT (Thin Film Transistor), which is called the film field-effect transistor, has made crystal electrodes through using thin-film technology, and control the opening and closing of any one point through using the method of scanning. It needn’t use LED lights back to light the liquid crystal display, so it has no high-pressure, and is securer to use in the high-pressure oxygen chamber. Discussion: We must pay attention to the materials of liquid crystal display of the monitor which is used in the cabin and use TFT LCD screen to the greatest possible extent. Medical electronics, pneumatic equipment which are used in the oxygen chamber could bring about problems of high-voltage, superficial views on the author, related departments should plan as soon as possible, to make detailed laws and regulations of the usage of electronic medical equipment which is in the hyperbaric oxygen chamber, and to ensure the safety of usage. K141 Preventive maintenance of equipments and hyperbaric oxygen chamber Zhu JianMing, Yuan YunLai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China When hyperbaric oxygen chambers are at work, they are confined manned pressure containers, so the safety is a very important issue, the paper will be on the way to do a study about Preventive Maintenance. Background: It is a very important issue to ensure the safety of the usage of oxygen chambers. In the daily usage of the oxygen chamber, routine maintenance work must be done well rather than repair it when it is out of work, which is to ensure the safety and effectiveness of treatments. The requirements of preventive maintenance: 1. When oxygen chambers are at work, they are in the oxygen-rich environment, so do remember to pay attention to the range of lubricants when using PM. 2. Generally speaking, a small amount of lubricating oil can be used only when the internal of oxygen chambers in addition to the revolving door to add flexibility, and other parts for lubricating oil is prohibited. 3. PM asked to reflect "P", is Preventive, so the cycle of doing PM should be classified according to the frequency of usage of hyperbaric oxygen chambers, at least twice a year. The implementation of preventive maintenance: 1. As far as possible to set a relatively fixed date, do not arbitrarily extend the cycle of PM. 2. In addition to preparing the appropriate cleaning supplies, we must also prepare a strong suction vacuum cleaner and other equipments. 3. We must prepare silicone oil according to the characteristics of hyperbaric oxygen chambers. 4. To the devices, instrumentations and equipments inside the oxygen chambers, case work such as cleaning dust should be done. 5. First of all, a test module should be done on equipments of oxygen chambers to observe and monitor the real-time working conditions for the record, and after the end of PM, we should control the situation before and after. 6. Safety teats, current tests and inspection of the grounding impedance should be done to equipments inside chambers. 7. After the end of PM, all work should be on record and classified archive for verification in the future. The discussion of preventive maintenance: It can extend the life of hyperbaric oxygen chamber through PM, and now the instruments are used within the SMT surface-mount technology to assemble electronic components, IC-pin is only 1 mm spacing, so if there is dust and plot the event of a humid air, pin indirectly on a larger on-resistance phenomenon have caused the breakdown between the pin-damaged. It will be more good rather than harm to do PM regularly, of course, when doing PM, carefully formulated work must be done, and the equipment within the CMOS circuitry must be careful noticed and not use vacuum cleaner to suction circuit, which will cause the possibility that circuit vacuum cleaner was hit head on the electrostatic Wearing. We should take Preventive Maintenance as a main way, and take repairing as a supplemented way to extend the service life of hyperbaric oxygen chambers and save valuable resources of medical equipments and increase the profits of hospitals. K142 Analysis of 12 cases of the common fault in hyperbaric oxygen chamber Zhu JianMing, Yuan YunLai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China When the hyperbaric oxygen chamber works, it is an airtight pressure vessel carries people. The most important problem is to make use of security. Based on my years of maintenance repair experience in medical equipment including hyperbaric oxygen chamber, I will explore the common fault in hyperbaric oxygen chamber below. The integrity of hyperbaric oxygen chamber is the primary guarantee to ensure the use of safety and treatment and to keep the oxygen chamber in the normal work state is the prerequisite of hyperbaric oxygen therapy. Below makes a discussion to the common fault in the use of hyperbaric oxygen equipment. Common fault in the use of hyperbaric oxygen chamber subsidiary equipment: 1. At the use of the walkie-talkie of the oxygen chamber occasionally leads to “ broadcast ” voice of the radio broadcast interference in the middle of the night, would seriously affect the signal communication between in and outside the chamber. The main reason is 220V the city electricity 50Hz power frequency disturbance string amplifier, returned to original state “the broadcast sound”. Solution: (1) Improve the grounding of the walkie-talkies to make the grounding more reliable. (2) Place a capacitor capacity from 0.01 µ f to 0.01 µ f on the secondarily power transformer of the walkie-talkie in order to reduce the disturbance phenomenon by the distributed capacitor. (3) Use the transformers with center shielding layer between first and secondary to replace the original one. (4) Change the moving coil microphone and speaker which used in chamber into the piezoelectric ceramic chip. 2. The lung type oxygen used in oxygen chamber is specially designed for the driver attracts the oxygen equipment, needs about 300Pa negative pressure to turn on the rocking bar valve to attract the oxygen, when no oxygen absorption in failure, refer to the following steps to inspect: (1) Inspects whether the rubber cone-way valve piece in the three-way pipe has the aging and anti-roll or shifting bumps into attracts the oxygen tube collar extension. (Row of oxygen breakdown reverse inspection row of oxygen tube.) If found the rubber one -way valve has the aged phenomenon, exchange a new one. If the one-way valve bumps into three contacts collar extension, install once again, not bump into the collar extension as suitably. (2) Check the interior feeling press diaphragm of the lung type oxygen whether it would produce the aged chap in the course of time, if aging exchange a new diaphragm. (3) The rocking bar valve module like occurs loses the elasticity, cannot work when the normal work scope, must adjust the module operating region or use in exchange the new module. (4) The inspection lung type oxygen supply with for the oxygen pipeline attachment point, discovered when has the air leakage phenomenon, must disassemble the attachment point, changes into newly the aged O circle. 3. The use of self-flow oxygen in oxygen chamber: In the oxygen cabin uses flows automatically the oxygen general procedure uses the lung type oxygen supply, adjusts the screw rod to move most ambassador the oxygen to supply continuously, supplies the oxygen with the face guard to the patient. This method author thought improper, not only adjusts the biggest time oxygen from to supply the oxygen pipe flow to leave also can “see the seam from the lung type oxygen supply to drill” in all directions the overflow, creates in the cabin the oxygen concentration to elevate suddenly. In lung type oxygen supply for an oxygen pipeline connection place addition three contacts connection, moreover meets one for the oxygen tube, connects in parallel fashion into a small oxygen flow idea, follows the current on the gauge outlet the direct supplies to have to use flows automatically the oxygen patient, instead reduced in the oxygen cabin oxygen concentration. 4. the problem in the use of the rescue of medical equipment in hyperbaric oxygen chamber. The 220V alternating current supply cannot enter the oxygen chamber is advantaged in the personal safety, but also limited the rescue medical equipment to enter the oxygen chamber. There are many air operated medical equipment (with rechargeable battery inside) to be possible to supply in the oxygen chamber to use. That large-scale oxygen chamber needs frequently to rescue the seriously injured patient in the oxygen cabin must install the special-purpose fast oxygen connection in the chamber for the oxygen pipeline on. 5. The common problem on the equipment supplies the oxygen in the hyperbaric oxygen chamber. Enters the cabin after the oxygen pipeline to divide into the left and right two group supplies lung type oxygen supply, such procedure can produce inevitably for the oxygen pipeline “the blind end”, causes “the blind end” on patient to attract the oxygen to feel the hard sledding. Installs one in each lung type oxygen supply for the oxygen pipeline attachment point “the cushion pot” to solve, “the cushion pot” must have the volume which the enough big like 2 litres control. 6. The problem in the installment of the lung type oxygen supply in oxygen chamber. In the oxygen cabin the lung type oxygen supply installment direction common is all kinds, there are the top and bottom installment and the left and right one. The correct installment direction of lung type oxygen supply should be according to supplies under the oxygen tube vertical dynasty, adjusts the screw rod to be vertical in on installs. This way is the most reasonable one, the patient attracts when the oxygen not only depends on the negative pressure the function, moreover has the action of gravity help to make an effort slightly. 7. The daily adjustment method of the lung type oxygen supply. From attracts on the oxygen tube the plastic three-way pipe to draw out places nearby the ear on, adjusts the screw rod dextrorotation, when just heard “si si” leaked the oxygen sound, the screw rod maneuver half-turn, the lung type oxygen supply is adjusted by now in “the critical point”, attracted the oxygen to be at the optimum condition to make an effort slightly. 8. The problem in the supply of oxygen source in the oxygen bottle. The problem produced by the valve gasket which between the bus and the oxygen cylinder is that in the use of oxygen bottles (pressure is 15MPa/150KPa) as a source of oxygen supply, because of the use of nylon or Teflon used as the gasket material for valve interior, some articles reported frequently that a valve gasket in the combustion. The ignition point temperature of Teflon is 300℃, not easy to burn, so it is safety to use the gasket which is made by material of the pure Teflon, but uses the gasket which the material does on is easily to be a burning accident. Completely change the Teflon gasket in the oxygen supply pipeline into the red copper material so that once and for all solves the burning hidden danger which possibly exists. 9. Console oxygen supply oxygen chamber pressure gauges, indicators can not return to the issue. Installs an evacuation valve between the secondary reducer and the control bench for the oxygen valve can solve the problem. After the daily payload separation ended, close the oxygen valve then open the evacuate valve, drain away completely the pipeline in remaining oxygen causes the indicator to return the zero. It can extend the life of the oxygen pressure gauge that close the oxygen valve and then immediately evacuate the remaining oxygen in the oxygen pipeline, protect the oxygen pressure gauge when the secondary reducer sudden malfunction and the oxygen gauge hand ultra time limit. 10. The problem in the compressed air used as the compression medium. The air pressure cabin uses the compressed air to take the compression medium when treat patient, its quality is related with patient's safety and the effect of the treatment directly. In medical oxygen cabin GB code stipulated the compressed air must store up period of time after the preparation to be able to use, but in fact can achieve the oxygen cabin is few. In my humble opinion, the compressed air used in the oxygen cabin should refer to the standard of the military symbol "Diving Breath Gas" to carry out to maintain patient's treatment benefit. The first choice of vents one's anger with air pressure is non-oil air compressor. Install the heat interchanger behind the air outlet of the compressor, which cause the compressed air temperature prepared dropped greatly and reduce the presence of hydrocarbon in the compressed air. Install the multistage fluids behind the export mouth in the heat interchanger separator to reduce the hydrocarbon again. Conditional liquid oxygen chamber should increase behind the gas separator with a dedicated dry precision porous filter so that the preparation of the compressed air would be a better quality. 11. The selection of the activated carbon in oxygen chamber. The round circle columnar husk should be the first choice of the activated carbon in oxygen chamber supply air filters, because the graphite activated carbon is refined from the coal and the coal-tar oil, but 0.3MPa the air feed limiting pressure can run out the micro granulated activated carbon from the air strainer, therefore the graphite, the micro granulated activated carbon does not suit in the oxygen cabin air feed air strainer to use. K143 Curative effect of the treatment with HBO for ulcerative colitis Zhu Hourong NanJing JiangNing Hospital, Nanjing, China Objective: To evaluate the curative effect of the combined treatment with Sulfasalazine and Hyperbaric oxygenation (HBO) for ulcerative colitis. Methods: 38 cases with light or moderate ulcerative colitis at active stage were randomly divided into 2 groups, treatment group(n=19) receiving sulfasalazine and HBO, and control group(n=19), receiving sulfasalazine only, the curative effect, the reoccurrence in 6 months,the change of main symptoms before and after treatment were evaluated。 Results: The total effective rate of treatment group (89.47%) was significantly higher than that of control group(68.42%) (P<0.05), there existed an obvious difference in symptom relief, such as abdominal pain, diarrhea, mucus bloody stool and tenesmus, between the 2 group after treatment (P<0.05). Conclusions: the combined treatment with Sulfasalazine and HBO is of better curative effect for ulcerative colitis and it can reduce the reoccurrence. K144 The research on treating hypoxic ischemic encephalopathy by hyperbaric oxygen treatment and the changes of cytokines Zhou Yihong, Chan Guiyang, Tang Lanfen, Ao Dang Department of Pediatrics, Affiliated Hospital of Guang Dong Medical College, Zhanjiang, China Objective: To investigate the changes of serum Interleukin-6(IL-6), Tumor necrosis factor-α (TNF-α) and Insulin-like growth factor-1 (IGF-1) in hypoxic ischemic encephalopathy(HIE) by hyperbaric oxygen treatment (HBOT) and clinical significance. Methods: Fourty-eight neonates with HIE were divided into two groups. Routine treatment group were intervened with the conventional treatment, hyperbaric oxygenation group in addition to the conventional treatment. Serum IL-6, TNF-α and IGF-1 in 48 cases of HIE were detected by radio-immunity. Result: The increaseed range of serum IL-6 in HBOT group were significantly higher than routine therapy group (P < 0. 05); the decreased range of serum TNF-α and IGF-1 in HBOT group were significantly higher than routine therapy group (P < 0. 05). Conclusion: HBOT could increase the production of IL-6 and reduce the production of TNF-α and IGF-1 . HBOT is an effective therapy for hypoxic and ischemic brain damage. K145 Hyperbaric oxygen therapy adhesive effect of 114 cases of obstruction Yubao Zhang Lei Ge Shumin Meng Wen Zhai Fuqin Wang The Frist Peoples Hospital of Harbin, Ha’erbin, China Objective: To investigate the high-pressure oxygen (HBO) for the effect of adhesive intestinal obstruction. Methods: 114 cases of postoperative adhesions with obstruction were randomly divided into two groups, the control group using conventional drug treatment. HBO group, in addition to conventional drugs, the daily 0.25 MPa pressure, oxygen absorption 60 minutes (10 minutes to break the middle), a total of 20 days. Results: 20 days later, HBO group cure rate significantly higher than that, there was a significant difference, statistical significance. Conclusion: The high-pressure oxygen therapy can increase the intestinal wall of the blood supply adequate oxygen supply, accelerate intestinal peristalsis, and promote the absorption of inflammatory mediators, in the treatment of adhesive obstruction plays a role should not be underestimated, is an effective treatment measures. K146 Hyperbaric oxygen chamber, hospital infection control Haiying Qiu, Yan Zhao, Ji Wang, Lihua Liu, Rui Li The Frist Peoples Hospital of Harbin, Ha’erbin, China Objective: To eliminate nosocomial infections, control of high-pressure oxygen chamber and ancillary devices colonies of bacteria to ensure that the hyperbaric oxygen therapy effective. Method: Siebenpfeiffer disinfectants and ultraviolet light to the oxygen chamber of the air, oxygen subsidiary devices were disinfected. Results: air control colonies in ≤500cfu/M3, articles colonies in the control of ≤10cfu/M3, put an end to the oxygen chamber treatment in hospital infection. Conclusion: The weekly regular disinfection of the patient and reasonable arrangements for a special event, special disinfection, to put an end to high-pressure oxygen treatment of hospital infection. K147 HBO treat meniere syndrome 66 cases 1 2 2 2 Danhong Song , Wen Zhai , Pei Liu , Xiaohua Li , 2 Hong Li 1. The second Peoples Hospital of Harbin, Ha’erbin, China 2. The Frist Peoples Hospital of Harbin, Ha’erbin, China Purpose: Detection HBO treats Meniere Syndrome (MS) clinic curative effect. Method: There are 2 groups, 66 cases. Except HBO group routine medication of dilatated blood vessels, there are HBO pressure 0.20 mpa and absorb pure oxygen 60 mins (break 10 mins), once per day, total 15 times. Comparison group adopt routine medication of dilatated blood vessels. Result: HBO treat MS total efficient rate 95.8%.Comparing with comparison group, diversity is obviously (P<0.05). Enforcing position in 7 days, fear reduced earlier (P<0.05). Conclusion: HBO treat MS is one of curative effect at present. K148 Observation on the curative effect of HBO on treating continuing vegetative state Xuming Zhou, Haiying Qiu, Qun Cai, Huiting Cong, Ji Wang The Frist Hospital of Ha’erbin, China Purpose: Detection HBO curative effect observation of treat continuing vegetative state (CVS). Method: Random sample divided 2 groups of HBO treatment and comparison. Except HBO group routine medication treatment, there are HBO pressure 0.25mpa and absorb pure oxygen 60 mins (break 10 mins), once per day, total 20-70 times. Comparison group routine medication treatment. Result: Curative effect of HBO group surpassed comparison group (P<0.01), which is early and long period of treatment are better curative effect. Conclusion: HBO which is importance of CVS routine treatment. K149 Treating 180 cases of paroxysmal deafness by using HBO combined with acusector Xuming Zhou, Shumin Meng, Lei Ge, Bo Zhai, Bo Dong The Frist Hospital of Ha’erbin, China Purpose: Discussion HBO result of HBO combines abusector which treats paroxysmal deafness (PD) Method: Random sample there are 2 groups which 180 PD HBO and comparison. Group HBO: Except routine treat with acusector and medication. Meanwhile, there are HBO pressure 0.25mpa and absorb pure oxygen 60 mins (break 10 mins), once per day, total 10-30 times. Group comparison routine treat with acusector and medication.Meanwhile, sickness in a week and over a week treat with HBO and comparison with PD under treatment of routine acusector and medication. Result: Group HBO for PD curative effect rate and getting better rate and more than over a week obviously (P<0.01). Group in a week curative effect rate and getting better rate are more than over a week HBO treatment group(P<0.05). Diversity exist prominence and significance of statistics. Conclusion: HBO combine acusector and medication which treat PD are better than simple acusector and medication obviously. Meanwhile earlier treatment is better for curative effect. K150 Hyperbaric oxygen treating 32 cases of metal poisoning Li Wen, Zhang ZhiGe, Tuo LiuYing, Yang Meiping, Shi Zhongheng Department of Hyperbaric Oxygen, Jiangbin Hospital of Guangxi We applicated hyperbaric oxygen (HBO) treatment in 32 cases of metal poisoning in November 1996 to December 2007, and compared to similar cases who received conventional treatment in November 1987 to November 1996, there was significant difference, it is report as follows: Clinical data: 1. General information: There were 63 cases, 56 cases from the production workers, 9 cases of mistaken consumption poisoning. 32 cases of HBO treatment group, 20 cases men, 12 women, aged 22-55 years old, of which 9 cases of lead poisoning, 12 cases of manganese poisoning, 9 cases of tin poisoning, 2 cases of arsenic poisoning. 31 cases of control group 19 men, 12 women, aged 20-56 years old, of which 9 cases of lead poisoning, 11 cases of manganese poisoning, tin poisoning in 10 cases, 1 case of arsenic poisoning. Two groups had almost the same performance. 2. Clinical performance: there are different levels of unconsciousness in 12 cases and the rest had the performance of headache, dizziness, fatigue, insomnia, nausea, vomiting, tremor, polyuria and so on. 3. Treatment: two groups used metal driving, symptomatic treatment and support treatment. HBO treatment group used medium-sized hyperbaric oxygen chamber, compressing air to 0.2 MPa, inhaling oxygen for 80 minutes, the middle rest for 5-10 minutes,once a day, 12 times was 1 course, general 2-3 courses, up to 5 courses. 4. Efficacy evaluation standard: full recovery: consciousness and other symptoms are back to normal. markedly effective: consciousness has returned to normal, but the signs have not been completely back to normal. improveing: symptoms and signs have got better slightly after treatment. invalid: signs and symptoms did not change after treatment. Results: effect of HBO treatment group were: 11 cases full recovery, 11 cases markedly effective, 7 cases improved, 3 cases invalid, and the total efficiency was 90.6 percent. Control group: 5 cases full recovery, 8 cases markedly effective, 9 cases improved, 9 cases invalid, the total efficiency was 70.9 percent. There was significant difference in two groups, P <0.05. Discuss: the mechanism of HBO treatment in metal poisoning is to rapidly improve the state of hypoxia, to interrupt the vicious cycle of edema, so it can effectively alleviate symptoms. HBO can increase blood oxygen pressure, improve the metabolism of brain cells, reverse or delay the degeneration of brain cells caused by the poisoning, maintain the flexibility and toughness of red blood cells and reduce the occurrence of hemolysis. This observation of HBO treatment in metal poisoning had quite satisfactory results. So for the patients of metal poisoning,we suggest take early HBO treatment on the basis of metal driving and symptomatic treatment, patients of chronic poisoning should increase more courses appropriately. K151 Treating a case of scald by HBO Haiping Yang, Juan Chang, Chuanying Sun Youanmen Hospital of Beijing hospitail association, Beijing, China This article reported a case of scald by boil water, who is a diabetic woman, was treated by HBO. The wounds of her legs caused a long delay, had infected and fever. After 26 times HBOT, the wounds were recovered.The treatment principls of scald by HBO were discussed in this report. K152 The clinical application of a new oxygen inhalation-exsufflation device with emergency intra-chamber atomization and humidification Youcun Wang, Peizhen Shi, Jianwei Xu, Zengshan Liu The department of hyperbaric oxygen, General Hospital of Jinan military area, Jinan, China The manufacture and clinical application of a new oxygen inhalation-exsufflation device with emergency intra-chamber atomization and humidification were reported. Without any defect that the traditional device has, the new device was work-reliable and simple-operated. The application of the new device in hyperbaric oxygen chamber increased the methods of intra-chamber emergency treatment, the indications and the rescue capability of the chamber, as well as improved the hygienic criterion of intra-chamber oxygen-supply and the effects of treatments. It could also eliminate the hidden danger of accidents. K153 A case of using hyperbaric oxygen to treat mathenol poisoning Yalin Wang, Xiujie Li, Rong Li Dalian Center Hospital, Dalian, China A patient, male, 40 years old, suffered from sudden serious stomach ache for 2 hours during working, accompanied by nausea and vomiting. He touched methanol in working environment. Preliminary diagnosis: the stomach ache requires further examination. Two hours later, the illness severity increased. His awareness became unclear, accompanied by breathing difficulty, limb getting cold, cyanosis, systemic tinea versicolor, no urine, and BP 90/60 mmHg. Examination in laboratory shows: K 5.63mmol/L, BUN 12mmol/L, Cr 315umol/L, artery blood Pa CO213mmHg, PH6.8. Diagnosis: methanol poisoning, acute renal failure, metabolic acidosis, hyperkalemia, and distributed shock. The treatments to the patient include orotracheal intubation and mechanical ventilation, puncturing administration to right internal jugular vein, and hemofiltration. 24 hours later, the patient’s awareness recovered, the amount of urine returned to the normal level, and he could make conversations. We stopped mechanical ventilation. The patient said that he could not see objects. Ophthalmology consultation: his eyes had no light perception; the pupils dilated, D=5mm; direct and indirect light reflex were both weak. We use energy mixture, neurotrophic drugs to improve microcirculation and use Hyperbaric Oxygen (HBO) therapy. 48 hours after the patient entered the hospital, we performed HBO therapy. Treatment Program: surface pressure 0.12Mpa, oxygen inspiring time 60min, once per day. 32 days after the patient received HBO treatment, his eye sight recovered completely. Discussion: The patient is a typical patient suffering from methanol poisoning, the diagnosis is clear, and the HBO therapy is effective. The purposes of using hyperbaric oxygen therapy in the treatment include: 1. HBO helps to improve the activity of cytochrome oxidase, to inhibit the generation of formic acid and lactic acid, and to ease the acidosis. 2. HBO has positive effect to repair and regenerate damaged nerves, and helps to recover the function of optical nerves. 3. HBO accelerates the regeneration of damaged capillaries, provides oxygen for the establishment of circulation in branch retina, improves the hypoxia status of the fundus tissue, and prevents pathological changes of inner cells of retina caused by ischemic and hypoxia. 4. The formic acid generated during the methanol metabolism is also toxic to the retina. Hyperbaric oxygen may enhance the activity of formyl-H4 folate dehydrogenase, further promote the metabolism of formal acid. On the whole, the patients suffering from harmful gas poisoning should be treated with HBO as early as possible. And HBO is one of the necessary treatments to cope with harmful gas poisoning. K154 A therapy effect analysis of hyperbaric oxygen combination with method of blood-activating and collateral-unblocking in treating patients with acute cerebral infarction Wang Xiaohong Department of Rehabilitation and Physiotherapy,Wuhan General Hospital of Guangzhou Command, Wuhan, China Objective: To investigate the clinical effects of hyperbaric oxygen (HBO) combination with method of blood-activating and collateral-unblocking (BACU) on patients with acute cerebral infarction (ACI) and to analyze the mechanism of action. Methods: 84patients suffered from ACI were randomly divided into HBO plus BACU therapy group (HBO group) and BACU therapy group (BACU group). The levels of serum endothelin (ET-1), nitric oxide (NO) and the C-reactive protein (CRP) were measured before and after treatment. The resultant data were compared with normal healthy crowd. Results: The levels of serum ET-1 and NO in patients with ACI obviously elevated (P<0.01). After treatment, the serum ET-1 decreased, NO enhanced, and the ratio of ET-1/NO decreased, while the decrease degree of the HBO group was more remarkable, compared with the BACU group (P <0.01)At the same time, the CRP level in HBO group was low significantly, compared with those before treatment (P <0.01), and no obvious change were observed in CRP levels in patients before and after BACU therapy (P> 0.05). Conclusions: Compared with solitary drug therapy, HBO combination with BACU had better effect on ACI. The main mechanisms of above combined therapy shows that it could improve of vascular endothelium function, inhibit the formation of ET-1, relieve vasospasm, decrease in vivo inflammatory reaction, restrain blood clotting, promote the establishment of collateral circulation, and prevent ischemic brain tissue damage. K155 The effect of hyperbaric oxygen treatment on the plasm concentration of tPA, PAI-1 in the patients of ischemic strok 1 2 2 2 Wei Wang , Lin Yang , Chunjin Gao , Baosen Pang 1. Department of Hyperbaric Oxygen, The Third Hospital of Hebei Medical University, Shijiazhuang, China 2. Department of Hyperbaric Oxygen, Beijing Chao Yang Hospital, Capital University of Medical Sciences, Beijing, China Objective: To investigate the effect of hyperbaric oxygen treatment on the plasm concentration of tPA, PAI-1in the patients of ischemic stroke. Methods: 137 patients with acute ischemic stroke were divided randomly into routine therapy group (routine group), hyperbaric oxygen therapy group (HBO group). There were 27 healthy volunteers in control group (control group). We measured the plasm concentration of tPA, PAI-1 respectively in the patients st th with ischemic stroke on the 1 and 11 day after admission. Results: On the 1st day, in the patients of the HBO group or of the routine group, the plasm concentration of tPA and PAI-1 were significantly higher than that of the control group (P>0.05); The tPA concentration was lower in the HBO group compared with the routine group (PAfter the routine treatment, the plasm concentration of tPA decreased (P<0.01); After HBO treatment, the plasm concentration of tPA, PAI-1 both decreased (P<0.01). Conclusion: In the patients of acute ischemic stroke, hyperbaric oxygen treatment can decrease the plasm level of tPA, PAI-1. Thus hyperbaric oxygen treatment can effectively improve the function of coagulation-fibrinolytic system in the patients with ischemic stroke, and may ameliorate therapeutic effect. K156 Clinical effective observation on combined hyperbaric oxygen therapy for noxious gas poisoning Shuzhen Wang, Yuqin Han, Yun Li, Hongling Yang, Jianming Zhan Qilu Hospital of Shan Dong University, Jinan, China Objective: To investigate the effect of combined hyperbaric oxygen therapy on noxious gas (mainly on carbon monoxide) poisoning. Methods: 339 cases of carbon monoxide poisoning were treated by hyperbaric oxygen, with the supplement of the medicine (vasodilator, diuretic, neurotrophic medicine). On the base treatment of air compression, patients were treated with 0.2 Mpa hyperbaric oxygenation (severe patients at 0.25 Mpa), wearing masks and inhaling pure oxygen for 20 min and the air in chamber was inhaled for 5 min, repeating 3 times such inhalation, then decompressed. Twice HBO therapy a day for severe patients, once a day after the patients awake. For 10 time HBO as a period of treatment. Results: 325 cases were cured, becoming life-independent, 8 cases dead because of failure to receive HBO treatment due to critical condition and transient vital signs, and 6 cases of carbon monoxide intoxication delayed encephalopathy. The total effective rate is 95.8%. Conclusions: The combined hyperbaric therapy for noxious gases poisoning is effective, with a high cure rate, quick effect, less complication and low mortality rate. K157 Therapeutic effect of hyperbaric oxygen integrated therapy on hydrocephalus of craniocerebral injury Shengzhi Wang, Yu Peng Binhai Hospital, Shengli Oil Administration, Dongying, Shandong, China Objective: To explore the curative effective of hyperbaric oxygenation (HBO) combined with drugs therapy on hydrocephalus of craniocerebral injury. Methods: Ten pentients with hydrocephalus from craniocerebral injury were treated with hyperbaric oxygen treatment which given 0.23 MPa HBO exposure ,20 min × 4( oxygen ) + 5 min (air ) once daily for 1~6 courses all together and once course was 10 days, basides drug`s treatment of citicoline sodium injection and adenosine disodium triphosphate injection al. to observe and evaluate the clinical changes and hydrocephalus change on CT. Results: Ten pentients with hydrocephalus from craniocerebral injury improved significantly clinical symptoms and signs after 3~10 days, the patients clinical symptoms ,signs and hydrocephalus on CT almostly disappeard after 30 days `treatment. Some pentients went on treating for 60 days and all cured. Conclusions: Hyperbaric oxygen integrated therapy may promotly repair the circulatory system of cerebrospinal fluid in craniocerebral injury`s pentients and hydrocephalus were gradually insorpted or got into the circulatory system of cerebrospinal fluid, thus controled hydrocephalus growth. It must be treated the pentients on hydrocephalus of craniocerebral injury with HBO at the right time, in order to increase the therapeutic effect. K158 The effect of hyperharic oxygen on D-dimer and fibrinogen in the blood plasma of ischemic apoplexy patients 1 1 2 Qiusha Wang , Shizhong Wang , Chunjin Gao , 1 1 1 1 Qihua Yang , Jin Mei , Ping Zhang , Jianding Gu 1. Department of HBO, The 2nd People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, China, 2. Departmen of Hyperbaric Medicine, Beijing Chaoyang Hospital, Beijing, China Objective: To observe the effect of hyperbaric oxygen (HBO) on D-dimer (D-D) and fibrinogen (Fg) in the blood plasma of ischemic apoplexy patients. Methods: Ischemic apoplexy patients were randomly divided into routine treatment group (97 cases), HBO treatment group (137 cases), and healthy control group (40 cases) was setup. D-D and Fg levels in blood plasma were detected by coagulometer of the STAGO Company and its corresponding kit. Results: D-D and Fg levels in the blood plasma of the routine treatment group were higher than those of from the control group when hospitalized (P<0.01, P<0.05). D-D kept increasing on the 10 th day, after admission (P<0.01); while Fg was lower than that of the cortrol group (P<0.01). On the 20thday, D-D started to decrease. However, it was still higher than normal level (P<0.05); while Fg becomed normal, which showed no significant difference from that in the control group (P>0.05); D-D and Fg levels in the blood plasma of the HBO group were higher than those of the control group when hospitalized (P<0.01,P<0.05). D-D kept increasing on the 10thday after admission (P<0.01). However, it was still lower than that of the routine treatment group (P<0.05); while Fg started to decrease, but it was higher than normal level (P<0.05). On the 20th day, D-D and Fg levels showed no significant difference from those of the control group (P>0.05). Conclusions: HBO can relieve coagulation, anticoagulation and abnormal fribrinolysis due to ischemia and damage in the vessels through regulation of D-D and Fg levels in blood plasma, which was effective in preventing treating and ischemic apoplexy. K159 Effect of hyperbaric oxygen on iron deficiency in patients with sensorineural deafiness 1 2 2 qiusha wang , shuchang tian , aihua sun , 2 3 1 1 baodong wang , fuqiong pan , haian yu , shizhong wang , 4 xuejun sun 1. Department of Hyperbaric Oxygen, the 2nd People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, China 2. Department of Otorhinolaryngology, Shanghai Changzheng Hospital, China 3. Department of Medical Rehabilitation, the Peoples Hospital of Sichuan Province, China 4. Department of Nautical Medicine, Faculty 0f Navy Medicine, Second Military Medical University, Shanghai, China Objective: To evaluate the effect of hyperbaric oxygen (HBO) therapy on iron defieiency in patients with sensorineural deafness. Methods: Two hundred and fifty three patients were randomly selecled from outpatients and inpatients with sensorineural deafness and treated with HBO therapy from Dec. 1996 to Dec. 2004. Serum ferritin (SI) and hemoglobin (Hb) were measured before treatment and after one and two courses of treatment. Hb and SI were also measured in 250 people undergone healthy check-up in 2005. Results: After two courses of HBO therapy, better curative effect was obviously shown in treating mild deafnes than in treating moderaie deafness. Statistically significant difference in Hb and SI was observed before treatlment and after one course of treatment, also after one course of treatment and after two courses of treatment, respectively (P<0.05, P<0.01). There was no statistically significant difference in Hb between patients after two courses of treatment and healthy people (P>0.05), but there was a statistically significant difference in SI between thern (P<0.05). Conclusions: Hyperbaric oxygen therapy may adjust SI and Hb in patients with sensorineural deafness. K160 Application of the apparatus for eustachian tube opening function (ETOF) measurement before the hyperbaricoxygenation (HBO) 1 2 3 Qiusha Wang , Chunjin Gao , Peisong Wang , 4 4 1 Yunjing Wang , Yuming Yang , Yuhong Zhang , 1 1 1 Guoying Wu , Yi Zhou , Jing Cao 1. Department of Hyperbaric Oxygen, the 2nd People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, China 2. Department of Hyperbaric Oxygen, Beijing Chaoyang Haospital, Capital University of Medical Science, China 3. Department of Hyperbaric Oxygen, Medical school Hospital Haospital of Qingdao University, China 4. Naval Medical Research Institute of CPLA Shanghai, China Objective: To monitor Eustachian tube opening function with the application of measurement of sound conduction before HBO. Methods: Eustachian tube opening function were monitored in patients before HBO with a newapparatus for ETOF measurement, model HY-100 applied with high frequency sound at 7KHZ.If at the first time the patient’s Eustachian tube was not open, the measurement would be done in the next time after actions of swallow, Valsalva maneuver and mandible oscillation had been did. The results of measurement were classificated by four grades. The standard for HBO was made by the grade and whether Eustachian tube is open. Results: The patient’ Eustachian tube with grade four in classification and failure in five times of continues action during the measurement was regarded as it was not open and the patient was not suitable for HBO. Conclusion: There is an advanced, stable and reliable performance in the newapparatus for ETOF measurement, themonitor and classification of Eustachian tube opening function prevents from barotrauma and keeps HBO in going well. K161 Effect of hyperbaric oxygen combined therapy on persistent vegetative state in 46 patients Wang Min Department of Rehabilitation of Longgang District Central Hospital of Shenzhen, Shenzhen, China Objective: hyperbaric oxygen combined therapy on persistent vegetative state and explore the best therapeutic regimen for it. Methods: Forty-six cases of persistent vegetative state treated with hyperbaric oxygen combined therapy from 1995 to 2006 were analyzed retrospectively, including the effects of etiological factors and age factors and treatment juncture on therapy. Result: The excellence rate and the improvement rate were significantly higher in cerebral trauma group than those in no cerebral trauma group. And two groups in which the patients began to receive treatment when became persistent vegetative state for less 61 days recovered better than the other one in which the patients began to receive treatment when became persistent vegetative state for more 60 days. The excellence rate and the improvement rate were significantly higher in cases below 30 years than these in cases over 30 years. Conclusion: The effectiveness of hyperbaric oxygen on the patients with persistent vegetative state caused by cerebral trauma and the patients who just begin to receive hyperbaric oxygen therapy treatment when having been ill for less 61 days is better. The effectiveness of therapy is better in younger cases than that in old cases。 K162 Effect of hyperbaric oxygen on ultrastructure of liver and kidney in rats after acute carbon monoxide poisoning Guozhong Wang, Chunjin Gao, Huan Ge Department of Hyperbaric Oxygen, Beijing Chaoyang Hospital, Capital University of Medical Sciences, Beijing, China Objective: Acute carbon monoxide poisoning (ACMP) is likely to be the most common cause of poisoning worldwide and often results in persistent damage to the important organs such as brain, liver and kidney. Some trials have definitively shown hyperbaric oxygen (HBO) as the efficacious therapy for acute carbon monoxide poisoning. The objectives of this article are to study the protective effect of hyperbaric oxygen on the ultrastructure of liver and kidney in rats after acute carbon monoxide Poisoning. Methods: The rats were randomly divided into ACMP 1st day group, ACMP 5th day group, ACMP 10th day group, ACMP15th day group,HBO1st day group, HBO5th day group, HBO10th day group, HBO15th day group and normal control group. Model rats after acute carbon monoxide poisoning were established. The ultrastructure changes of liver and kidney in rats of all groups were observed by electron microscope. Results: Slight mitochondria swelling, focal vacant area and rupture of mitochondria crista was observed in some liver cells of ACMP 1st day group. The pathological changes became aggravating in liver cells of ACMP 5th day group and ACMP 10th day group, and alleviating in liver cells of ACMP 15th day group. Compared with simultaneous ACMP group, the pathologic changes of ultrastructure in liver cells of HBO groups were significantly improved. From ACMP 1st day group to ACMP 5th day group, the pathologic changes of ultrastructure in kidney cells was ingravescent. Although the pathologic changes of ACMP 10th day group and ACMP 15th day group became alleviating, slight mitochondria swelling was observed in some epithelial cells, meantime interstitial edema and congestion remained obvious. Compared with simultaneous ACMP group, the pathologic changes of renal glomerulus and tubule of HBO 1st group and HBO 5th group were significantly improved. Slight mitochondria swelling was observed in a few renal tubular epithelial cell of HBO10th day group and HBO15th day group. Conclusion: Carbon monoxide has the toxic effects of tissue hypoxia and produces various systemic and neurological complications. Early hyperbaric oxygen can alleviate pathologic lesion of ultrastructure of liver and kidney in rats after acute carbon monoxide poisoning, which have significant protective effect on the liver and kidney. clinical therapy effectually , the curative effect of HBO have been assumed. K163 Empiricad study about the expression of IGF-1 on brain tissue injured by treatment of hyperbaric oxygenation in rats after traumatic brain injury Jinzhong Teng, Jianfeng Wen The 94th Hospital of PLA, Nanchang, China K165 Study of the medical security on the 140m heliox saturation–166m excurssion diving Qinglin Lian, Xuejun Sun Department of Diving Medicine, Second Military Medical University, Shanghai, China Objective: To investigate the relationship between the therapeutic effect of hyperbaric oxygenation on brain injury and the cerebral expression of IGF-1. Methods: Base upon the Feeney’s model, we set up the cerebral trauma model in SD rats. The rats were randomly assigned to four groups: sham operated group, Control, trauma and normal pressure oxygenation treatment (NPO) group, trauma and hyperbaric oxygenation treatment (HBO). The cerebral expressions of IGF-1 were analyzed with immunohistochemical technique. Results: After the treatment of hyperbaric oxygen, the expression of IGF-1 in hyperbaric oxygen treatment group was higher than normal pressure oxygen treatment group and surgical trauma control group (P<0.01). Conclusion: The expression of IGF-1 enhanced in nerve cells after brain injury, and it enhanced more obviously under hyperbaric oxygen treatment. It indicates that the treatment of hyperbaric oxygen can protect and recover the impaired nerve cells. Improved the expression of IGF-1 in brain tissue cells might was one of the nerves protection ways. Objective: In order to raise the salvageability of the naval, cultivate the divers of the saturation deep diving and cultivate the person of medical security and diving equipment support. Methods: eight divers were exposed to 140m He-O2 saturation pressure in the DCC for 48h, the partial pressure of O2 was 40±2 kPa in the DCC. During the saturation period, the divers the excursion dives reached to a depth of 164~166m by means of the SCC and effectively finished the work on the bottom. The divers safely return normal pressure after 149 h 20 min decompression. Base on the clinical examination, the function of nerve, mentality, heart and blood vessels, respiration, immunity, stress, motion balance and audition of divers were tested in different phases. Results: At the saturation-excursion period, worry, anxiety and depression of the divers were existed, the MVV of pulmonary functions were significantly lower with the diving depth, the accurate rate of the ball put test decreased sharply, the levels of 17-OHCS, CA, A, NA, ACTH, FSH, T, GH, and C were significantly higher. Conclusions: In this successful diving, the medical security was very effective and practical. The physiological changes of the body were temporary and may be recovered. K164 Attendant experience of combination therapy containing hyperbaric oxygen for fetal growth restriction induced by severe preeclampsia Yuhua Wang, Hongjian Liu The people’s hospital of Cangzhou, Hebei, China Objective: To explore the attendant means of combination therapy containing hyperbaric oxygen(HBO) for fetal growth restriction induced by severe preeclampsia. Methods: 32 patients with fetal growth retardation(FGR) induced by severe preeclampsia, treated by HBO combined with routive methods .treatment Pressure was 0.15 Mpa,Qd; Continnal therapy times is five. Results: in all 32 patients, the prominent effective ratio was 59.4%, the effective ratio was 100%, and the existent ratio of newborn baby was 94.1%. By strengthening psychology nursing and special nursing of the boodle pregnant woman, no one side effect was found. Oxygen –toxicosis were not discovered in the newborn babies observed two years later. Conclusions: By improving blood oxygen-content and blood oxygen dispersive capability, so the placental microcirculation improved significantly, lacking oxygen of fetus corrected ,the live rate of newborn babies improved significantly. By mentality nursing timely and effective and nursing in oxygen-store meticulously and attentively, the HBO treatments to the boodle of pregnant women were accomplished smoothly. Supporting the carry out of K166 Mechanism of hyperbaric oxygen preconditioning in neonatal hypoxia-ischemia rat model Li Zhang, Wenwu Liu, Zhimin Kang, Xuejun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China Objective: We examined the mechanism of hyperbaric oxygen preconditioning (HBO-PC) in neonatal HI rat model. Methods: Seven-day-old rat pups were subjected to left common carotid artery ligation and hypoxia (8% oxygen at 37ºC ) for 90 min. HBO (100% O2, 2.5 atmospheres absolute for 2.5 h) were administered by placing pups in a chamber 24 h before HI insult. Brain injury was assessed by the survival rate, 2, 3, 5-triphenyltetrazolium chloride (TTC), Nissl, TUNEL straining and caspase-3,caspase-9 activities after HI. Results: In HBO preconditioned animals, survival rate was increased, infarct ratio was decreased, and the positive stained TUNEL cells was reduced, accompanied by and suppression of caspase-3 and -9 activities. Conclusion: These results indicate that a single HBO-PC appears to provide brain protection against HI insult via inhibition of neuronal apoptosis pathways. K167 Hyperbaric oxygen pretreatment accelerates angiogenesis and alleviates myocardial ischemia in rats 1 1 1 2 Cuihong Han , Li Lin , Qiang Sun , John H. Zhang , 1 Xuejun Sun 1. Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, 200433, P. R. China. 2. Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, California, USA Objective: Hyperbaric oxygen (HBO) has been previously shown to protect the heart from ischemia-reperfusion injury. The present study aimed to test the hypothesis that HBO pretreatment enhances neovascularization in ischemic myocardium. Methods: Adult male Sprague-Dawley rats were randomly divided into four groups: normoxia + sham surgery (CS), normoxia + permanent occlusion of the left anterior descending (LAD) coronary artery (CMI), HBO pretreatment + sham surgery (HS), HBO pretreatment + permanent LAD occlusion (HMI). Rats receiving HBO pretreatment were intermittently exposed to 100% O2 at 2.5 atmospheres absolute (ATA) for 60min, twice daily for 2 days followed by 12h of recovery in room air prior to the myocardial ischemic insult induced by LAD ligation. Rats in the normoxia group were time matched with the HBO group and maintained under normoxic conditions prior to LAD occlusion. At 3 and 7 days after LAD occlusion, heart function parameters were measured by inserting a catheter into the left ventricle, infarct size was calculated using the method of TTC staining, myocardial capillary density was determined by immunohistochemical staining with a monoclonal anti-CD31/PECAM-1 antibody, VEGF protein level was determined by Western blot analysis, and cell proliferation was detected by BrdU staining. Results: At 3 days after LAD ligation, the infarct size of the HMI group was significantly smaller than that of the CMI group (26±2.5% vs. 38±3%, Pmax and -dP/dtmax were significantly improved in the HMI group compared to the CMI group at 3 and 7 days after LAD occlusion. Capillary density, VEGF protein levels, and cell proliferation detected by BrdU staining were significantly increased in the ischemic myocardium pre-exposed to HBO. Conclusion: HBO pretreatment accelerates angiogenesis and alleviates myocardial ischemia in the present rat model. K168 The affect of hyperbaric oxygen therapy on the cerebral infarction 1 2 2 Wenli Zhang , Xiaojie Ding , Wei Wang 1. Thoracic hospital of Qingdao, China 2. Central hospital of Qingdao, China Objective: To study the affect of hyperbaric oxygen therapy on the cerebral infarction; Methods: In the hyperbaric oxygen therapy group, 90 patients were treated with hyperbolic oxygenation one time in ten days besides the medicine treatment; Results: The affect of hyperbaric oxygen therapy group on the cerebral infarction was more than the medicine treatment group; Conclusion: hyperbaric oxygen therapy could disease the side effect of nerve damage, and prevent the recurrent of the cerebral infarction. K169 Hyperbaric oxygen preconditioning promotes angiogenesis in rat liver after partial hepatectomy 1 2 2 2 Ping Ren , Zhimin Kang , Guojun Gu , Yun Liu , 2 2 3 2 Weigang Xu , Hengyi Tao , John Zhang , Xuejun Sun 1. Department of pharmacology, Chinese Pharmaceutical University, Nanjing, China 2. Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China 3. Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, California, USA Objective: Hyperbaric oxygen preconditioning (HBO-PC) increases the level of HIF-1α and its target gene VEGF which is involved in angiogenesis. Liver regeneration is an angiogenesis-dependent process. We hypothesized that HIF-1α and VEGF mediated the angiogenesis effect of HBO-PC on regenerating rat liver. Methods: Male Sprague Dawley rats received HBO-PC followed by 70% partial hepatectomy. Proliferation of hepatocytes and endothelial cells was evaluated by BrdU staining. Microvascular density was assessed by immunohistochemistry. mRNA expression of HIF-1α was assessed by quantitative RT-PCR and protein levels of HIF-1α and VEGF were assessed by western blot. HIF-1α DNA-binding activity was determined with an ELISA-based kit. Results: HBO-PC increased the proliferation index of endothelial cells and microvascular density at 48 hr after partial hepatectomy. The protein level and DNA-binding activity of HIF-1α and the protein level of VEGF were increased by HBO-PC before and after partial hepatectomy. Partial hepatectomy alone also increased proliferation index and the expressions of HIF-1α and VEGF. Conclutions: Our results indicated that the angiogenesis effect of HBO-PC on liver after partial hepatectomy could be achieved by increased HIF-1α activity and VEGF expression. However, the angiogenic effect of HBO-PC is moderate and HBO-PC failed to produce additional effect on the enhancement of HIF-1α and VEGF induced by partial hepatectomy alone. K170 Hydrogen therapy reduces apoptosis in neonatal hypoxia-ischemia rat model Jianmei Cai, Zhimin Kang, WenWu Liu, Xuejun Sun Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China Objective: Hydrogen gas has been used in medical applications to prevent decompression sickness in deep divers from safety profiles. Recently, Ohsawa et al found that molecular hydrogen can selectively reduce •OH and ONOO– in cell-free systems and exert a therapeutic antioxidant activity, using a rat middle cerebral artery occlusion model. But the mechanism involved in the protective effects of Hydrogen therapy was unclear. Hypoxia-ischemia brain injury is a major cause of neuronal cell death especially apoptosis in the perinatal period. This study was designated to examine the effect of hydrogen therapy on apoptosis in an established neonatal Hypoxia-ischemia rat pup model. Methods: Seven-day-old rat pups were subjected to left common carotid artery ligation and then 90 min hypoxia (8% oxygen at 37 °C). Immediately after Hypoxia-ischemi a insult, pups were placed into a chamber filled with 2% Hydrogen for 30 min, 60 min, or 120 min, respectively. 24 hr after 2% Hydrogen therapy, the pups were decapitated and brain injury was assessed by 2,3,5-triphenyltetrazoliumchloride (TTC), Nissl, and TUNEL staining, as well as caspase-3, caspase-12 activities in the cortex and hippocampus. Results: Hydrogen treatment in a duration dependent manner significantly reduced the number of positive TUNEL cells and suppressed caspase-3 and -12 activities. Conclusion: these results indicated Hydrogen administration after Hypoxia-ischemia appeared to provide brain protection via inhibition of neuronal apoptosis. K171 Hyperbaric oxygen treatment in nitrogen poisoning Sun Lin, Guan Hongye No.1 People’s Hospital of Foshan Guangdong Province, China Objective: Further understand the importance of hyperbaric oxygen treatment in Nitrogen poisoning. Actively cooperated with the clinical treatment, hyperbaric oxygen can improve the survival rate. Methods: The patient put on the PSA-controlled gas-breathing machine and received treatment in high pressure hyperbaric oxygen cabin. Increase pressure for 25 minutes and pressure is 2.3 ATA. Breathing oxygen for 1 hour, then take a 5-minute break and decrease the pressure for 20 minutes. Result: The patient recovered. Conclusion: Hyperbaric oxygen is a fast and effective therapy of saving acute hypoxia caused by Nitrogen Poisoning. K172 The research of the cerebral anabiosis success under hyperbaric oxygen 1 1 2 3 Li Sun , Yan Shi , Guoping Feng , Yonggang Tan 1. Hyperbaric Oxygen Department, Shengli Oilfield Central Hospital, Shandong, China 2. Emergency Department, Shengli Oilfield Central Hospital, Shandong, China 3. ICU room, Shengli Oilfield Central Hospital, Shandong, China It reported eighteen cases of operating cerebral anabiosis under hyperbaric oxygen after cardiopulmonary anabiosis success and discussed the factor of success. There are fourteen cases of cerebral anabiosis success, two cases of bequeathing persistent vegetative state, two cases of death. The result of the treatise prompts that the operating of hyperbaric oxygen therapy on early stage basing the cardiopulmonary anabiosis success can improve the success rate of the cerebral anabiosis. K173 Psychological problems of the patients in hyperbaric chamber and nursing methods Song Juan the 306th Hospital of P.L.A, Beijing, China Objective: This thesis mainly studies the psychological problems of the patients who are treated in the hyperbaric chamber, and discuss the nursing methods of appeasing the psychological problems of the patients. Methods: Based on the different psychological problems of the patients, we adopt the health education, organizing informal discussions, nursing in the chamber and other kinds of measures. Results: Patients objectively get some knowledge of hyperbaric oxygen treatment. They also actively cooperate the treatment with a very stable mood. Conclusion: Nurses should make a lot of progress in the professional qualities and are aware of the importance of accompanying the patients in the chamber. K174 The detection and clinical significance of NSE level in cerebral infarction patients’ serum with hyperbaric oxygen treatment Hansheng Sheng, Hongbo Liu Zhu Hai People’S Hospital, China This paper is to study serum NSE level in cerebral infarction patients with hyperbaric oxygen treatment. The more NSE, the more it effusing from cells into cerebrospinal fluid and blood, combined with the changes of the cerebral blood flow metabolism, due to cerebral edema, which can cause the secondary lesion in century nervous system and aggravate the deterioration of the function of the blood-brain barrier. The NSE level after cerebral infarction if positive related to the pathogenetic condition. Therefor contrasting the NES level after pure oxygen and mixture hyperbaric oxygen treatment can help to predict severity and outcome of cerebral infarction. It provides evidence that Hyperbaric oxygen treatment can improve cerebral anoxia, lower intracranial pressure, increase the partial pressure of oxygen of reticular activating system and brain stem, thus reduce the NES, then promote consciousness recovering, improve the clinic symptom eventually. K175 Clinical value of HBO and drug comprehensive treat in chronic appendicitis Jing-yi SHAO, Yan-bin ZHANG, Zi-yang CAO, Zhi-hong XIU, Pei-jin Lu Liaocheng Second People’s Hospital Affiliated to Taishan Medical University, China Purpose: Inquiry the clinical value that the hyperbaric oxygen (HBO) with drug in treating chronic appendicitis. Method: 116 chronic appendicitis patients is divided into treating set and matched set random, the treating set treated with HBO and drug comprehensive, the matched set with applied drug only. Results: Treat set 58 cases, recovery 47 (81.0%), valid 9 (15.5%), invalid 2 (3.5%), total efficiency 96.5%;Matched set 58 cases, recovery 35 (60.3%), valid 16 (27.6%), invalid 7 (12.1%), total efficiency 87.9%.Two sets of total efficiency have shown the relatively difference (p<0.01). Conclusion: HBO with drug comprehensive treatment in chronic appendicitis has the relatively effect, and has important clinical application value. K176 Interfering effect of hyperbaric oxygen on the patient of cerebral tumor and cerebral artery tumor after operation Cunge Ren, Fen Wei, Futing Ma The Affiliated Hospital of AirForce Aviation Medical Research Institute of PLA, Beijing, China Objective: To approach the interfering effect of hyperbaric oxygen on the patient of cerebral tumor and cerebral artery tumor after operation. Methods: 30 patients of cerebral tumor and cerebral artery tumor after operation were divided equal 2 group by the method of semi-stochastic, the hyperbaric oxygen exposure group and the control group. The former group was cured by hyperbaric oxygen based on routine method, the later were only carried through injection of nerve-nutrition and sustain drug. Results: The therapy effect of 2 group have obvious distinct in directional thought, daily behavior, improve of the remembrance, the ability of self-control (P<0.05). Conclusion: The therapy of hyperbaric oxygen are advantaged in nerve tissue rehab, eliminated the oppressed symptoms of nerve tissue, reduce the sequela etc. It can shorten the time window of miss the opportunity of nerve function obviously, and improve the life quality of patient. K177 Hyperbaric Oxygen Therapy Nursing of Patients with Tracheotomy Qian Chunling, Wang Neng Chizhou People’s Hospital, Anhui, China Objective: To analyze the medical safety and effect of hyperbaric oxygen (HBO) therapy in patients with tracheotomy. Methods: The paper analyzed the situation of the50 patients treated with hyperbaric oxygen, holding that three tasks should be done to improve the treatment level: to prepare oxygen cabin and nursing articles, to nurse carefully, for example: general nursing, oxygen inhale, sputum suction and observation on patients illness and vein transfusion, to improve the level of nursing care and enhance their sense of responsibility. Results: The treatment of patients was not broken off, and no complication happened. Conclusion: It is key factor for patients with tracheotomy to keeping breathe a lucid before hyperbaric oxygen therapy, middle and after that. K178 Observation of curative effect of hyperbaric oxygen therapy on 3 cases of severe trauma patients in wenchuan earthquake Qi Yan the Second Provencal People’s Hospital of Guangdong , Guangzhou, China Objective: TO observe the curative effect of hyperbaric oxygen on 3 cases of severe trauma patients in Wenchuan earthquake. Method: Besides conventional therapy, such as support therapy, anti-inflammatory treatment and anticoagulant therapy, the 3 cases are treated by HBO per day; 15 days are 1 course of treatment. To observe the curative effect of hyperbaric oxygen after 1 day, 3 days and 7 days, respectively. Result: The symptoms of dizziness and headache of the 3 cases have disappeared, The quality of sleep and emotion have been improved, the hematoma has been obviously absorbed, the wound has healed well, The sensory function has recovered gradually, the muscle strength has been increased above 1 grade, which total effective rate is 100 percent. Conclusion: It is effective and safe for the severe trauma patients in earthquake early to obtain hyperbaric oxygen therapy on the basis of conventional therapy. K179 The Influence of Anxiety on the Effect of Sudden Sensorineural Hearing Loss Jiang Yan, Wang Rongzhen, Chen Lijuan, Ding Xiaohong, Lu Wei Dept. of HBO, First Affiliated Hospital of College of Medicine, Zhejiang University Objective: To study the influence of anxiety on the effect of sudden sensorineural hearing loss. Methods: 80 cases were divided into two groups according to anxiety scores. Group 1 had 57 cases, anxiety scores was more than 40. Group 2 had 23 cases, anxiety scores was less than or equal to 40. All the cases were treated by sympathetic method of medicines combined with hyperbaric oxygenation. Result: The general effective rate of the two groups was 53% and 85% respectively, with significant difference (p<0.05).Conclusion: :Anxiety has significant influence on the curative effect of sudden sensorineural hearing loss. K180 The clinic experience of Hyperbaric oxygen in Epilepsy Research Summary and Recommendations 1 2 Jinxiang Xie , Yongzhong He 1. Shantou Central Hospital Affiliated Shantou Hospital of YAT-SEN University, China 2. Department of pediatrics, Longhu Peoples Hospital, Shantou, China Aims: The purpose of this study is to sum up the clinic experience of Hyperbaric oxygen (HBO) in Epilepsy (EP) and make some sound recommendations. Methods: Several aspects, including means and main points of therapy, use of anti- epilepsy drugs (AEDs) and electroencephalograph (EEG), evaluation and affected factors of curative effect , of Clinic data about HBO in EP ware analyzed and concluded. Results: Recommendations: ①Theory and practice research of HBO in EP should be enhanced. ②Better therapeutic process of HBO in EP should be explored persistently.③ EP can be considered as one of the diseases treated by HBO. Sound curative effect of HBO in EP can be obtained according to choosing subjects correctly, seizing the curative time, working properly, using EEG and AEDs. Conclusion: Hyperbaric oxygenation therapy (HBOT) in EP has its own merits, such as short period of treatment, sound curative effect, no obvious side effect. Therefore, HBOT is a new and secure kind of technique and it can be used extensively. Affirmatively curative effect of HBO in most clients with EP can be achieved and its effect mainly lies on the results of the primary diseases. K181 Hyperbaric oxygen preconditioning reduces ischemic-reperfusion injury by inhibition of apoptosis in a middle cerebral artery occlusion rat model 1 2 1 1 Jiasi Li , Zhi-min Kang , Su-ju Ding , Wen-wu Liu , 3 1 John Zhang , Xue-jun Sun 1. Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China 2. Changhai Hospital, Second Military Medical University, Shanghai, China 3. Department of Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, California, USA Objective: This study examined the mechanisms of hyperbaric oxygen preconditioning (HBO-PC) on ischemic reperfusion brain injury. Methods: Male Sprague-Dawley rats (250-280g, n=144) were divided into control, middle cerebral artery occlusion (MCAO) for 90 min, and MCAO plus HBO-PC groups. HBO-PC was conducted four times by given 100% oxygen at 2.5 atmosphere absolute (ATA) , for 1 hour at every 12 hour interval for 2 days. At 24 hour after the last HBO-PC, MCAO was performed and at 24 hour after MCAO, mortality, neurological function, brain water content, infarct volume, and cell death were evaluated. Enzymatic activity of capase-3 and -9, expressions of cytochourome c, Bcl-2 and Bax proteins were performed in the samples from hippocampus, ischemic penumbra and core, respectively. Results: HBO-PC reduced brain edema, decreased infarction volume, suppressed mortality, and improved neurological recovery. HBO-PC decreased caspase enzyme activities, upregulated BCl2 expression, and reduced cytoplasm cytochourome C levels. Conclusions: HBO-PC protects brain tissues from ischemic reperfusion injury by suppressing mitochondrial apoptotic pathways. K182 Clinical observation of hyperbaric oxygen and drug treatment on facial neuritis WEI Fen, MA Futing, REN Cunge Affiliated Hospital of Institute of Aviation Medicine of Air Force, Beijing, China Objective: To observe the clinic curative effect of hyperbaric oxygen and drug treatment on facial neuritis. Methods: The subjects included 45 patients, which were randomly divided into two groups: treatment group (n1=21, drug therapy plus hyperbaric oxygen, 0.2MPa 99.5%oxygen, oxygen inhalation60min, 10days as one course) and control group (n2=24, drug therapy: prednisone 20-30mg/d po, and given vitB1 100mg+vitB12 500ug, take intramusular injection for 14days). Results: Comparing the changes of clinical symptoms after one course of treatment, there were notable difference in the curative rate (91.7% vs 84.2%) between treatment group and control group. The therapeutic effect of the treated group is better than that of the control group (P<0.05). Conclusions: Early HBO and drug therapy can shorten the course and raise the cure rate of facial neuritis. K183 The discussion on static-preventate -discharge technologyfor single human hyperbaric oxygen chamber Jianhua Yang, Yan He, Caijun Mei Affiliated Hospital to Chuanbei Medical University, Sichuan, China Objective: This paper analyses and explains the objective properties on HBOC static electricity existence so that inspire the manufacturer of single human hyperbaric oxygen chamber pay more attention to possible static harm in design, manufacture and install. Methods: We discuss the static-preventate -discharge technology about the manned HBOC vessel with the aids of some directed or indirected static electricity experiments and some actual circumstances of the three-variety single human hyperbaric oxygen chamber in our hospital. Results: The static-preventate -discharge technology for the human-body or the equipment units in the HBOC have feasibility and are practical. Conclusion: The static-preventate -discharge technology for the human-body or the equipment units in the HBOC need to be done some researches and improved deeply so that the safties are in the course of running the single human HBOC at any time. K184 Risk Management and Preventive Measures of Hyperbaric Oxygen Chamber YAN Xiaomin The First Affiliated Hospital, Chongqing Medical University, Chongqing, China Objective: To discuss risk management and preventive measures of hyperbaric oxygen chamber. Methods: To identify and evaluate the risk factors of hyperbaric oxygen therapy. Results: preventive measures for risk management of hyperbaric oxygen chamber were constituted. Conclusions: To establish the holistic operation regulations and implementation of risk management of hyperbaric oxygen chamber are ultimate guarantee for patient safety. K185 Study on brainstem reflex in patients with primary brain stem injury treated by hyperbaric oxygenation integrated therapy Lei Xue, Gangchuan Wu Department of Hyperbaric Oxygenation, Nan Fang Hospital, The Southern Medical University, Guang-zhou, China Objective: To investigate the predictive values of brainstem reflex (BSR) on the evaluation of severity, the effect and the prognosis in the patients with primary brain stem injury treated by hyperbaric oxygenation (HBO) integrated therapy. Methods: Sixty patients were divided into two groups: HBO group (n=30) and control group (n=30). HBO group were treated with HBO integrated therapy. Control group were treated without HBO conventional integrated treatment. During the treatment BSR were monitored at once every day for finishing treatments. The relationship for BSR ,Glasgow coma scale (GCS) and Glasgow outcome scale (GOS) were analyzed. Results: The BSR were closely related with GCS and GOS. The lower of disappear-level of BSR, GCS and GOS, the worse of the prognosis of the patients. The death have 3 scores in GCS, BSR disappears on the level of number Ⅳ~Ⅵ. The BSR were to be an index used for adjusting the proposals of HBO treatment. Conclusions: BSR were considered to be valuable to the evaluation of severity, the effect and the prognosis in the patients with primary brain stem injury treated by HBO integrated therapy and to be an index used for adjusting the proposals of HBO treatment. K186 Monitoring effect of disinfection in hyperbaric oxygen chamber and oxygen humidified tank and measures of nosocomial infection control Lei Xue, Xiaohui Liu Department of hyperbaric 0xygenation, Nan fang hospital, Southern medical university, Guang-zhou, China Objective: To disinfect the air of hyperbaric oxygenation (HBO) chamber, article surface of HBO chamber and oxygen humidified tank and monitor their bacteria counting and identification regularly. To improve the way of disinfection with monitoring effect and control nosocomial infection. Methods: The ways of disinfection included cleaning up HBO chamber and ventilating by electric fan, cleaning article surface of HBO chamber with disinfectant and water, disinfecting HBO chamber with disinfector for 30min~60min. Before HBO therapy and after disinfecting of HBO therapy, the air of HBO chamber, article surface of HBO chamber and oxygen humidified fluid of oxygen humidified tank were sampled regularly. The samples were analyzed with bacteria counting and identification. The effect of disinfection was be used to improve the way of disinfection control nosocomial infection. Results: Our Disinfecting of HBO Therapy kept the bacteria counting in the air of HBO chamber at 3 ≤500cfu/m and on article surface of HBO chamber at 3 ≤10cfu/m , fulfilled the requirement of class Ⅲ environmental sanitation standard. The bacteria counting in oxygen humidified fluid of oxygen humidified tank kept 3 at < 10 cfu/ml. Conclusions: Our Disinfecting Measures of HBO therapy can controls nosocomial infection. K187 The effect of combined hyperbaric oxygen on severe head injury (report of 42 cases) Zhihui Xie, Jianguo Li, Zuoxun Chen The Affiliated Hospital of Zunyi Medical College, Guizhou, China Objective: To investigate the clinical effect of hyperbaric oxygen (HBO) therapy on severe head injury. Method: 42 cases with severe head injury received combined HBO and the effect was determined according to the clinical curing criteria of diseases diagnosis. Results: Recovery in 7 cases (16.7%),improvement in 30 cases (71.4%) and inefficacy in 5 cases (11.9%),the total effective rate was 88.1%.The effect was better in the group of short course than the group of long course, and it was significant especially within twenty days(the total effective rate was 93.3~ 94.4%). The total effective rate of the children below ten years old was higher obviously than that of the adult (it was 100%,84.3% ~ 85.7% respectively). Conclusions: As an effective treatment, HBO plays a specific role in remedy of the acute and severe head injury. HBO should be applied to the patients with severe head injury as early as possible if their conditions allow. Moreover, HBO has significant effect on severe head injury in children compared with the adult; therefore, it should be adopted early. K188 An Investigation on hyperbaric oxygen in premature infants with hypoxic-ischemic encephalopathy and the long-term effect 1 2 Yongzhong He , Jinxiang Xie 1. Department of pediatrics, Longhu Peoples Hospital, Shantou, China 2. Shantou Central Hospital, Affiliated Shantou Hospital of YAT-SEN University, China Aims: According to reviewing and summing up the short-term and long-term effect of Hyperbaric Oxygen Therapy in premature and underweight Infants with Hypoxic-ischemic Encephalopathy (HIE), as well as the experience, the purpose of this study is to recommend some principles of Hyperbaric Oxygen Therapy. Methods: Based on analyzing the clinic data and the primary therapy, infant hyperbaric oxygen chamber was used, the pressure was 0.13MPa, the content of oxygen is between 72% and 75%, and once a day, 60min at a time, 9.6 times for every infant on average. Effect of just terminating therapy and seven years old was assessed. Results: All 33 infants recovered and leaved hospital after Hyperbaric Oxygen Therapy. However, during the observation, one died and five with serious HIE infants had sequelas, the rest with serious HIE and all with slight or moderate HIE recovered completely, the total efficiency is 96.7 % (32/33). One infant in 32 has cerebral atrophy in CT for brain and the other are normal. Side-effect such as Broncho pulmonary dysplasia (BPD) and Retinopathy of prematurity (ROP) has not been discovered. Conclusion: According to the research of BPD and ROP made in abroad, in principle, Hyperbaric Oxygen Therapy should be forbidden in premature and underweight infants. K189 A case of hyperbaric oxygen treatment causing pneumatocephalus Rong Xie, ZhiQiang Zhuang PuNan Hospital, Shanghai, China Objective: To approach the pneumatocephalusability when hyperbaric oxygen treatment for acute brain injury patient. Method: reporting a practicality. Result: a patient suffered a acute brain injury and got left frontal bone fracture. We cured him with hyperbaric oxygen. The pressure of chamber is 0.12Mpa, the oxygen uptake time is 30 minutes, then interrupt with 5 minutes air, and input oxygen for another 30 minutes, the compression time 15 minutes, and lower to atmospheric pressure with 20 minutes. After 5 times of hyperbaric oxygen treatment, head CT of the patient showed elliptical gas density in left front brain. Conclusion: On the occasions of the head lacerated wound, the fractured skull or skull bottom, around the eye socket hypodermic and the conjunctiva ecchymosis, the external auditory meatus or nasal passage had the bloodstain, cerebrospinal fluid leaks from nose, ear or eye. malfunction of smell, the vision to be fuzzy, and symptoms of oculomotorius damage. It is necessary to take a head CT before making the hyperbaric oxygen treatment. If the patient shows some symptoms of headache, dizziness, diplopia or vomit in the pressure chamber. the doctor should stop compress, respire oxygen and reduce pressure slowly. Then reexamine head CT, to prevent the gas from entering encephalocoele and cause pneumatocephalus. K190 The first to enter is last to exit law of gas saturation and de-saturation Xiao Pingtian Xiangya Hospital of Centre South University, Changsha, China objective: To investigate the law of gas getting into or out of the body during changes of environmental gas pressure. Method: We used two methods of cabin operation to compare the region of variation of real efficiency figures of partial oxygen pressure (PO2T) and partial nitrogen pressure (PN2T) in five kinds of hypothetical tissues, and with different compression time and different steady pressure: In procedure I, patients were assigned to inspire air during the compression stage; In procedure II, the patients inspired oxygen during the compression stage. Results: ①The PO2T of procedure II was markedly larger than that of procedure I and the PN2T of procedure II was markedly less than that of procedure I;②The size of region of variation of PO2T and PN2T in both procedures was in direct proportion to the speed of gas saturation of the tissues;③The PO2T and PN2T of all groups increased as the steady pressure increased. The PN2Tof procedure I of all group increased on lengthening the time of compression, but the PO2T was not increased, and, on the contrary, it reduced a little. Conclusion: The law of gas going into or out of the body is that the gas that is saturated first, is the last to de-saturate (first to enter is last to exit), and this law is mainly to increase the time efficiency of hyperbaric effect. The law of “first rapid, later slow” is to raise the pressure efficiency of gas saturated in advance of hyperbaric effect. These two laws are the significant theoretical basis for hyperbaric oxygenation pretreatment and the reason that procedure II is selected to replace procedure I. However, when procedure II is applied, the compression time should not be overly prolonged. K191 The effect of hyperbaric oxygen on consciousness recovery of the coma patients suffering from brain ischemia re-perfusion Xiao Pingtian Xiangya Hospital of Centre South University, Changsha, China Objective: To investigate the effect of hyperbaric oxygen on consciousness recovery of the coma patients who suffer from brain ischemia re-perfusion. Method: 11 cases of coma patients suffering from brain ischemia re-perfusion were recruited in this study. The clinical data of the treatment of hyperbaric oxygen were collected and analyzed. Results: 1) all five subjects with full recovery received hyperbaric oxygen treatment within 60 hours after coma; 2) There were two cases with little intelligence damage. One patient were treated with hyperbaric oxygen five 5 hours after coma. The other one received sub-hypothermia treatment immediately after the occurrence of cardiac arrest, and started hyperbaric oxygen therapy at 21st day. 3) One subject receiving hyperbaric oxygen three days after brain ischemia coma was in persistent vegetative state. Another patient starting hyperbaric oxygen four days after coma died finally. Conclusion: The prognosis of the coma patients suffering from brain ischemia re-perfusion is related to many factors. An appropriate treatment opportunity is critical to the protective effects of hyperbaric oxygen on brain cells in the coma patients suffering from brain ischemia re-perfusion. K192 Safe oxygen inhaling device without resistance in hyperbaric oxygen Wu Zhide Xiangya Hospital, Zhongnan University, Changsha, China Objective: To evaluate the clinical value of a new oxygen inhaling device by observing the oxygen inhaling resistance and oxygen concentration in chamber. Method: To divide into three groups: pulmonary oxygen supply apparatus (A group), continuous oxygen supply apparatus (B group), and new oxygen inhaling apparatus (C group). Oxygen inhaling resistance and oxygen concentration in chamber of three groups were measured. Result: there was significant difference for oxygen concentration in chamber in three groups (P<0.05), B group was obvious higher than A group and C group(P < 0.01), But no significant difference was found between group A and group C(P>0.05); A group was obvious higher than B group and C group in oxygen inhaling resistance(P<0.01), But no significant difference was found between group B and group C(P>0.05). Conclusion: New oxygen inhaling device can diminish the oxygen inhaling resistance and cut down oxygen concentration in chamber, in favor of the treatment and safety of hyperbaric oxygen, then to be worth further clinically generalization. K193 Hyperbaric oxygen for acute myelitis----one case report Haibin Xiang, Rong Xie Shanghai Punan Hospital, Shanghai, China A 8-year-old girl entered the hospital with the chief complaint “Lower limbs fatigue, following walking dysfunction and the obstacles of urination and defecation ”. PE: Disapear of PTR and ATR tests. Muscle strain declined, and the muscle force of the lower limbs were of grade 0~I. The Babinski’s signs of the lower limbs were negative. The cerebrospinal test indicated the corruption of blood brain barrier (BBB), the dispropotion increased of IgG. And the MRI of the spine revealed: abnormal signal of spinal cord (T4~T11), advisement diagnosis was acute myelitis. Then the patient was given high-dose hormone implusion treatment, associated with neurotrophic drugs. Three days later, the patient could urinate by herself. On the ninth day, the patient was noted to have pathologic signs of neurosystem and can defecate herself. But her lower limbs were still disability. Ten days after the patient entered the hospital, she took the oxygen treatment. One oxygen chamber session finished, the patient’s muscle force of lower limbs increased to grade Ⅲ-Ⅳ and the muscle strain also improved. PTR test exist. She can walk by help. When two oxygen chamber sessions finished, the patient recovered, she can walk by herself. The PTR test performed showed normal exist, the muscle force was grade Ⅳ—Ⅴ. This case the patient had unsatisfactory effect under normal treatment, however, combined with hyperbaric-oxygen treatment, the paralysis gradually reduced, muscle force improved, and the patient could walk without help. The hyperbaric-oxygen treatment could improve the spinal oxygen saturation and the pressure of spinal oxygen, increase the oxygen dispersion, thus could improve the anoxic situation of spinal cord, decrease the dropsy of spinal cord, and also improve the function of BBB, alleviate the inflammational conglutination of the tissue. The hyperbaric-oxygen treatment could also extend the time of neurocell regeneration; protect the reversible nerve, which in the end improve the function of the nerve. Since the BBB dysfunction could easily result in paralysis, we recommended the use of hyperbaric-oxygen treatment and especially use this remedy at the acute period of the disease. K194 The safe nurse of hyperbaric oxygen treatment on moderate to severe craniocerebral injury patient Wu Qiaoning The Six Affiliated Hospital of GuangXi Medical University Objective: To explore the preferred way of the safe nurse of hyperbaric oxygen treatment on moderate to severe craniocerebral injury patient. Methods: According to clinical classification, pars affecta, associated injury, operation, pathogenetic condition, complication and so on,122 moderate to severe craniocerebral injury patients were adopted correspondence safe nursing intervention at prior hyperbaric oxygen treatment, during hyperbaric oxygen treatment and post hyperbaric oxygen treatment. Result: Because of safe nursing intervention is targeting, all of the 122 moderate to severe craniocerebral injury patients can complete hyperbaric oxygen treatment safety and successfully, and there are no the complication and accident of hyperbaric oxygen treatment. The curative effect is satisfaction. Conclusion: Reinforcement on prior, during and post hyperbaric oxygen treatment safe nursing is the key point of treatment. K195 Prevention and Treatment on the decompression sickness of diving work fishermen Wen Chengwen People’s Hospital, Hainan, China Objective: To study prevention and cure method and treatment effect of the decompression sickness diving work fisherman. Method: The object of treatment is divided into patient’s team and health cure treatment set. It is adopted dissimilar treatment project of the Chinese air diving decompression sickness compression treatment form. Result: The treatment efficient of patient team is ninety porcent. The decompression sickness rate of health cure treatment set is 0.67%. Conclusion: For the fisherman of diving work, It should carry on compression treatment periodical. For the patient of decompression sickness, It should carry on compression treatment as early as possible. K196 Clinical observation of hyperbaric oxygen and ginaton in the treatment of sudden deafness Cuixia Xue, Xinli Zhang, Lin Wang Department of hyperbaric oxygen, The First People’s Hospital of Qingdao Economic and Technological Development Area, Shandong, China Objective: To investigate the effect of hyperbaric oxygen (HBO) combined with ginaton for sudden deafness (SD). Methods: 109 patients with sudden deafness were divided into hyperbaric oxygen group and control group at random. Both of the two groups were given ginaton. 57 patients with SD were exposed to HBO, which also were divided into group A that was exposed to HBO in 3 days after getting SD and b that after 3 days. 52 patients for comparison (non-HBO group) were treated only by ginaton without HBO. Results: The overall effective rate in HBO group (84.2%) was higher than that in non-HBO group (65.4%) (χ2=4.211, P<0.05). Furthermore, it in group A (96.3%) was higher than that in group B (73.3%) (χ2=4.041, P<0.05). Conclusion: Therapeutic effect of HBO combined with ginaton for SD is significantly better than that of simple ginaton without HBO. K197 Case Study: A 56-year-old Man with acute methyl chloroform saturation Shi Chunmei Shanghai Shuguang Hospital, Shanghai University of Traditional Chinese Medcine and Pharmacology, Shanghai Clinical data: A 56-year-old man was inadvertently exposure in methyl chloroform gas on Dec21st 2007, immediately the patient felt headache and dizziness, unsteady step like drunk, limb fatigue and numbness, malaise and vomiting. The patient was seen in the out-patient and given transfusion treatment. The tremedy of transfusion was not clear. His symptoms were controlled for a time. However, the headache and dizziness increased, and he did not have a response to treatment with transfusion, the patient was scheduled for oxygen treatment on Dec27th 2007. The protocol of hyperbaric-oxygen treatment was: exposed to 100 percent oxygen at 1 and then 2.2 atmospheres absolute during the chamber session. After five times oxygen chamber treatment, the patient recovered and remained chest bored and limb fatigue. When one oxygen chamber session finished, the patient was evaluated in the out-patient clinic. Additional information were obtained, it was learned that the chest bored disappeared, the headach and dizziness decreased, and the limb numbness also decreased. After two oxygen chamber sessions, the symptoms of the patient dissapeared. Discussion: Methyl chloroform was a kind of low toxity poison. Reports on its poisoning mechanism on health were poor. The approach for its poisoing was predominately through aspiratory system. The target apparatus of methy chloroform was neural system. When exposure in low-concentration methyl chloroform, the symptoms were restrain effects of neural system such as body im-balanced. However, the exposure in high-concentration methyl chloroform would lead to an aesthesia-like symptoms of the neural system, even the loss of respiratory and resulting in the death of patient. In this case, the patient was inadvertently inhaled the methyl chloroform gas during work, which resulting in the nerual system symptoms such as headache and dizziness, unsteady steps, limb fatigue, vomiting, chest boring and weeping. All the clinical representation was consistent with the data. The report of hyperbaric-oxygen treatment on the methyl chloroform poisoning was very poor. This case was gained satisfied effect by using oxygen chamber treatment. The mechanism of it was need further investigated. K198 The Effects of the Hyperbaric Oxygen on Consciousness Recover With Serious Brain Injury 1 2 2 Wu Qiong , Weng Qibiao , Wang Hongjun , Chen 2 2 3 Lingzhen , Chen Xuelin , ChenQiuYan 1. Taishan People’s Hospital of Jiangmen City, Guangdong Province, China 2. Department of Hyperbaric oxygen, Zhujiang Hospital attached to Southern Medical University, China 3. Nanhai People’s Hospital of Foshan City, Guangdong Province, China Aim: The effects of the Hyperbaric Oxygen on consciousness recover with serious brain injury. Method: Using single hyperbaric oxygen chamber to cure the patients whose brains are seriously damaged before losing their consciousness in 41 cases. Scheme: 0.2MPa 20min×2+40min.using the Hyperbaric oxygen chamber to cure the patients after their consciousness recovered.Scheme:0.20Mpa 20min×2+90min. Result: 29 in 41 cases recoveredcure rate: 70.73%. Conclusion: The Hyperbaric Oxygen is helpful in curing patients whose brains are seriously damaged and it can reduce the rate of persistent vegetated situation. K199 The prognosis analysis of different hyperbaric oxygen treatment period after cerebral hematoma removal Wen Li, Jinlong Sha, Haili Tang, Yan Yang, Hua Qiu Dongguan Hospital, Dongguan, China Objective: To investigate the effects of hyperbaric oxygen treatment during the different period after intracerebral hemorrahage removal. Methods: 73 postoperative patients after intracerebral hemorrahage removal were divided into early treatment group (group A, within 14days after operation, the patient number is 38, Male:25, Female:13,age:28~70Y,average age:58Y) and later treatment group (group B, more than 14days after operation, the patient number is 35, Male:26, Female: 9, age:30~69Y, average age:61Y) according to the ’ beginning time of therapy. Results: group A s efficient ’ rate is 94.73%, group B s efficient rate is 71.43%. To compare the early treatment group with its counterpart, there were significant difference (P < 0. 05) on the improvement of therapeutic effect and daily living activity between two groups. Conclusion: The therapeutic effect of early treatment group is better than that of later treatment group, The more early to start hyperbaric oxygen treatment, the better prognosis we can get. K200 Prevention and treatment of carbon monoxide intoxication and tardus encephalopathy by HBO Xia Huang, Guoyi Ren, Wenhui Li Zhujiang Hospital, South Medical University, China Objective: To investigate the therapeutic effect of hyperbaric oxygen (HBO) on acute carbon monoxide intoxication and the feasibility on prevention of tardus encephalopathy. Methods: The clinical data of 46 cases of moderate or severe acute carbon monoxide intoxication treated with hyperbaric oxygen (HBO group) and 30 cases of acute carbon monoxide intoxication with regular treatment except HBO (control group) were analyzed. Results: The effective rates were 97.83% for HBO group and 76.67% for control group. There was a significant difference between the two groups (p<0.05). The incidences were 2.94% for HBO group and 13.33% for control group. There was a significant difference between the two groups (p<0.05). Conclusion: Hyperbaric oxygen treatment can reach an obvious therapeutic effect on acute carbon monoxide intoxication and reduce the incidence of tardus encephalopathy. K201 Clinical therapeutic effect of hyperbaric oxygen treatment for craniocerebral injury Quyun Yang, Qibiao Weng Zhujiang Hospital, South Medical University, China Objective: Value the Therapeutic effect hyperbaric oxygen treatment for Craniocerebral Injury. Methods: Totally 192 patients samples were enrolled, all the patient s are randomly assigned to three groups. Group A (control conventional therapy group). Group B (giving hyperbaric oxygen treatment after Craniocerebral injury for 20 to 30 days) and gaining satisfied effect. Results: Stress ulcerbleeding occur rate: There was significant difference between group B and group A (P < 0.05) after Craniocerebral Injury for 20 to 30 days. And no significant difference between other groups (P < 0.05) on rest stage and groups. Conclusion: Hyperbaric oxygen treatment shows obvious curative effect for Craniocerebral Injury, and treatment after injury for 20 to 30 days is the best performance time. HBO is an important and active measure in curing the Craniocerebral Injury. K202 Investigate the effect observation and coordinate with humanistic care nursing strategy of high-pressure oxygen (HBO) treatment of persistent vegetative state (PVS) Wu Ruilan HBO Center, Affiliated Hospital of Hainan Medical College, Hainan, China Objective: Investigate the effect observation and nursing strategy of high-pressure oxygen (HBO) treatment of persistent vegetative state (PVS) patients. Methods: 134 cases of PVS patients were randomly divided into two groups: HBO treatment (n = 84) and conventional treatment group (n = 50), testing PVS before and after the treatment, and contrast with HBO after treatment efficacy and duration, frequency, causes relations, coordinate with humanistic care, observation of treatment. Results: The total efficiency of HBO group is 85% and conventional treatment group is 52%, respectively X2 = 16.59. P<0.01, the effect of HBO treatment was significantly better than conventional treatment group;compared to conventional treatment before and after, the statistical difference was no significant (P>0.05). Conclusion: HBO treatment to PVS patients with a positive role in restoration, and have closely related with the duration of treatment, frequency and causes. The appropriate care during treatment, will reduce the pressure of patients, and establish confidence in the treatment and improve treatment. K203 The effect of hyperbaric oxygenation therapy on the flash electroretinogram in rats with experimentally elevated intraocular pressure Wu Shuanggui Lengshuijiang People’s Hospital, Hunan, China Objective: To investigate whether hyperbaric oxygenation therapy can improve the electroretinogram in rats with experimentally elevated intraocular pressure (IOP). Methods: Acute elevated IOP model was built in each eye of 18 Wistar rats, then they were divided into A and B groups randomly. Group A (no HBO group), nine rats were not used any therapy. Group B (HBO group), nine rats used hyperbaric oxygenation therapy after model building. The electroretinogram was recorded again after 7 days. Results: The b wave recoveries of the electroretinogram in group A were (41.85±13.20)%; that in group B were (60.04±13.20)%. The difference between two groups was statistically significant (P<0.01). Conclusions: Hyperbaric oxygenation therapy promoted the FERG b wave recoveries. It indicated that HBO therapy could protect retina on fighting against the ischemia injures. K204 Hyperbaric oxygen and traumatic brain injury Yali Wu, Lianbi Xue Hyperbaric Center of Beijing Tiantan Hospital, Capital Medical University, Beijing, China Objective: :Traumatic brain injury (TBI) is called the silent epidemic in china, because of which our society is now suffering from heavy economic burden. All kinds of medicine and hypothermia treatments have failed to improve the TBI patients’ functional outcome and lower down mortality rates. Recently, oxygen therapy has shown a great effect in the animal and clinical research, and it is quite promising to treat TBI with hyperbaric oxygen (HBO) therapy. So the HBO therapy is getting more and more important in the treatment of the acute TBI and in the process of recovery. Consequently, this review summarizes the current mechanisms of HBO treatment in traumatic brain injury (TBI) and their efficacy. Methods: Directed literature review. Results: It was considered that the cerebral vasoconstriction and increasing the oxygen utilization were the primary mechanisms of HBO in treating TBI. But now, it is found that HBO can improve the cellular level cerebral aerobic metabolism so as to make the damaged mitochondrial recover. Furthermore, HBO, with the ideal treatment paradigm of 1.5 ATA during 60 minutes, does not produce oxygen toxicity so the patients will be relatively safe. However, although whether to use HBO to treat TBI, remains controversial, more and more evidences show that HBO may be a method to treat the patients with brain injury. So further investigations are required to prove the effect of HBO in treating TBI and the pharmacy and treatment opportunity still need research. K205 Hyperbaric oxygen treatment and nursing of 33 cases of sudden deafness Wu Yanqiu Henan Provincial peoples Hospital in Zhumadian City Centre, China Objective: Discussion HBO on the effect of sudden deafness observation and influence. Method: the 33 cases 1Outstanding deafness by age less than 50 fears old and is divided into more than 50-years old with the effect of observation. 2Checks can be divided into mild, moderate and severe when the effect of HBO. 3After treatment from the disease sooner or late can be divided into less than a week and less than tree months, more than three months to six months when the effect of six months. Sudden deafness hyperbaric oxygen treatment efficacy significantly. Results: According to the incidence of different ages and the length and pure-tone audiometry, the clinical course of the 3 - 4 separate high-pressure oxygen, treatment, younger, the higher the cure rate and efficiency, the shorter the onset time, the cure rate and more efficient, pure-tone audiometry, classification, the more light deafness, the higher the cure rate and efficient. Conclusion: HBO treat of sudden deafness the clinical efficacy and age, the incidence of time and the severity of the illness. Middle-aged incidence after treatment sooner, the best effect. K206 Analysis of the therapeutic effect of low molecular weight heparin sodium combined with hyperbaric oxygen in patients with acute cerebral infarction. Lianhua Wu, Chunjin Gao, Huan Ge, Guozhong Wang, Liming Zhao, Yu Gao, Yi Zhang, Linlin Ma, Fujia Liu Department of Hyperbaric Oxygen, Chaoyang hospital Affiliated of Capital University of Medical Sciences Beijing, China Objective: To investigate the therapeutic effect of low molecular weight heparin (LMWH) combined with hyperbaric oxygen (HBO) on Patients suffered from acute cerebral infarction. Method: 203 patients with acute brain infarcted were divided in to 2 groups firstly. 101patents in control group, were treated by0.1ml/10kg LMWH Sodium, hypodermic injection, once per 12 hours, treatment begun in 72 hours after acute brain infarcted. for a treatment course of 7 days, There were102patents in the HBO group, were treated with LMWH Sodium combined with HBO witch was once a day for 20days.Neurological impairment scores (NIS) and ability of daily life (ADL) scores (Barthel index)were used as effective parameters before and after treatment in two groups .Results: The NIS was significant lower in HBO group than in control group (p<0.01)and ADL score of the HBO group was higher than control group(p<0.05) after treatments. Conclusion: Low Molecular Weight Heparin combined with Hyperbaric Oxygen has more therapeutic effect than Low Molecular Weight Heparin in treating patients of acute cerebral infarction. K207 Clinical study on the relate markers of blood coagulation in the patients with avascular necrosis of the femoral head after severe acute respiratory syndrome lianhua wu chunjin gao guozhong wang lin yang xiaomin hou huan ge chengqing xia man qi Department of Hyperbic Oxygen ,Chaoyang hospital Affiliated of Capital University of Medical Sciences Beijing China Hyperbaric Oxygen Department, People’s Hospital, China Objective: To investigate the blood coagulation function in the patients with avascular necrosis of the femoral head after severe acute respiratory syndrome. Method: we measured respectively the expression of CD 31, CD61, CD 62p, CD63 and PAC-1 on platelet membrane by flowcytometry, and measured the plasma prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT) ,and fibrinogen (Fbg) by blood clotting instrument in 26 patients with avascular necrosis of the femoral head after severe acute respiratory syndrome and in 17 healthy adults. Results: The expression of CD31, CD61, CD 62p, CD63 and PAC-1 on platelet membrane in 26 patients were all lower than those in 17 healthy adults (p0.05) in those markers between patients and 17 healthy adults. Conclusion: The blood may not be in hypercoagulable state in patients with avascular necrosis of the femoral head after SARS. ISO refers to International Organization for Standardization. The essence of standardization is the design and implementation of all kinds of rules and regulations. The design and implementation of rules are absolutely necessary for treatment with hyperbaric oxygen chamber. We can assure absolute safety of hyperbaric oxygen chamber in treatment process, increase the overall quality of the Hyperbaric Oxygen Department, increase the safety management level for hyperbaric oxygen chamber, improve all of the rules and regulations in the process of modification and assure that the safety management of hyperbaric oxygen chamber keeps at the best level only when the designed rules and regulations are strictly obeyed and firmly implemented to turn visible rules into invisible actions. ISO standardized management is the top priority in the treatment process with hyperbaric oxygen chamber as it is directly related with the life safeties of patients. Absolute life safeties of patients who are treated with treated with hyperbaric oxygen chamber can be assured only when all hidden dangers are eliminated. The key to the safety management of hyperbaric oxygen chamber lies on the implementation as well as continued modification and perfection of all sorts of rules and regulations. Standardized management is extremely important in the safety management of hyperbaric oxygen chamber. K208 The role of hyperbaric oxygenation on the convalescence of brain injury at high altitude Hongzhi Xia, Suzhi Li, Chengliang Huang, Xuehong Yang, Qing Zhang, Maoxu Wang Department of hyperbaric oxygenation,Military general hospital of Tibet, Lhasa, China Aim: To evaluate the role of hyperbaric oxygenation (HBO) on the convalescence of brain injury at high altitude. Method: 270 patients convalescence of brain injury treated with HBO adding to medicines compared with 98 patients treated with medicines at the same period. Result: The cure rate in HBO group was obviously higher than that in medicine group. Conclusion: HBO can ameliorative brain tissue anoxia quickly, increase contain of oxygen, increase the oxygen save, make blood vessel constringency of each organism, increase or reduce little of sacral vertebrae iliac artery hem the discharge, ameliorative reticular formation function of brain stem, cerebella winning, benefiting to patients consciousness instauration with wide awake, and can accelerate the disease cooking stove the clearance, hematoma absorption and make organize the inside gum quality the cell to divide to increase in value, produce the large quantity gum quality the fiber the tissue that repair the harm, and establish the vice circulation, urge the capillanisum regeneration quickly, promote the tapetum tissue recovered. K209 Standardized Management Based on ISO 9000 System is the Fundamental Assurance for Safety Management of Hyperbaric Oxygen Chamber Sun Li Haikou Municipal K210 Effects of hyperbaric oxygen on the content of inflammation mediators in the rat brain tissue following fluid-percussive brain injury 1 2 1 2 Yue Li- na , Gao Chun-jin , Zhou Li-chun , Pang Bao-sen , 2 2 Zhao Qi-hang , Wang Guo-zhong 1.Department Of Neurology, Beijing Chaoyang Hospital,Capital University Of Medical Science, Beijing, China 2.Department of Hyperbaric Medicine, Beijing Chaoyang Hospital,Capital University Of Medical Science, Beijing, China Objective: To observe the changes of content of interleukin-1beta(IL-1β),tumor necrosis factor- alpha (TNF-α),Intercellular adhesion molecule-1(ICAM-1) and interleukin-10 (IL-10) before and after hyperbaric oxygen in the injuried brain tissue of Sprague-Dawley rats following severe lateral fluid-percussive brain injury and to explore the mechanism of hyperbaric oxygen on traumatic brain injury. Methods: 72 male Sprague-Dawley rats were randomly distributed into 3 different groups: traumatic brain injury group (TBI group), hyperbaric oxygen group (HBO group) and sham-operation group (SO group).The severe traumatic brain injury models were established by the fluid percussion device. After 6 to 72 hours of survival, rats were killed, and about 200 mg of brain tissue that contained the injury site, as well as tissue proximal to this region,was isolated for homogenizing.The concentrations of IL-1β, TNF-α, ICAM-1and IL-10 in the homogenate of brain tissue were measured at 6h, 24h, 48h and 72h, respectively, by using enzyme-linked immunosorbent assay (ELISA).Protein levels were determined by the method of Bradford. Results: were expressed as means±stand deviation.The SPSS 11.5 software was used for statistical analysis. The differences between groups were compared using a One-Way ANOVA,followed by an inter-groups analysis using the Student Newman Keuls Test. Differences were considered significant if the P value was <0.05. Results: 1.The concentration of IL-1β in homogenate in the HBO group at 6h was significantly higher than that of the SO group (p<0.05), but lower than that of the TBI group (p<0.05). The concentration of IL-1β in homogenate in the HBO group at 24h was significantly lower than that of the TBI group (p<0.05). 2. The concentration of TNF-α in homogenate in the HBO group at 6h was significantly lower than that of the TBI group (p<0.05). 3. The concentration of ICAM-1 in homogenate in the HBO group respectively at 6h, 24h, 48h and 72h was significantly higher than that of the SO group (p<0.05),but lower than that of the TBI group (p<0.05). 4.The concentration of IL-10 in homogenate in the HBO group respectively at 6h, 24h and 48h was significantly higher than that of the SO group (p<0.05),but there was no significant difference compared with TBI group (p>0.05). Conclusions: 1. Fluid percussion device can establish a severe traumatic brain injury model of rat successfully. 2. IL-1β, TNF-α, ICAM-and 1IL-10, which took part in the inflammatory mechanism after trauma, were elevated in the injuried brain tissue following TBI. 3. HBO treatment can effectively relieve the inflammatory following TBI through inhibiting the expression of IL-1β, TNF-α and ICAM-1, but can not throuth elevating the expression of IL-10. HBO may play a role in preventing the secondry brain injury and protecting the injury brain through the above mechanisms. First Author’s Index A Renu, Agnihotri OR08 Chavez, Alberto OR10 B Jiaxiang, Bai K11 Dirk J., Bakker B1 Jian, Bao K64 John M, Batle OR11 P52 Michael, Bennett OR06 Zhumei, Bi K56 Jing, Bian K76 C Jianmei, Cai K170 Jorge, Calderón OR12 Hao, Chen K62 Jianhui, Chen K123 Lijuan, Chen K61 Sailian, Chen K60 Yanhua, Chen P53 Yifei, Chen P15 Jincheng, Cheng OR21 Philippe, Colombani P25 Frans, Cronjé PL2 Cao, Cui K73 Yan, Cui K125 D Congying, Deng K32 Jordi, Desola PL11 Yuqin, Du K59 Shutian, Duan K46 F Wenqing, Fan K131 Lianfeng, Fei P14 John, Feldmeier OR02 P44 Jochen, Freier PL5 G Chunjin, Gao P10 Ningqin, Gao K57 Xiudong, Gao K68 Yu, Gao P33 K55 Chaoming, Ge K54 Huan, Ge K53 Guojun, Gu K66 Guanghan, Guo K52 Junmei, Guo K51 Na, Guo K50 Stephen, Guthrie PL10 H Michal, Hajek OR03 Christer, Hammarlund OR14 Cuihong, Han K167 Chunyang, He P20 Guiying, He P13 Xia, He K49 Yongzhong, He K188 Mingyan, Hei K48 Christtian, Heiden OR01 Xiaomin, Hou K47 Te-Chun, Hsia P38 Cheng-Pu, Hsieh P42 Guiping, Hu K79 Huijun, Hu K81 Shengli, Hu OR28 Lingling, Huang P18 Min, Huang K74 Xia, Huang K200 Xiang, Huang OR13 J Mingyi, Ji K90 Yunping, Ji K89 Jianping, Jiang K88 Wenbo, Jin K86 K Mahito, Kawashima PL1 Lei, Kong K84 Jacek, Kot OR05 Aihua, Kuang K83 L Zhaopan, Lai K30 K34 Hui-Chieh, Lee P47 Changchun, Li K82 Chu, Li K58 Chunfang, Li K130 Dongjuan, Li K69 Hongyan, Li K80 Houcheng, Li K77 K78 K92 Jiasi, Li P08 K181 Jinsheng, Li P28 Li, Li K70 Lingfang, Li K124 Mingxing, Li P51 Peiyun, Li K132 Shouchao, Li P19 Shunyong, Li K24 Wen, Li K150 K199 Xianghui, Li P21 Yajuan, Li K20 Youmin, Li K16 Yuxian, Li K21 Zengmin, Li K15 K19 Zhang, Li K18 Zhicai, Li K09 Zhuo, Li OR17 Qinglin, Lian K165 Shaohua, Liang K22 Xiuqing, Liang K14 Mao-Tsun, Lin OR07 Shilong, Lin K12 Ying, Lin K13 Daodong, Liu K02 Fang, Liu P34 Fujia, Liu K03 Guangsen, Liu K10 Jinglong, Liu OR30 Min, Liu P30 Qingle, Liu OR09 Wencheng, Liu K04 Wenwu, Liu K104 Xinying, Liu K05 Xuehua, Liu OR25 Yaling, Liu K06 Yi, Liu K07 Ying, Long K35 Min, Lou OR20 Jiangjiang, Lu K44 Peigang, Lu P12 K45 Xiaoxin, Lu P31 M Linlin, Ma K43 Yongxin, Ma K41 K42 Yujie, Ma K39 Yongjun, Mai K38 Yoshihiro, Mano PL4 Fangguan, Mao K36 Lijian, Mao P04 Daniel, Mathieu PL8 Xiufang, Mei P11 Ying, Mei K23 Cristian, Melián P40 P41 Bing, Meng K40 Juan, Meng K28 Jun, Meng K33 N Yulin, Nie K26 Ko-Chi, Niu PL7 P Fuqiong, Pan OR15 Hekui, Pan K138 Jiexiang, Pan K29 K31 Lin, Pan K127 Shuyi, Pan OR18 K25 Xiaorong, Pan K136 Xiaowen, Pan P01 P16 Jinjun, Pang K37 Huiping, Peng K63 Ya, Peng K122 Zhaoyun, Peng K65 Zhengrong, Peng OR29 Q Yan, Qi K178 Chunling, Qian K177 Haiying, Qiu K146 Jun, Qu K27 Cuixia, Que K196 Lei, Que K185 K186 R Cunge, Ren K176 Ping, Ren K169 S Jingyi, Shao K175 Paul J., Sheffield B2 Hansheng, Sheng K174 Chunmei, Shi K197 Raymond C, Shields P43 Danhong, Song K147 Juan, Song K173 Li, Sun K172 K209 Lin, Sun K171 Xuejun, Sun PL9 T Zhongquan, Tang K179 Hengyi, Tao PL3 Jinzhong, Teng K163 Joseph, Ting K87 Chaoqun, Tu K17 V Johannes, von Reumont P50 W Chia-Ti, Wang P39 P48 Gang, Wang PL6 P09 Guohua, Wang P03 Guozhong, Wang K162 Hongjuan, Wang P45 Jun, Wang P17 Liping, Wang P07 K67 Min, Wang K161 Peidong, Wang OR22 OR24 Qinghong, Wang P35 Qiusha, Wang K158 K159 K160 Rongzhen, Wang K134 Shengzhi, Wang K157 Shuzhen, Wang K156 Shyanher, Wang P49 Wei, Wang K155 Wenjie, Wang K72 Wenlan, Wang OR19 Xiaohong, Wang K154 Xiaoli, Wang P23 Yalin, Wang K153 Yong, Wang OR27 Youbin, Wang OR26 Youcun, Wang K152 Yuhua, Wang K164 Chengwen, Wei K195 Fen, Wei K182 Qibiao, Weng OR23 K198 Lianhua, Wu K206 K207 Qiaoning, Wu K194 Ruilan, Wu K202 Shuanggui, Wu K203 Xiuyun, Wu K71 Yali, Wu K204 Yanqiu, Wu K205 Zhide, Wu K192 X Hongzhi, Xia K208 Haibin, Xiang K139 K193 Pingtian, Xiao P24 K190 K191 Jinxiang, Xie K180 Qiuyou, Xie P02 Rong, Xie K189 Xiaoping, Xie P27 Zhihui, Xie K187 Lili, Xu K01 Limin, Xu K85 Y Kazuyoshi, Yagishita OR04 Maoxing, Yan K129 Xiaomin, Yan K184 Chen, Yang P36 Haiping, Yang K151 Jianhua, Yang K183 Jingfu, Yang P05 Jinhua, Yang K94 Lin, Yang K119 K120 Ping, Yang K133 Qunfang, Yang K118 Quyun, Yang K201 Wenping, Yang K117 Xiaolin, Yang K116 Xin, Yang K115 Yuanbi, Yang K128 Yujia, Yang P06 P26 Zheng, Yang K114 Yue, Yao K91 Shifu, Yin K113 Daoyuan, Yu K110 Guoping, Yu K08 Ning, Yu K112 Qiuhong, Yu P22 Ronghao, Yu P29 P46 Xuelai, Yu K126 Youjie, Yu K111 Jing, Yuan K121 Lina, Yue K210 Z Shaoxia, Zeng K109 Denghua, Zhang K93 Dongyun, Zhang K75 Hechun, Zhang K107 Jian, Zhang K137 Jin, Zhang P37 Li, Zhang K166 Ludi, Zhang K105 Wenli, Zhang K168 Yan, Zhang K103 Yi, Zhang K102 Yubao, Zhang K145 Hui, Zhao K101 Chenggang, Zheng K100 Ming, Zhong K99 Qiaofen, Zhong P32 Dun, Zhou K98 Hongtu, Zhou K95 K96 K97 Kunru, Zhou K135 Shurong, Zhou OR16 K106 Xuming, Zhou K108 K148 K149 Yihong, Zhou K144 Hourong, Zhu K143 Jianming, Zhu K140 K141 K142 Stránka 1: [1] Komentář [L7] Lenvov 19.10.2008 4:39:00 Lenvov 2.2.2009 3:03:00 正确的称呼? Stránka 1: [2] Odstraněno Table of Contents Welcome Message from Conference President ......................................................................................... 1 Welcome Message from ICHM Executive President................................................................................... 2 Committees ................................................................................................................................................ 2 Conference Information ............................................................................................................................... 3 Scientific Information.................................................................................................................................... 5 Detailed Program (Oct. 27) .......................................................................................................................... 8 Detailed Program (Oct. 28) ........................................................................................................................ 12 Detailed Program (Oct. 29) ........................................................................................................................ 16 大会主席致辞 ............................................................................................................................................. 19 ICHM执行主席致辞 会议组织结构 ............................................................................................................................................. 21 会议基本信息 ............................................................................................................................................. 22 学术信息 .................................................................................................................................................... 23 详细日程 (10月27日) .................................................................................................................................. 25 详细日程 (10月28日) .................................................................................................................................. 28 详细日程 (10月29日) .................................................................................................................................. 31 Poster Program壁报日程 ........................................................................................................................... 33 Acknowledgement 鸣谢 ............................................................................................................................. 48 Exhibitors 展商 ........................................................................................................................................... 50 论文集 Abstracts ........................................................................................................................................ 50 Index 索引.................................................................................................................................................. 56 Konec oddílu (další stránka) 1 Welcome Message Dear friends and colleagues, th Welcome to Beijing for the 16 international Congress on Hyperbaric Medicine (ICHM2008). The world has witnessed the rapid economic and social development in China in the recent years. The HBO medicine is developing and advancing together with the economic growth. In particular, it has got inspiring achievements in China in the basic and clinical research of HBO therapy in the treatment of delayed neuropsychologic sequelae, ischemic cerebral vascular diseases and high altitude diseases. Chinese health professionals are willing to share our experience with our colleagues around the world. The ICHM2008 will be a summit meeting for all leading specialists in the field of h[l1]yperbaric and u[l2]nderwater Medicine, and a grand gathering for basic researchers and clinical experts from all over the world. World-renowned experts will give lectures during the congress. I am sure their speeches must be both educational and interesting. We also invite your family and friends to come with you. We have arranged special tours for your accompanying persons. I believe they will enjoy their stays in Beijing when you have busy scientific schedule at meeting. A rich cultural and historic heritage, accumulated through the passage of time, adds an extraordinary aura to Beijing. The five dynasties that chose Beijing as their capital have left abundant antique treasures. Travelers would marvel at every turn on a tour to this hottest destination of the world today: from the grandiose Forbidden City to the gorgeous Great Wall, and from the labyrinth-like hutong to other worldly royal mausoleums. Wish you a good stay in China. Prof. Gao Chunjin Congress President[l3] 16th International Congress on Hyperbaric Medicine Konec oddílu (další stránka) 2 Welcoming Address to the Participants of the XVI-th Congress of the International Congress on Hyperbaric Medicine (ICHM). Exactly 45 years ago, in 1963, the First Congress of the ICHM took place in the Surgical Clinic of the University Hospital, the Wilhelmina Gasthuis in Amsterdam, the Netherlands. Professor Ite Boerema, the “father of Hyperbaric Medicine” and professor of Surgery and his Staff had invited many colleagues from all over the World to discuss the first results of the application of Hyperbaric Oxygen Drenching, as Boerema used to call it, in a variety of indications. The most prominent indications at that time were Infectious diseases mainly Anaerobic Infections, Coronary Infarction, Experimental Cancer Therapy in a combination with Chemotherapy and Hyperthermia. Also the use of HBO in Carbon Monoxide poisoning, both experimental and clinically was discussed. Much attention was given to Physiological and Pharmacological problems and Oxygen Toxicity, with this new mode of therapy. Cardiovascular Surgery in combination with HBO and Hypothermia, the first and for some time the only indication, was also a leading subject. Both experimental and clinical results were reported. Building problems of chambers and Safety were also not forgotten. Participation to that Congress was strictly on invitation by Boerema himself, at that time well thought of, but fortunately the one and only time that this happened in our history. The participants came from the USA, the UK, France, Australia and South Africa. In a historical review Jack Jacobson II of New York started with mentioning the Diving Bell of Aristotle, used in 332 BC by Alexander the Great in his siege of Tyre. So our history of diving and hyperbaric medicine goes back almost as far as medicine in general. From that time on regular Congresses were held at a four-yearly (until 1981, Moscow) and later threeyearly interval. The first time that the Congress moved to Asia was in 1969 when we met in Sapporo, Japan. In 1993 the Congress gathered in China, in Fuzhou under the chairmanship of the late professor of Cardiac Surgery, Wen Ren Li. We are very happy that we are back in China today thanks to the efforts of our present chairman, professor Gao Chunjin and his whole team of the Chinese Medical Association (mrs. Chenchen) and the Chinese Hyperbaric Medical Society. I must say that I have been much impressed in the foregoing two years by the very solid and precise preparations of the Organizing Committee. Nothing has been left to chance. The same has been noticed by the whole world in the Organisation of the Olympic Games and the Paralympic Games just before our Congress this year. On behalf of the Executive Committee of the ICHM and all participants here, I will extend my sincere thanks and admiration to prof Gao Chunjin and his staff for this excellent organization. 3 We all look forward to the coming days, both professionally and socially. It is always a pleasure to meet old friends again in these nice surroundings. There will be also much work to do. The Executive Committee will lose two of its long standing members, our Secretary-Treasurer Fred Cramer and our Executive Director, Dirk Jan Bakker. After many years of serving you and because of our ages we will resign during this Congress and we will choose new members during the Governors Luncheon. I myself will stay involved in matters of the Congress but not any more in an official position. From this point I want to thank Fred very sincerely for his never ending efforts to advertise the Congress on various occasions, to solicit for new Membership and finding sponsoring for the Newsletter, which was really not an easy task. It will be difficult to replace him. Well ladies and gentlemen, dear colleagues and friends, I am convinced that we will have an excellent and rewarding time here in the magnificent historical city of Beijing, both scientifically and socially. I wish you all a very pleasant and happy stay. Thank you very much for your attention. D.J.Bakker, MD PhD h.t. Executive Director of the ICHM. Konec oddílu (průběžné) 4 Committees President: Gao Chunjin, Department of Hyperbaric Medicine, Chaoyang Hospital, Capital Medical University Vice Presidents: Pan Xiaowen, Hyperbaric Medicine Center, Navy General Hospital Tao Hengyi, Department of Diving Medicine, Second Military Medical University Secretary General: Tao Hengyi, Department of Diving Medicine, Second Military Medical University Chair of Logistic Committee: Wang Peisong, Department of Hyperbaric Medicine, Affiliated Hospital to Qingdao University Medical School Co-Chair of Logistic Committee: Weng Qibiao, Department of Hyperbaric Medicine, Zhujiang Hospital, South Medical University Chair of Scientific Committee: Yi Zhi, Shenzhen People’s Hospital, Guangzhou Co-Chair of Scientific Committee: Wang Gang, Affiliated Hospital, China Medical University, China Members: Joseph Ting (Maylasia), Pan Shuyi, Huang Xiang, Hu Huijun, Li Zhuo, Yang Lin, Lu Yan, Zhang Yue, Xu Weigang konec oddílu Congress Information 1. Registration & Information Center Venue: level 2, Beijing International Convention Center Add: No.8, Beichendong Road, Chaoyang District, Beijing, China Opening Hours: Oct.26 (Sunday) Oct. 27 (Monday) Oct. 28 (Tuesday) Oct. 29 (Thurday) 09:00-18:00 8:00-17:00 8:30-17:00 8:30-11:30 On-site Registration fee: Non Member ¥5,500 Accompanying Person ¥2,000.00 * Member ¥5,000 * *Nurse & Trainee ¥2,500.00 * Member is ICHM live member. * * A copy of student ID or a verification letter from his or her supervisor are requested. 2. Participant Identification and Entitlements Please wear your Congress badge during the Conference. Red Delegate Yellow Accompanying person Green Exhibitor Blue Staff Red Ribbon Invited Speaker / Chair / Committee Members 3. Congress Official Language English 4. Coffee/Tea Break Coffee, tea and snacks will be provided Oct. 27 Oct. 28 10:40-11:00am 10:00-10:30am 15:00-15:30pm 15:00-15:30pm Oct. 29 10:00-10:30am 15:00-15:30pm 5. Meals Oct. 26 Oct. 27 Oct. 28 Oct. 29 Lunch N/A Beijing Continental Grand Hotel Beijing Continental Grand Hotel Beijing Continental Grand Hotel Dinner Beijing Continental Grand Hotel Welcome reception (Laoshe Theater) Conference Dinner 5 6. Exhibition Area: Exhibit Hours: 09:00-17:00 Oct. 27 and 28, 09:00-12:00 Oct. 29, 2008 7. Accommodation For any inquiry about the hotel, please go to the Registration/Information Center (Level 2, Beijing Continental Grand Hotel). 8. Social Program Oct. 26 Acrobatics with dinner Price: 300 yuan The usual reaction to a Chinese acrobatics show is something like “Whoa! That was so…” The contortions and balancing acts are quite incredible. Audients will be at the edge of their seats through most of the show saying “don’t fall, don’t drop it!” and incredibly, they never do. Oct. 27 Welcoming banquet (Roast duck dinner and Peking opera) Free to all fully-paid participants and accompanying persons. Additional ticket: 340 yuan Audients will be led to a downtown theatre for Peking Operas, face changing opera and etc. Beijing Roast duck and other traditional Peking dishes will be served as well. Oct. 28 Conference Banquet Free to all participants and accompanying persons. Additional ticket: 200 yuan Oct. 29 Olympic Venue visits/Hospital visit The organizing committee invites you to some must-go Olympic venues like Bird's Nest and Water Cube. Free to all participants. Oct. 29 The Night of Beijing Price: 425 yuan The show is a dinner / theatrical performance unsurpassed in Asia. A luxurious artistic feast will be presented in this delicately decorated theatre that you can hardly resist. The brilliant Beijing Opera, the elegant Chinese dance, the magnificent acrobatics and marvelous Chinese Kongfu are well integrated with the beautiful costumes and settings. The pleasing music and spotlights and other modern stage arts will be a real shock of beauty and unforgettable experience to you in China. What’s more, the delicious Beijing food served in the theatre will make your evening more enjoyable. 9. Accompanying person’s tour – Exciting shopping tour Date: Morning, Oct. 29, 2008 A tour voucher is included in the accompanying person’s registration package. Please bring the voucher to the Tour Desk of Registration Area at level 2, Beijing International Convention Center to sign your name for and learn more information about the tour. 10. Post-Congress Inquiry CMA Meeting Planner, Chinese Medical Association Add: 42 Dongsi Xidajie, Beijing 100710, China Tel: +86 10 8515 8148 Fax: +86 10 6512 3754 Email: [email protected] konec oddílu 6 Scientific Information 1. Speakers: Please hand in your MS PowerPoint slides at least one hour before your presentation to the conference room staff. 2. Session Chairs: We suggest you meet the staff inside the meeting room in case of any adjustments in the program or speaker absences. 3. Poster: Poster area: Exhibit Hall 2, Level 1, Beijing International Convention Center Language: English Presentation Time: Oct. 27 Oct. 28 Oct. 29 10:40 – 11:00 10:00 – 10:30 10:00 – 10:30 15:00 – 15:30 15:00 – 15:30 Your poster will be displayed throughout the entire congress. Please stand by your poster and make presentation during the above mentioned timeslots. Please hand in your poster to the Poster Desk at the Registration Area and take off your poster 12:00-12:30, Oct. 29. konec oddílu 7 Detailed Program Oct. 27 8:30-9:00 Opening Ceremony Chairs: Zhi Yi 9:00-10:40 Invited Session 1 Chairs: Xiaowen Pan, Jordi Desola 9:00-9:50 B1 The use of Hyperbaric Oxygen in Necrotising Soft Tissue Infections: A Historical Perspective with an Update anno 2008 D. J. Bakker, MD, PhD. Amsterdam, the Netherlands 9:50-10:40 B2 Role of Tissue Oximetry in Assessment of Problem Wounds Paul J. Sheffield, PhD; International ATMO, Inc, Nix Wound Healing Center, San Antonio, Texas, USA 10:40-11:00 Break 11:00-12:00 Invited Session 2 Chairs: Peisong Wang, Ko-Chi Niu 11:00-11:30 PL1 The Indication of Hyperbaric Oxygen Therapy and for Orthopaedics in Japan Mahito Kawashima, Takashi Yamaguchi, Kawashima Orthopaedic Hospital, Japan 11:30-12:00 PL2 The Use of “Deep Stops” In Preventing Precordial Detectable Doppler Bubbles in Recreational Scuba Divers Frans J. Cronjé, MBChB, MSc, DAN Southern Africa; lunch 13:30-15:00 Invited Session 3 Chairs: Paul J. Sheffield, Qibiao Weng 13:30-14:00 PL3 An Overview of Diving and Diving Medicine in China Tao Hengyi, Department of Diving Medicine, Faculty of Naval Medicine, Second Military Medical University, Shanghai, China 14:00-14:30 PL4 DCS incidence of commercial dive works in Japan and Evaluation of the profile on multi-level diving by integration of nitrogen accumulation in each body tissue Yoshishiro Mano, Hyperbaric Center, Tokyo Medical & Dental University Hospital, Japan 14:30-15:00 PL5 Traumatic Spinal Cord Injuries – is There a Role for HBO? Jochen Freier, MD, Consultant für Diving and Hyperbaric Medicine (EDTC), Anaesthesiology and 8 Intensive Care, Vice President of the German Society für Hyperbaric Medicine (GTUEM), Tagesklinik Hofheim, Germany 15:30-17:15 Free Paper Session 1 Charis: Pingtian Xiao, Mano Yoshihiro 15:30-15:45 OR01 HBO and cytostatic chenotherapy Christtian Heiden, German Professional Soc. Hyperb. Chambers 15:45-16:00 OR02 Hyperbaric Oxygen: Does it Promote Cancer Recurrence or Metastasis? An Update John Feldmeier, University of Toledo Medical Center|Radiation Oncology Department; Toledo Radiation Oncology 16:00-16:15 OR03 Hyperbaric Oxygen for Complications of Oncological Treatment of Paediatric Patients Michal Hajek, Centre of Hyperbaric Medicine, Municipal Hospital of Ostrava, Czech Republic 16:15-16:30 OR04 Hyperbaric Oxygen may accelerate tumour-bearing mice to death Liu Qingle, Changhai Hospital, the Second Military Medical University, Shanghai, China 16:30-16:45 OR05 Hyperbaric oxygenation (HBO) in mediastinitis treated with an open mediastinum after cardiac surgery Jacek Kot, National Center for Hyperbaric Medicine, Medical University, Gdansk, Poland 16:45-17:00 OR06 Normobaric and hyperbaric oxygen therapy for migraine and cluster headache Michael Bennett, Dept. Diving and Hyperbaric Medicine, Prince of Wales Hospital, Sydney, Australia 17:00-17:15 OR07 Hyperbaric oxygen therapy induces antiinflammation and antipyresis in experimental studies Lin Mao-Tsun, Department of Medical Research and Department of Hyperbaric Oxygen therapy, ChiMei Medical Center, Taiwan, China 17:15-17:30 Satellite symposium Konec oddílu (další stránka) 9 Oct. 28 8:30-10:00 Invited Session 4 Chairs: Jochen Freier, Qingle Liu 8:30-9:00 PL6 Hyperbaric Oxygen Therapy in Acute Traumatic Peripheral Ischemic Diseases Wang Gang M.D. Ph.D., Emergency Dept & Hyperbaric Oxygen Dept., First Affiliated Hospital, China Medical University, Shenyang, China 9:00-9:30 PL7 The Application of Hyperbaric Oxygen Therapy in Critical Disorders Niu Ko-Chi, Department of Medical Research and Department of Hyperbaric Oxygen, Chi Mei Medical Center, Tainan, Taiwan, China 9:30-10:00 PL8 Hyperbaric Medicine: an European Perspective Daniel Mathieu, Centre Hyperbare, Hôpital Calmette, Centre hospitalier Régional et Universitaire, Lille, France 10:00-10:30 Break/Poster 10:30-12:00 Free Paper Session 2 Chairs: Joseph Ting, Shurong Zhou 10:30-10:45 OR08 Measurement of plasma nitrotyrosine and nitrite after a single treatment with hyperbaric oxygen in healthy human subjects RENU AGNIHOTRI, SABA UNIVERSITY SCHOOL OF MEDICINE 10:45-11:00 OR09 HBO in Tokyo Medical and Dental University in 2007 and The Effects of HBO on Soft Tissue Injury in Sports Activity Kazuyoshi Yagishita, Hyperbaric Medical Center/ Orthopaedic Surgery, Tokyo Medical and Dental University 11:00-11:15 OR10 adjunctive use of hyperbaric oxigenacion (HBO2) in the managment of cerebral hemorrhage in a pregnant patient: a case report Alberto Chavez, Hospital Angeles Metropolitano 11:15-11:30 OR11 Necropsic Findings Of Syndrome Of Intratoracic Hyperpressure In A Young Diver And A Decompression Accident After A Deep Scuba Diving In Veteran Diver (Two Particular Cases) John M Batle, MEDISUB Hyperbaric & Underwater Research Institute Palma de Mallorca SPAIN 11:30-11:45 OR12 24 cases of neurological decompression illness - 14 months of a single center experience 10 Jorge Calderón, hospital Ancud|Pontificia Universidad Católica de Chile 11:45-12:00 OR13 Effect of Hyperbaric Oxygen Treatment on Traumatic Brain Injury Rat by Magnetic Resonance Imaging Huang Xiang, Bejing Shunyi Hospital of China Medical University, Beijing, China 13:30-15:00 Free Paper Session 3 Chairs: Frans Cronje, Fuqiong Pan 13:30-13:45 OR14 The effect of hyperbaric oxygenation on diabetic foot ulcers (the HODFU-study). A single centre, prospective, randomised, double-blind placebo-controlled parallel-group study Christer Hammarlund, Helsingborg Hospital, Sweden|Lund University Hospital, Sweden|Malmoe University Hospital, Sweden 13:45-14:00 OR15 First-aid of 12 Gas Gangrene Cases Caused by the Earthquake Injuries by Use of Hyperbaric Oxygen Pan Fuqiong, Sichuan Provincial Hospital, Chengdu, China 14:00-14:15 OR16 A survey on HBO treatment of traumatic brain injury this century in China—A important evidence of HBO improve curative effect and prognosis of Brain injury Zhou Shurong, Zhou Shurong First Affiliated Hospital of Nanjing Medical University, Nanjing, China 14:15-14:30 OR17 Clinical analyses of 429 Cases of Acute CO Poisoning Li Zhuo, Beijing Chaoyang Hospital, Beijing, China 14:30-14:45 OR18 Review of Current situation on acute carbon monoxide poisoning in china Pan Shuyi, Navy General Hospital, Beijing, China 14:45-15:00 OR19 Effect of HBO on endogenous neural stem cells in rat models of acute CO poisoning Wang Wenlan, Department of hyperbaric oxygen treatment center, School of Aerospace Medicine, Fourth Military Medical University, Xi’ an, China 15:00-15:30 Break 15:30-17:15 Free Paper Session 3 Chairs: Daniel Mathieu, JIndong Lu 15:30-15:45 OR20 Hyperbaric oxygen treatment attenuated the decrease in regional glucose metabolism of rats subjected to focal cerebral ischemia: a high resolution positron emission tomography 11 study M. LOU, Department of Neurology, the Second Affiliated Hospital, Zhejiang University, School of Medicine, Hangzhou, China 15:45-16:00 OR21 Treatment of micro-found drilling cranium and hyperbaric oxygen on 94 cases of patients with extradural hematoma Cheng Jincheng, 123th Hospital of People’s Liberation Army 16:00-16:15 OR22 The effect of hyperbaric oxygen on the osteoporosis rats Wang Peisong, Department of hyperbaric oxygenation, The affiliated Hospital of Qingdao University Medical College, Qingdao, China 16:15-16:30 OR23 Trial of cabin-oxygen-concentration distribution of single oxygen pressurized module Weng Qibiao, Zhujiang Hospital attached to Southern Medical University, Department of Hyperbaric oxygen, Guangzhou, China 16:30-16:45 OR24 Clinical Research on Effect of HBO plus Electric Stimulation for Treatment the Cerebral Resuscitation Wang Peidong, Chinese HBO Medicine Association Research Center of Brain Recovery, Nanjing, China 16:45-17:00 OR25 Effect of Hyperbaric Oxygen Treatment on the content of VEGF, HIF-1,CX43 in skin flaps of rabbits Liu Xuehua, Department of Hyperbaric Oxygen, Chaoyang Hospital, Capital Medical University 17:00-17:15 OR26 Hyperbaric Oxygenation Preconditioning Induce Skin Flap Ischaemia Tolerance in Rat Model Wang Youbin, Plastic Surgery Department of Peking Union Medical College Hospital, Beijing, China Konec oddílu (další stránka) 12 Oct.29 8:30-10:00 Invited Session 5 Chairs: Christtian Heiden, Qiang Wang 8:30-9:00 PL9 The Pretective Effect of Hyperbaric Oxygen Preconditioning on ischemic/hyoxia Injury Xuejun Sun, Department of diving medicine, Second Military Medical University. Shanghai, China 9:00-9:30 PL10 Disruption of Viral Pathogenesis Following Patient Exposure to Hyperbaric Environments with Altered Inspired Gas Mixtures Stephen D. Guthrie, MD, PhD, Designed Altobaric Research Institute, Livonia, Michigan, USA 9:30-10:00 PL11 Carbon Monoxide Poisoning Clinical Findings, Common Errors, And Early diagnose: A prospective analysis of 2900 cases Jordi Desola, MD, PhD, Hyperbaric Therapy Unit of Barcelona, Barcelona, Spain 10:00-10:30 Break/Poster 10:30-11:30 Free Paper Session 5 Chairs: Yunping Ji 10:30-10:45 OR27 The Effect of Hyperbaric Oxygen on Histopathology and Coagulation-fibrinolysis Systems in Rabbits with Steroid-induced Avascular Necrosis of the Femoral Head Wang Yong, Department of Hyperbaric oxygen, Fuxing Hospital, Capital Medical University, Beijing, China 10:45-11:00 OR28 Hyperbaric oxygen preconditioning protects against traumatic brain injury at high altitude Hu Shengli, Department of Neurosurgery, Southwest Hospital of the Third Military Medical University, Chongqing, China 11:00-11:15 OR29 The effect of hyperbaric oxygen on the proliferation and death of Nasopharyngeal Carcinoma Cells and its mechanisms Peng Zhengrong, Xiangya Hospital, Central South University, Changsha, China 11:15-11:30 OR30 Effect of Hyperbaric Oxygenation (HBO) on Unilateral Spatial Neglect ( USN) Liu Jinglong, Heilongjiang Rehabilitation Hospital, Ha’erbin, China 11:30-12:00 Closing Ceremony Chairs: Zhongquan Tang Closing Remark, Hengyi Tao[L4] Konec oddílu (další stránka) 13 大会主席致辞 尊敬的各位同道、各位朋友: 首先,我谨代表大会组织委员会欢迎各位同仁前来北京参加第十六届国际高气压医学学术会议暨第十七届全国 高压氧医学学术会议。 本次会议是国际高气压医学会自1993年以来的[l5]第二次在中国举行会议[l6],是我国高压氧医学蓬勃发展、加 强国际交流的结果。 近几年,世界见证了中国经济和社会的高速发展,高压氧医学也伴随经济进步的脉搏向前超越。特别是应用高 压氧治疗一氧化碳中毒迟发性脑病,缺血性脑血管疾病及高原疾病领域,中国在基础和临床研究方面取得了令人鼓 舞的成绩。中国的医务工作者期盼与世界分享我们的经验,同时也向世界各国的同道学习、交流。 本届大会将是高压氧医学和潜水医学权威学者的一次峰会,也将成为各国研究者及临床专家的盛会。多为(位 )享有盛誉的学者欣然接受邀请到会并作精彩生动的报告。 金秋十月,阳光和煦,微风送爽。继2008年北京奥运会和残奥会之后,古都北京到处充满了新的生机和活力。 我们特地选择了北京国际会议中心作为大会会场,它毗邻奥运村,与“鸟巢”咫尺相隔。会后,感兴趣的代表可参观 奥运赛场。 再次感谢您的光临,并希望各位在北京参会期间愉快、有所收货(获)。 高春锦 第十六届国际高气压医学学术会议主席 中华医学会高压氧医学分会主任委员 Konec stránky 国际高气压医学会主席致辞 国际高气压医学会主席致辞 45年前,即 1963年,第一届国际高气压医学学术会议于 Stránka 1: [3] Odstraněno Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 45年前也就是1963年在 Stránka 1: [4] Odstraněno 荷兰阿姆斯特丹Wilhelmina Gasthuis大学医院外科部隆重召开。受“高压氧医学之父”、 外科教授Ite Boerema和他的同事之邀, Stránka 1: [5] Odstraněno Lenvov 2.2.2009 3:03:00 各国同仁积极参会并共同探讨 14 Stránka 1: [6] Odstraněno Lenvov 2.2.2009 3:03:00 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 了最初被Ite Boerema教授称之为“高压 Stránka 1: [7] Odstraněno 在不同病种中的应用及疗效 Stránka 1: [8] Odstraněno 用于不同症状的初步效果 Stránka 1: [9] Odstraněno ,“高压纯氧浸透法”是Ite Boerema教授最初对高压氧疗法的称呼。 Stránka 1: [10] Odstraněno Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 当时高压氧疗法最主要的 Stránka 1: [11] Odstraněno 适应症为以厌氧菌感染为主的感染性疾病,冠状动脉梗塞,结合化 Stránka 1: [12] Odstraněno Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 和高温疗法治疗癌症。大会讨论了 Stránka 1: [13] Odstraněno 各种传染病,例如厌氧菌感染,冠状动脉梗塞及试验性癌症疗法。也对 Stránka 1: [14] Odstraněno Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 应用高压氧治疗一氧化碳中毒的临床和基础研究, Stránka 1: [15] Odstraněno ,科研和临床(都)予以了讨论。 Stránka 1: [16] Odstraněno 同时,大家还也很关注 Stránka 1: [17] Odstraněno 生理、药理以及氧中毒 Stránka 1: [18] Odstraněno 问题予以了特别关注。大会的首要议题还包括探讨高压氧结合 Stránka 1: [19] Odstraněno Lenvov 2.2.2009 3:03:00 3:03:00 低温疗法辅助进行心血管手术的临床与基础研究,这在一段时期内曾经是高压氧唯一的也是最主要的适应症, 除此之外,是第一个用途,在一段时间也是惟一的用途,并且是惟一的主题。临床和试验的结果都有所报道。建设 氧仓和安全问题也没有忘记(被忽略)。 那时参会者都是收到了Boerema教授本人的要求(邀请),(那时)是经过深思熟虑的,但是幸运的是,这是 惟一一次也是最后一次(在我们的历史上是空前绝后的)。参会者来自美国,英国,法国,澳大利亚和南非。在历 史回顾中,来自纽约的Jack Jacobson II首先提到了公元前332年亚历山大大帝在提尔城之围中用到了亚里士多德的潜水钟。如此看来,潜水和高气压的历 史与医学史一样古老。 从那时起每四年召开一次会议,直到1981年莫斯科会议以后,变为每三年举办一次。国际高压氧医学会首次亚 洲会议是于1969年在日本札幌举行。1993年在中国心脏外科专家李温仁教授的主持下,我们首度在中国福州举办 15 了国际高压氧医学学术会议。我们非常高兴今天再次来到中国举办会议,感谢今天的大会主席高春锦教授,中华医 学会及中华医学会高压氧医学分会所做的努力。 在刚刚结束的奥运会和残奥会中,我们看到了优秀的组织工作。而在过去的两年中本次会议组委会所作的具体 而细致的准备工作同样让我印象深刻。 我代表国际高压氧医学会执行委员会和各位参会者,向高春锦教授和她的团队表示衷心的感谢。未来的几天里, Stránka 1: [20] Odstraněno Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 Lenvov 2.2.2009 3:03:00 我们无论从学术上还是活动上都期待接下来的几 Stránka 1: [21] Odstraněno 全体代表将共享这次盛会 Stránka 1: [22] Odstraněno 能在这样美好的 Stránka 1: [23] Odstraněno 。 未来的高气压医学任重而道远,由于年龄原因,在为各位服务多年后,我们的财务秘书[L7] Stránka 1: [24] Odstraněno Lenvov 2.2.2009 3:03:00 Fred Cramer和执行主席Dirk Jan Bakker将要退出执行委员会。 Stránka 1: [25] Odstraněno Lenvov 2.2.2009 3:03:00 由于年龄原因,在为各位服务多年后,我们将要退出,在委员午餐中选出 Stránka 1: [26] Odstraněno Lenvov 2.2.2009 3:03:00 新的成员将在委员会会议中选举产生。我本人 Stránka 23: [27] Odstraněno Lenvov 19.10.2008 7:15:00 HBO in Tokyo Medical and Dental University in 2007 and The Effects of HBO on Soft Tissue Injury in Sports Activity Kazuyoshi Yagishita, Nobuo Yamami, Seiichiro Togawa, Yoshihiro Mano Hyperbaric Medical Center, Tokyo Medical and Dental University, Tokyo, Japan Objective: In our university hospital, multiplace chamber including 3 rooms and the capacity of 16 patients was set up in 2001. In 2007, 7970 times hyperbaric oxygen therapy (HBO) in 958 patients were performed, which is the most patients number in one institute in a year in Japan. The purposes of this study were to report the diseases and the patients performed with HBO in our hospital last year. The effects of HBO on crush injury and compartment syndrome were well documented by many authors, and randomized controlled studies revealed the effects of HBO on reduction of necrosis and edema. We now perform HBO aggressively to soft tissue injury including compartment syndrome, ankle sprain, knee ligament injury, and muscle strain. The purposes of this study were also to investigate the effect of HBO on soft tissue injury in sports activity. Patients and Methods: 7970 times HBO in 958 patients were performed in our hospital in 2007. The number of the patients and HBO times were evaluated. In 180 patients with soft tissue injury in sports activity, visual analog scale (VAS) scores and recovery time to previous sports activity were evaluated. Results: The number of the patients and HBO times in decompression illness were respectively 374 patients and 764 times, 87 patients and 934 times in sudden deafness, 34 patients and 740 times in peripheral vascular disorder including diabetes and arteriosclerosis obliterans, 47 patients and 1046 times in osteomyelitis, 180 patients and 865 times in soft tissue injury related sports activity, 90 patients and 1644 times in myelopathy and radicuropathy, 19 patients and 220 times in carbon monoxide poisoning, and 18 patients and 259 times in radiation-induced cystitis. In patients with soft tissue injury nd in sports activity, VAS scores improved compared between pre and post 2-hour HBO. In patients with 2 grade medial collateral ligament injury of the knee in HBO group, recovery acceleration to previous sport activity was observed. Conclusion: In HBO procedure in our university in 2007, no major patient troubles and no chamber problems were recorded. The effects of HBO on soft tissue injury were strongly suggested in this study. Stránka 25: [28] Odstraněno Lenvov 19.10.2008 19.10.2008 7:15:00 16 OR09 Hyperbaric Oxygen may accelerate tumour-bearing mice to death Qingle LIU, Chenggang Zheng, Xiaohua Hang Changhai Hospital, the Second Military Medical University, Shanghai, China Objective: To explore the influence of hyperbaric oxygenation (HBO) on life-span in tumour-bearing mice. Method: Male Balb/c mice were randomly divided into celiac-tumour group: inoculating tumour cell into abdominal cavity of the animal, celiac-tumour-HBO group: inoculating tumour cell into abdominal cavity and then exposing to hyperbaric oxygen, back-tumour group: inoculating tumour cell under skin of the back of the animal, back-tumour-HBO group: inoculating tumour cell under skin of the back of the animal and then exposing to hyperbaric oxygen. There are 7 mice in each group. After s-180 tumour cell was translated to mice HBO was given once a day in concerned group. The life-span and skin ulcer were observed. Results: The life-span is 27.57士4.4693 days in celiac-tumour-group, 24士2.9439 days in celiac-tumour-HBO group, 63.43士21.844 days in back-tumour group, and 35.14士8.934 days in back-tumour-HBO group. The life-spans in celiac-tumour group and in celiac-tumour-HBO group are different, but P value is 0.133204; the life-spans in back-tumour group and in back-tumour-HBO group are significant and P value, 0.009002. Conclusion: The life-span of mice in backtumour-HBO group was shorten by exposing HBO, and life-span in celiac-tumour-HBO group is tendency to be shorten by HBO exposure. The ulcer formation is postponed by HBO in back-tumour-HBO group. Stránka 30: [29] Odstraněno Lenvov 19.10.2008 7:43:00 The medical oxygen pressurized cabin which is convenient and suitable for patients with different diseases and ages has been widely used for decades. Meanwhile, it is accepted by a majority of hospitals. To select appropriate input/output of oxygen, structure and washing method is beneficial to oxygen concentration elevation and distribution in cabin, because pure oxygen is used as medium for compression. Three ways of oxygen input/output(on the top, middle and bottom of the cabin), three states of the cabin(with a bed, with a bed and a patient, without a bed and a patient) and three ways of washing method(continued washing method with boosting pressure, washing method of boosting pressure of the gap of the door, boosting pressure directly without cabinwashing) was adopted in our trial. To detect oxygen distribution during the procedure of elevated, stable and decreased pressure, nine sampling outlets which located on the top, middle and bottom of cabin were set. Delivery pressure in cabin is 0.1 MPa in the meter. Experimental session lasted for 80 minutes. Process of experiment accorded to the rule of Chinese Medical Association—HBO branch. Measurement range of digital oxygen analyzer is 0-100%. Interval time of sampling is 2 minutes. Influential factor of oxygen distribution in cabin-Our research suggests that main influential factor of oxygen distribution are broadside stretcher and input/output location of oxygen at the bottom of cabin. Oxygen distribution of the structure that broadside stretcher combined with input/output oxygen at the bottom of cabin is as follow: 90% under the broadside stretcher, 40% on top of it, while 60% in the middle of it. Such distribution of oxygen is not good for safety of cabin and could not meet the effect of hyperbaric oxygen therapy. The main reason of asymmetrical distribution of oxygen is that broadside stretcher exerts negative influence on oxygen diffusion and short-circuit at the bottom of the broadside stretcher (mal-design of input/output location of oxygen leads to automatic washing beneath the broadside stretcher). Whereas, the structure mentioned above is the most widely used one in the single pure oxygen chamber. If the entrance of oxygen is designed on top of or in the middle side of cabin ( on top of the broadside stretcher) may make oxygen concentration achieve up to 65~75% when the pressure is stable at 0.1MPa, thus, oxygen distribution will be symmetrical in cabin. Output of oxygen has nothing to do with oxygen concentration in cabin. However, broadside stretcher not only plays an important role in oxygen diffusion in cabin, but also divides the cabin into two parts. Therefore, to minimize the broadside stretcher plays a positive role in oxygen diffusion in cabin. Best way of washing the cabin- Oxygen concentration and distribution in cabin is the same with ordinary compression procedure that five minutes continued washing method or pressure achieved at 0.1 MPa directly.( with the cabin washed, oxygen concentration is higher by 2% on top of it, while the middle and the bottom part are higher by 4% versus not to wash the cabin.) However, washing method of normal pressure of the gap of the door is the most ideal way because it may elevate oxygen concentration up to 80% in 5 minutes inside the cabin. Selection of sampling outlet of oxygen-Sampling outlet of oxygen is located on top of the broadside stretcher in the middle of cabin at present. Oxygen concentration is affected by the following factors: differences of the width and height of broadside stretcher; irrationality of oxygen input/output design; different ways of washing. Hence, ordinary method for oxygen detection fails to reflect oxygen distribution in cabin. Solution for symmetric oxygen concentration is to change oxygen input location and adopt the most ideal way of washing. The specific way is to have the sampling outlet located on top of the broadside stretcher. Oxygen diffusion in cabin-In our 15 times experiment, we found no alteration of oxygen concentration all over the cabin with the pressure up to 0.1 MPa for 40 minutes. It is suggested that oxygen diffusion didn’t change apparently in both quantity and quality with the pressure up to 0.1 MPa for 40 minutes. Nevertheless, oxygen diffused obviously when pressure decreased. Oxygen concentration on the top and the middle of the cabin was almost the same whereas relatively higher at the bottom of cabin when there existed a broadside stretcher with the pressure of 0.06 MPa inside the cabin. Oxygen concentration is almost the same in the upper, middle and lower location when the pressure is about 0.03 MPa. 17 18
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