Objective To summarize the clinical features,diagnosis and surgical strategies of the acute and subacute nontraumatic spinal cord injury.Methods We analyzed retrospectively 46 cases of patients with acute and subacute nontraumatic spinal cord injury,who were admitted in the southwest hospital between January 2010 and december 2015.We summarized the clinical data and the effects of the surgical treatments.Results Among the 46 patients,There were 27 males and 19 females with mean age of 40.7 years (10-70).They were followed up for more than 3 months.Neurological function of ASIA at the initial admission included A in 9 cases,B in 6,C in 12 and D in 19.There were 5 hematoma patients (10.9％),11 neurilemmoma cases(23.9％),4 cases of acute disc herination (8.7％),Vascular Malformation 7 cases (15.2％),5 meningioma patients (10.9％),glioma 10 cases(21.7％) and enterogenous cyst 1 case(2.2％).46 patients underwent preoperative MRI examination,followed by spinal canal exploration,lesion resection and/or decompression.Operation within 8 hours,the signs and symptoms were improved in 6 cases.Operation within 8-24 hours were improvement in 2 cases,Operation after 24 hours improvement in 25 cases.Conclusion Early MR imaging and emergency spinal canal exploration and lesion resection with or without lamina decompression surgery is effective for the treatment of patients with acute and subacute nontraumatic spinal cord injury.

OBJECTIVE:To systematically review the efficacy and safety of ramucirumab in the treatment of adenocarcinoma in stomach or gastroesophagealjunction,and provide evidence-based reference for clinic. METHODS:Retrieved from Wanfang database,CJFD,PubMed,EBSCO,Medline and Cochrane Library,randomized controlled trials(RCT) oframucirumab and (or) other medicines or other chemotherapy (test group) versus placebo or and Clinical Trials. gov other antibiotics(control goroup) were collected with time limit from establishment to Sept. 2015. Meta-analysis was performed by using Rev Man 5.3 software after data extraction and quality evaluation by Cochrane systematic review manual 5.1.0. RESULTS:Totally 3 RCTs involving 1 188 patients were enrolled,including 652 patients in the test group and 536 patients incontrol group. Results of Meta-analysis showed, the overall survival[HR=0.83,95%CI(0.72,0.95),P=0.006] and progression-freesurvival[HR=0.66,95%CI(0.47,0.92),P=0.01] in test group were significantly longer than control group,the difference was statistically significant;there was no significant difference in the objective response rate[RR=1.31,95%CI(0.81,2.11),P=0.28]. The incidence of severe adverse reactions(degree level:3-4 grade) in test group was significantly higher than control group,the difference was statistically significant [RR=1.14, 95%CI (1.00,1.29),P=0.04].CONCLUSIONS:Ramucirumab can extend overall survival and progression-free survival of adenocarcinoma in stomach or gastro-oesophageal junction,but the incidence of adverse reactions should be noticed.