Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome,13 mild morbidty,2 severe mordity,1 were in persistent vegetative state,3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation,close observation of patients with their consciousness,pupil and changes in vital signs;attend that it is premature to stop dehydrating agent,too fast,to review the head dynamic CT,the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.

Objective To investigate the impact of the different mode of delivery on postpartum lactation.Methods 1 678 pregnant women in our hospital were divided into cesarean section group(798 cases) and natural delivery group(880 cases).Open milk after delivery,breast fullness,the number of neonatal sucking and post-natal self-assessment milk water were compared between the two groups of pregnant women,and the impact of the mode of delivery on postpartum lactation was analyzed.Results Whether or not began to lactation (721/77cases),and the time of labor to beginning to lactation [(33.45 ± 9.68) h],and whether or not having breast fullness feeling (512/286 cases),and the time of labor to breast fullness feeling[(57.12 ± 13.90) h] in cesarean section group had significant difference with those of spontaneus labor group [(845/35 cases),(30.12 ± 10.25) h,(690/190 cases),(52.98 ±15.09) h] (x2 =21.613,t =2.452,x2 =41.813,t =2.818,all P ＜ 0.05).There was no significant difference in selfrating milk score [(2.02 ± 0.45) points vs (2.45 ± 0.51) points],and newborn sucking times 4 ～ 6d postpartum [(5.21 ±1.21) times vs (5.89± 1.82)times](t =2.012,2.532,all P ＜0.05).Conclusion Efficiency of the breast-feeding was affected by the impact of the mode of delivery.Rationalized breastfeeding guidance was necessary to strengthen for pregnant women by cesarean section.

Bacause of few side effects,low expenditure,the adaptability for long－ term treatment and the ability of treating both principal and secondary aspect of disease of chinese herbs,to cure osteoporosis by chinese herbs and the combined treatment of traditional chinese and western medicine has become a hot task in china.It has been demonstrated that the chinese herbs can prevent and treat osteoprosis effectively.Many research also show that the chinese herbs can increase the intestine calcium absorption,decrease PYH and increase 1,25(OH)2D3 level.This review intends to show and summarize the progress made all those years.

Objective: To study the effect of different transdermal penetration enhancers on the skin permeation ability of indomethacin and salbutamol in vitro. Methods: Valia-Chien diffusion cell was adopted as the apparatus for in vitro skin permeation test. Excised SD-rat abdomen skin was pretreated with penetration enhancers including Azone, Propylene glycol, N-methylpyrrolidone, oleic acid, peppermint oil, and a combination of Azone and Propylene glycol. A UV method was established to determine the contents of indomethacin and salbutamol in receiver diffusion cells. Results: Compared with blank control group, all the enhancers showed significant enhancement effect on the permeability of indomethacin and salbutamol except for propylene glycol (P < 0.01). Azone combined with propylene glycol showed the greatest ability to enhance the flux of indomethacin(125.91 μg · cm-2 · h-1) and salbutamol(155.94 μg · cm-2 · h-1). Conclusion: Azone combined with Propylene glycol, Azone, N-methylpyrrolidone, Oleic acid, and Peppermint oil can be used as penetration enhancers in the transdermal preparation of compound indomethacin.

Objective To observe and analyze curative efficacy of Desloratadine Citrate Disodium in combination with endoscopic sinus surgery and its effects on serum TIgE, ECP and inlfammatory factors in patients with chronic sinusitis.Methods 90 patients with chronic sinusitis who received therapy in our hospital from January 2015 to June 2016 were collected as research objects to be randomly divided into the control group and the observation group equally. The control group was given endoscopic sinus surgery, and the observation group was given Desloratadine Citrate Disodium in combination with endoscopic sinus surgery. Then, visual analogue scale (VAS) was applied to assess the severity of subjective symptoms of the disease. Three months after the surgery, the curative efifcacy, scores of visual analogue scale (VAS) relfecting clinical symptoms, levels of serum TIgE, ECP and inlfammatory factors were compared between the two groups.Results All patients undergone successful surgery. The observation group had a total therapeutic efifciency ratio of 95.6%, which was signiifcantly higher than that of 82.2% in the control group (P < 0.05). In comparison with the control group, the observation group had lower VAS scores of nasal discharge, nasal obstruction, cheek pain, headache, hyposmia [(1.84 ± 0.89) vs (3.12 ± 1.03) points, (1.87 ± 0.81) vs (2.55 ± 1.14) points, (1.24 ± 0.86) vs (1.88 ± 0.79) points, (1.15 ± 0.54) vs (1.97 ± 0.83) points, (1.84 ± 0.73) vs (2.18 ± 0.84) points], lower levels of serum TIgE, ECP [(58.62 ± 7.36) vs (64.39 ± 7.18) kU/L, (4.25 ± 0.84) vs (5.01 ± 1.07) ng/L)] and inflammatory factors of TNF-α, IL-6, IL-8 [(1.27 ± 0.46) vs (2.62 ± 0.53) ng/ml, (5.13 ± 1.24) vs (9.54 ± 2.23) pg/ml, (282.63 ± 32.42) vs (315.84 ± 35.89) ng/L)] with statistical differences (allP < 0.05).Conclusion Desloratadine Citrate Disodium in combination with endoscopic sinus surgery is effective for chronic sinusitis, which can signiifcantly relieve clinical symptoms, reduce levels of serum TIgE, ECP and alleviate inlfammatory reaction.

AIM: To study whether there was a correlation between central foveal thickness (CFT) assessed with optical coherence tomography (OCT) and visual acuity of patient with high myopia after phacoemulsification and intraocular lens implantation.METHODS: Totally 67 patients with high myopia underwent phacoemulsification and intraocular lens implantation were enrolled in the study.Best corrected visual acuity (BCVA) was recorded and CFT was measured using OCT at 1wk,1 and 3mo after oerations.BCVA and CFT were compared before and after the operation.All patents were divided into two groups by the BCVA at 3mo after operation,BCVA>0.5 in Group A and BCVA≤0.5 in Group B.ANOVA,Spearman correlation analysis and independent t test were used for statistical analysis.RESULTS: There was a statistically significant difference between preoperative BCVA and postoperative BCVA (F=115.04,P<0.01).Preoperative CFT was different compared with that 1wk and 1mo after operation (P=0.04,0.02) and was not different with that 3mo after operation(P=0.52).There was a statistically significant difference in CFT of postoperative 3-month compared with that of postoperative 1-week(P<0.01) or that of postoperative 1-month (P<0.01).BCVA showed significant positive correlation with CFT without foveal lesion on postoperative 3mo (r=0.28,P=0.03).CFT of Group A and Group B was significantly different at 3mo after the operation (t=-2.24,P=0.03).There was no significant difference in age and intraocular lens of two groups.CONCLUSION: Optical coherence tomography allow for objective assessment of retinal construction changes in eyes with high myopia are correlated to visual acuity.

Objective To systematically analyze therapeutic effects of extracorporeal photopheresis (ECP) on refractory steroid-resistant,-dependent or-intolerant graft-versus-host disease (GVHD),to compare remission rates of skin GVHD in detail.Methods Databases were searched for studies concerning remission rates of GVHD after the treatment with ECP,and relevant data were extracted and pooled by using meta-analysis with STATA 12.0 software.Results A total of 22 literatures were reviewed,including 787 patients with refractory GVHD.Meta-analysis showed that the pooled complete remission (CR) rate and overall remission (OR) rate were 57％ (95％ CI:47％-66％) and 79％ (71％-86％) respectively in patients with acute GVHD,27％ (21％-33％) and 63％ (58％-69％) respectively in patients with chronic GVHD,77％ (71％-82％) and 87％ (82％-91％) in patients with acute skin GVHD,as well as 39％ (30％-48％) and 70％ (63％-77％) in patients with chronic skin GVHD.Conclusion ECP is an effective therapy for refractory GVHD,especially for skin GVHD.

This article reviewed hot spot and problems in the research of the senile dementia,and proposal the researching thoughts and the tentative treament plan of this disease.

Objective To explore the clinical value via comparison of umbilical incision and traditional right upper quadrant abdominal transverse incision of congenital hypertrophic pyloric stenosis.Methods According to the digital table,38 children with congenital hypertrophic pyloric stenosis were divided into two groups,the study group (n=19)was given umbilical transverse incision,the control group(n=19)was given right upper quadrant abdominal transverse incision.The effect of the two groups were compared.Results In the study group,the operate time was (20.4 ±1.47)min,incision scar healing time was (5.53 ±0.51)d,which were significantly lower than (24.00 ± 1.36)min and (7.26 ±0.45)d of the control group(t=7.835,11.090,all P<0.05).The length of incision scar [(0.53 ±0.015)cm]was obvious shorter than that of the control group[(2.03 ±0.12)cm](t=54.070,P<0.05). The postoperative eating time[(23.84 ±0.96)h]and hospitalization time[(9.37 ±0.83)d]of the study group had no difference with the control group of[(24.11 ±0.81)h and (9.42 ±0.84)d](t=0.936,0.184,all P>0.05). Followed up for 6-8 months,all children had good growth and development,but abdominal scar was obvious in the control group,and the study group had no obvious scar.Conclusion Umbilical incision for the treatment of congenital hypertrophic pyloric stenosis does not prolong the operation time,and has rapid postoperative recovery and better beau-ty effective than the traditional operation,.It is suitable for primary hospitals with no condition to carry out laparoscop-ic operation.

Wake-up stroke (WUS) patients are those who go to sleep without stroke symptom and wake up with stroke symptom. WUS is very common in clinical practice. One out of every five new ischemic strokes is WUS. These patients are usually excluded from thrombolytic therapy because their exact onset time is unknown. The latest research have shown that reperfusion therapy is safe and effective in selected WUS patients based on multimodal imaging. This article reviews the imaging -guided reperfusion therapy for WUS.