Objective: To discuss the influence factors of the prognosis of intraventricular hemorrhage.Methods: 96 consecutive cases were studied.General information,onset symptoms,PE on admission,features on CT scan,treatment strategies and complications such as pneumonia and stress ulcer were used as independent valuables.Prognosis was judged with Scandinavian Stroke Scale after 3 months.The valuable influence factors were filtrated and formulated with multivariate regression analysis model.Results: The data were processed with statistic software,found that Glasgow Coma Score(GCS),consciousness grade on admission,pupil size,treatment strategies,complications and the ventricles which were involved,especially the third ventricle and the contralateral ventricle,were found to affect the prognosis.Conclusion: GCS,consciousness grade,pupil size,pneumonia,stress ulcer,treatment strategies,in special,the position and volume of intraventricular hemorrhage affect the prognosis of intraventricular hemorrhage.

Objective To analyze the clinical characteristics of ulcerative colitis (UC) in elderly patients.Methods A total of 166 cases with diagnosed UC were recruited.The clinical characteristics were compared between the elderly group (n=35,≥60 years) and the young group (n =131,20 59 years).Results The number of male patients were more than female patients in both groups.The incidence of abdominal pain was significantly lower in the elderly group than in young group (P＜0.05).The number of severe patients were significantly lower in the older group than in young group.Severe UC prevalence was 27.5％ (36 cases) in the young versus 11.4％ (4 cases) in the elderly (x2 =3.89,P＜0.05).The prevalence of total colitis was lower in elderly group than in younggroup [31.4％ (11 cases) v,.51.1％ (61 cases),~ =4.31,P＜0.05],however,the prevalence of proctitis is more common in the elderly than in young group.The extra-intestinal manifestations and the ratio of receiving immune inhibitor and operation showed no significant differences between the two groups.Conclusions Compared with young group,there are a lower incidence of abdominal pain,a higher number of severe patients,a lower incidence of total colitis,and a higher incidence of proctiits in elderly group.

Objective To analyze the clinical effects of sinus tarsi approach with minimal-inva-sive percutaneous screw fixation of calcaneal fractures. Methods From February 2014 to July 2015,28 ca-ses of calcaneal fracture patients(Sanders Ⅰ ~ Ⅲ)were treated with minimal-invasive percutaneous screw fixation via sinus tarsi approach in our department. There were 18 males and 10 females with age ranging from 16 to 68 years(mean,32 years). According to the classification of Sanders,six cases were classified as Type I,twelve as Type Ⅱ,and ten as Type Ⅲ. The Bohler angle and Gissane angle were compared be-fore and after operation. Clinical results were evaluated with the Maryland foot scoring system. Results All the patients were followed up for 14 to 20 months(mean,15. 5 months). Anatomic or almost anatomic reduction was achieved in all patients according to the results of postoperative images. All fractures healed,and the healing time ranged from 4 to 7 months(average,5. 3 months). There was no wound infec-tion,necrosis or bone nonunion. According to the Maryland foot scoring system,16 cases were defined as excellent,10 cases as good,and 2 cases as poor. The good and excellent rate was 92. 8% . Conclusion For calcaneal fractures,sinus tarsi approach with minimal-invasive percutaneous screw fixation has the ad-vantages of small trauma,safe operation,limited complication,and stable fixation,which is a satisfactory clinical treatment.

Jaundice is a common clinic presentation which can be caused by various benign or life-threating disorders.Charaterization by unconjugated(indirect)hyperbilirubinemia and conjugated(direct)hyperbilirubinemia may help clinic diagnosis and treatment.The reasons causing unconjugated hyperbilirubinemia include hemolytic anemias,ineffective hematopoiesis,malfunction of bilirubin absorption and combination by hepatocytes or hyperbilirubinemia after hepatitis.Moreover,liver excretion disfunction by inherited disease,hepatocellular jaundice,or various obstruction of the duct system can lead to conjugated hyperbilirubinemia.This article discusses the category of jaundice according to different serum bilirubin,which warrants to clarify the cause quickly so that treatment can begin as soon as possilble.

Adult ; Aged ; Electroacupuncture ; Fecal Incontinence ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Postoperative Complications ; etiology ; therapy ; Rectal Prolapse ; surgery ; Young Adult

Objective To observe the effects of marzulene(L-glutamine and sodium gualenate)on cellular immune function in patients with severe acute pancreatitis(SAP). Methods A prospective study method was conducted in which 80 patients with SAP were divided into trial group and control group(each 40 cases)according to the table of random number methods,and in the mean time 20 healthy volunteers were enrolled in the healthy control group. Both SAP groups received standard total parenteral nutrition(TPN)with same quantities of heat and nitrogen, and the trial group additionally accepted intravenous drip of marzulene 0.4 g?kg-1?d-1(once a day)for 7 days,while the control group received the same amount of normal saline intravenous drip for 7 days. One day before treatment and on the 7th day after treatment,the peripheral venous blood samples were collected. The T-lymphocyte proliferation activity was tested by methyl thiazolyl tetrazolium(MTT)assay,and the interleukin-2(IL-2)and interleukin-6(IL-6) secretion levels were detected by enzyme-linked immunosorbent assay(ELISA). Results Compared to the healthy control group,the levels of T lymphocyte proliferation activity〔absorbance(A)value〕and IL-2(ng/L)were markedly decreased and IL-6(ng/L)secretion level was obviously increased before treatment in the two SAP groups(P<0.05 or P<0.01). Compared to prior treatment,the levels of T lymphocyte proliferation activity and IL-2 were significantly increased after 7 days of treatment in the trial group(both P<0.05),and basically restored to normal levels,while in the control group they were progressively decreased(both P<0.05),the levels in trial group being significantly higher than those of the control group(T lymphocyte proliferation activity:1.08±0.27 vs. 0.43±0.25,IL-2:16.5±1.4 vs. 9.4±2.9,both P<0.05),but compared to prior treatment,the level of IL-6 was significantly decreased in the two SAP groups(both P<0.05),the level of IL-6 in control group was recovered to the level of healthy control group,and the level in trial group being significantly lower than that of the control group(18.8±4.5 vs. 22.3±3.1, P<0.05). Conclusions The patients with SAP have cellular immune dysfunction,the manifestations being the suppression of T lymphocyte proliferation and IL-2 and increase of IL-6 release. Early application of marzulene can help to improve the immune function of lymphocytes in patients with SAP.

BACKGROUND: The number of patients undergoing total knee replacement due to severe gouty arthritis is increasing rapidly in recent years, and the ages of patients also present younger and younger. However, its clinical efficacy remains controversial, and it is lack of retrospective systematic analysis. OBJECTIVE: To assess the clinical efficacy of total knee replacement for severe gouty knee arthritis from several aspects, such as pain, function, quality of life and complications. METHODS: From January 2006 to January 2015, 17 patients (20 knees) with severe knee gouty arthritis received total knee replacement in Department of Orthopedics of Nanjing General Hospital of Nanjing Military Region of Chinese PLA. They underwent knee joint surface replacement with posterior cruciate ligament, and patel a was not replaced. Posterior stabilized prosthesis was used. Al patients were successful y fol owed up postoperatively. The Hospital for SpecialSurgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were determined before and after replacement and during final fol ow-up. RESULTS AND CONCLUSION: Patients were fol owed up for 1-9 years. No serious complications occurred during and after replacement. The Hospital for Special Surgery Knee Score, range of motion of the knee, Visual Analogue Scale score and SF-36 scale scores were significantly higher after replacement and during final fol ow-up than those before replacement (P < 0.001). X-ray films showed good prosthesis position, satisfactory limb alignment without radiolucent lines or loosing. These findings verified that total knee replacement was considered as the final way to treat the severe gouty knee arthritis; its short-term clinical effect is significant, but systematic anti-uric acid, prevention and treatment of complications, pain control, function exercising, and healthy mood maintenance were needed to get a better long-term clinical efficacy.

Recent in vitro and in vivo experiments have revealed that ellagic acid and its metabolites can inhibit the growth of digestive system malignant tumor cells by inhibiting tumor cell proliferation,inducing apoptosis,breaking DNA binding to carcinogens,blocking virus infection,disturbing inflammation,angiogenesis and drug-resistance processes required for tumor metastasis.Ellagic acid and its metabolites are potential chemoprevention and therapeutic drugs against human cancers.

Primary hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide.MicroRNAs (miRNAs) are a kind of endogenous non coding singlestranded RNAs,which can function as a tumor promoter or suppressor in the development and progression of human malignant tumors.Studies have shown that miRNAs play an important role in the occurrence and development of HCC.Numerous studies have found that the expression of miR-34a in various tumors is reduced and it participates in the carcinogenesis.Currently,the role of miR-34a in the tumorigenesis and development of HCC has attracted widespread attentions.Studies have confirmed that miR-34a can regulate the expression of its target genes and thus affect some key biological processes such as cell proliferation,apoptosis,invasion and metastasis of HCC.In this paper,we mainly reviewed the recent research progress on the role of miR34a in HCC.

[Objective]To assess the accuracy and value of radiographic technique using computed tomography(CT) measurements in cadaveric specimens during anterior cervical corpectomy in order to define the safe lateral limit of dissection.[Method]The gutter of C4～6 corpectomy on 5 cadaveric samples was filled with radioopaque dye.An antero-posterior X-ray was used to measure the narrowest distance from dye column to the line of uncovertebral joints.A CT scan confirmed the distance from the borderline of the gutter to vertebral arteries.[Result]The distance between the X-ray dye column and the line of uncovertebral joints averaged 4.7 mm in the left and 4.2 mm in the right.While the distance from the borderline of the gutter to vertebral arteries with CT scan averaged 6.1 mm in the left and 5.9 mm in the right.The measured distance by radiographic technique underestimated the true distance.[Conclusion]Intraoperative radiographic technique can estimate the lateral distance between the gutter of corpectomy and vertebral arteries by measuring the distance from the dye column to the line of uncovertebral joints.This technique provides surgeons an additional margin of safety during anterior cervical corpectomy.