The changes of immunoreactive TRH (TRH-ir) in cerebrospinal fluid (CSF) and plasma before and after acute traumatic head injury were determined with radioimmunoassay (RIA) on a feline model of acute experimental head trauma. The results showed that the concentrations of TRH-ir in experimental animals pre- and 2, 4, and 6h post-injury were 119.48?51.77, 460.71 ?178.72, 377.27? 139.33, and 280.17?110.46pmol/L in CSF, and 122.58?28.87,1158.89?163.18, 909.69?160.55, and 545.38?132.80pmol/L in plasma, respectively, while those in control animals measured at the corresponding time were 112.22?53.42, 105.36?49.64, 100.63?52.89, and 104.52?52.42pmol/L in CSF, and 113.57 ?25.79, 107.32?26.60, 119.84?31.53, and 117.21?28.95pmol/L in plasma, respectively. The contents of TRH-ir in CSF and plasma in the experimental group after traumatic head injury were significantly higher than those, in the control group (P

ObjectiveTo identify the relevant factors of expansion of contusive cerebral hemorrhage following unilateral decompressive craniectomy in patients with severe craniocerebral injury and discuss their relation with prognosis.MethodsA total of 161 consecutive patients with craniocerebral injury undergoing unilateral decompressive craniectomy were prospectively studied.Their initial cranial CT data (data after injury,data before operation,and data after first operation) were recorded.Mortality or Glasgow Outcome Scale (GOS) at 6 months after injury was used as the criteria for evaluation of prognosis.ResultsThe volume of increased contusive cerebral hemorrhage among the patients after craniectomy was (18.66 ± 22.69) ml.The Rotterdam score of their initial cranial CT after injury was significantly associated with the occurrence or not of expanded contusive cerebral hemorrhage following decompressive craniectomy and the expanded hematoma volume.The expanded volume of contusive cerebral hemorrhage ( ＞ 20 ml) after craniectomy showed significant relevance to mortality and poor prognosis six months later.The magnitude of external cerebral herniation ( ECH ) on the initial post-operative CT was associated with the prognosis. ConclusionsThe severity of patients with craniocerebral injury manifested by the initial cranial CT may predict the risk of expansion of contusive cerebral hemorrhage following decompressive craniectomy.The expansion volume of contusive cerebral hemorrhage and ECH are correlated with mortality and poor prognosis.

The fetal spleen cells were transplanted following the injection of S180 carcinosarcoma into the muscle,abdominal cavity,peripheral veins and portal vein in mice.The size inhibitory rate of the transplanted tumor and natural killer activity were evaluated 30 and 60 days after the injection.It was found that the growth of transplanted tumor was dramatically inhibited and natural killer activity was increased 30 days after the transplantation.But 60 days after the transplantation only portal venous transplanted tumor showed a satisfactory function of inhibiting tumor growth and natural killer activity maintained at a high level.These results indicated that portal vein was the best approach for the spleen cell transplantation

To improve the AIDS's knowledge level and intervention ability of peer lecturers in college, from the accumulation idea and activity type of experience value on Moso Teach, the author carried out systematic resource construction around the course design principles and objectives, at the same time one quantitative scoring system including learning degree and sharing degree was constructed. Through voluntary enrollment and selection among the students, the first group of peer lecturer training on AIDS prevention were set up, and 28 students were collected to experience the "mixed" application of the course. After the evaluation, it was found that there were positive functions in promoting the ability of AIDS prevention in the peer lecturer training course based on experience value of Moso Teach as the driving force and quantification. According to the problems exposed in the construction, the author put forward improvement strategies from the aspects of scoring system, off-line activities and resource optimization.

OBJECTIVE To study the risk factors and preventive therapeutic strategies of neurosurgical postoperative intracranial infection.METHODS Totally 1613 patients who had a neurosurgical operation from Jan 2005 to Jun 2008 in our department were chosen(64 cases with intracranial infection).The infection rate was 3.97%.The risk factors were studied retrospectively,?2 test was selected to analyze the factors which might cause infection.RESULTS The analysis of 1613 cases revealed that infection rate was closely related to ventricular drainage,long indwelling drainage,emergency subsequent surgery postcraniotomy,CSF leakage,the approach to the post fossa,surgical microscopy,operation time above 4 h and polluted operation;while had no significonce of sex,age,the season,application of antibiotics before the operation and emergency operation.CONCLUSIONS To decrease the infection rate,the suture should be complete to prevent CSF leakage,polluted region be cleaned effectively,strict asepticly technique be measured,the operation be finished as soon as possible,drainage be prevented from pollution carefully and the duration of the drainage be controlled strictly,especially to the ventricular drainage.

Objective To evaluate the clinical efficacy of retroperitoneoscopic nephrectomy for tuberculous nonfunctioning kidneys.Methods From October 2003 to November 2006,retroperitoneoscopic nephrectomy was performed in nine cases of tuberculous nonfunctioning kidneys in our hospital.Dissecting kidney and ureter with ultrasound scalpel,blocking kidney pedicle with Endo-GIA(n=4) or Hem-o-lok(n=5),kidney was put into kidney bags and taken out.Results All nine cases were performed nephrectomy successfully without conversions to open surgery.The mean of operative time was 110 min(range,90-180 min);the mean of blood loss was 94.4 ml(range,20-200 ml);the mean of postoperative hospital stay was 5.5 days(range,3-8 days).One case had a little cheese-like pura extravasation induced by laceration of kidney capsule.Peritoneum damage occurred in one case.The nine patients showed a primary healing of the wound.Follow-up of 1-38 months in nine cases showed normal function of contralateral kidney.Conclusions Retroperitoneoscopic nephrectomy for renal tuberculosis has advantages of minimal invasion,less blood loss and quicker recovery,therefore it is a fairly safe and reliable procedure for tuberculous nonfunctioning kidneys.

Objective To investigate the main causes and strategies for the difficulties in ureteroscopic lithotripsy.Methods From March 2004 to December 2006,19 cases of ureteral calculi,who experienced difficulties during holmium laser lithotripsy or pneumatic lithotripsy under a rigid ureteroscope,were analyzed retrospectively.Among the cases,3 had difficulties in ureteroscope placement due to the narrow ureteral ingress,6 owing to calculus obstruction complicated with ureteral inflammatory polypi,4 resulted from twisted ureter,and 6 because of stenosis of the ureter.Results In 15 of the patients,the operation was successfully performed by changing surgical approach,controlling the hydraulic irrigation,and incising the stenotic segments,etc.Two patients,who had stenotic ureter,received ESWL with double-J catheter dwelling.Lithotripsy failed in 2 cases,and PCNL was used to remove the calculi.The postoperative complications occurred in 4 cases,including 2 with mucosal laceration and 2 ureteral perforations.One of the 4 cases was transferred to an open surgery,and the other 3 were cured by conservative treatments.Conclusions Holmium Laser lithotripsy and pneumatic lithotripsy under a rigid ureteroscope are safe and effective in treating ureteral calculi.

Objective To report our initial experience on the complications of retroperitoneoscopic live donor nephrectomy(RPLDN)and their managements in 117 cases.Methods From December 2003 to January 2009,117 cases of RPLDNs were carried out in our hospital.The operation was performed through 3 lumbar ports,after the kidney was liberated fully and the ureter was severed 7-8 cm under the lower pole of the kidney,the renal artery and vein were blocked with Endo-cut or Hem-o-lok and then cut off.Endo-cut was used in 3 patients and Hem-o-lok in 114 donors.Afterwards,the kidney was taken out quickly from the donor and infused with 4℃ kidney preserving fluid(HCA)immediately.We reviewed the intraoperative and postoperative complications in the donors and the grafts and the managements of the cases.Results All the 117 operations were successfully completed.No patients died during the operation or had delayed graft function recovery postoperation.No one was converted to an open surgery or needed blood transfusion during the procedure.Surgery-related complications occurred in 5 donors(4.3%)including intraoperative bleeding in 2(cured by hemostasis during the operation)and retroperitoneal hematoma in 3(cured by conservative management).Graft-related complications occurred in 8(6.8%)cases;among which extra arteries in the graft owning to endovascular stapler was found in 1 patient(who had a short common stem of the main renal artery,the three branches were anastomosed with the external iliac artery and 2 branches of internal iliac artery respectively);two graft kidneys were lacerated by laparoscopic instruments superficially and were repaired using absorbable sutures;renal subcapsular hematoma was noted in 2 grafts,capsulotomy was performed in one of them while the other received no treatment,both the cases had normal function of the transplanted kidneys;ureteral complications occurred in 3 grafts,in which vesico-urethral anastomotic leakage was developed in 10 days after withdrawal of the double J stents,they were cured by ureteral re-implantation.All the donors and recipients with complications were followed up for an average of 50 months(range 15-62 months).No other complications were found in the cases.During the follow-up,blood and urine routine,liver and renal functions,and blood glucose level are all in a normal range,abdominal B-ultrasonography revealed no abnormalities.B-ultrasonography of the implanted kidneys showed normal morphology and renal functions.Conclusions RPLDN is a safe and reliable method.Most of its complications complications may be attributed to the learning curve.Refinements in surgical techniques may decrease the rates of both donor and graft complications.

Objective To evaluate the effciency of different embolic agents inducing the changes of the liver morphology and function in the selective portal vein embolization (PVE).Methods Forty five Spraque-Dawley rats were used in this experiment.Five were served as a control group and forty were randomly divided into 4 groups of 10 rats each.Right PVE was performed in each group by one of four different embolic agents respectively.Five rats from each group were sacrificed and dissected to inspect the morphological changes on 14th and 21st day after the procedure.The results of different groups were analyzed according to the weight ratios of the right lobe to the whole liver and the whole liver to the body,and the results were compared to each other and those of the control group using statistical Student“ t ”test. Results After the procedure,the embolized lobe was turned gray immediately with no significant differences between groups.Both on the 14th and 21st day after the procedure,the right lobe of the liver from the rats of group 1,2,3 were atrophied apparently with lots of spotty yellow scars in different sizes.There was no significant change of the embolized right lobe from group 4.By statistical analysis,the embolization using Lipiodol-ethanol 2∶1 mixture in group 2 resulted in better atrophy than group 1 ( P 0.05) and more than the gelfoam pieces ( P

Objective:To investigate the priorities of each factor influencing the casualties in refugees living in border areas, so as to provide evidence for casualty forecasting in the refugees. Methods: We summarized the factors affecting the refugee casualty in the border area through searching and reviewing the related literatures. The identified factors were classified into 3 levels and the quantitative index system was established by using Delphi method, i.e. expert consulting method. The names and the meanings of each index were revised according to experts’ suggestions after 3 rounds of consulting. The weights of each index were determined by analytic hierarchy process (AHP) and comparing-reordering method. Results: A 3-level quantitative system was successfully constructed, which consisted of 4 first level indices (including natural factors, social factors, medical factors, and war factors), 12 second level indices, and 37 third level indices; the weights of all indices were determined. Conclusion: The result of our study can be used in predicting refugee casualty and provide a reference for the medical service of refugees living in the border areas.