Objective To compare the impact of nimodipine combined with mannitol and mannitol only on the neurologic impairment score,cerebral hemodynamic parameters and clinical efficacy of hypertensive cerebral hemorrhage in acute phase.Methods 68 patients with hypertensive cerebral hemorrhage in acute phase were selected,and they were randomly divided into control group (34 cases) and study group(34 cases) by digital table method.The control group was treated with mannitol only,while the study group was treated with nimodipine combined with marmitol.The clinical efficacy,hematoma volume,area of cerebral edema,cerebral hemodynamic parameters,neurologic impairment score,Barthel score of the two grou.ps were compared,and the adverse drug reaction of the study group was observed.Results The total effective rate (82.4％ vs.94.1％) and efficiency rate (44.1％ vs.61.8％) of the two groups had statistically significant differences (x2 =5.688,4.956,all P ＜ 0.05).The neurologic impairment score [post-treatment of the control group (10.2 ± 9.3) points vs.pre-treatment (14.9 ± 11.6) points,t =4.607,P ＜ 0.05;post-treatment of the study group (6.0 ± 4.7) points vs.pre-treatment (14.4 ± 10.8) points,t =8.379,P ＜0.05],area of cerebral edema[post-treatment of the control group (3.7 ± 0.6) cm2 vs.pre-treatment (4.8 ±0.9) cm2,t =5.262,P ＜ 0.05;post-treatment of the study group (2.2 ± 0.8) points vs.pre-treatment (5.1 ±1.2) points,t =9.193,P ＜ 0.05],hematoma volume [post-treatment of the control group (12.5 ± 7.4) mL vs.pre treatment (18.9 ± 7.1) mL,t =6.033,P ＜ 0.05;post-treatment of the study group (8.6 ± 8.2) points vs.pre treatment (18.4 ± 7.3) points,t =10.437,P ＜ 0.05] and Barthel score [post-treatment of the control group (73.6 ±40.4) points vs.pre-treatment (32.8 ± 27.1) mL,t =7.827,P ＜ 0.05;post-treatment of the study group (85.6 ±46.8) points vs.pre-treatment (36.7 ± 28.6) points,t =10.966,P ＜ 0.05] of the two groups had statistically significant differences.The neurologic impairment score of the study group after treatment was much lower than that of the control group [(6.0 ± 4.7) points vs.(10.2 ± 9.3) points,t =3.955,P ＜ 0.05].There were statistically significant differences between after and before treatment of the control group in critical pressure [(9.3 ± 2.2)kPa vs.(9.6 ± 2.1) kPa,t =5.046,P ＜ 0.05],peripheral resistance [(1 788.2 ± 209.4) kPa · s-1 · mL-1 vs.(1 659.2 ±219.3)kPa·s-1 · mL-1,t =6.146,P＜0.05]and mean blood flow velocity[(6.4 ±1.1) mL/s vs.(7.9±1.2) mL/s,t =6.266,P ＜ 0.05].The cerebral hemodynamic parameters of the study group after treatment had statistical differences compared with before treatment in critical pressure [(8.9 ± 2.3) kPa vs.(8.2 ± 1.1) kPa,t =5.292,P ＜ 0.05],peripheral resistance [(1 794.3 ± 188.6) kPa · s-1 · mL-1 vs.(1 469.5 ± 161.8) kPa · s-1mL-1,t =4.693,P ＜ 0.05],mean blood flow velocity [(6.4 ± 1.3) mL/s vs.(8.6 ± 1.5) mL/s,t =4.069,P ＜0.05],mean blood flow volume [(13.3 ± 3.0) cm/s vs.(14.5 ± 3.3) cm/s,t =5.633,P ＜ 0.05].There were statistically significant differences between the two groups in critical pressure,peripheral resistance,mean blood flow velocity,mean blood flow volume (t =4.664,4.563,5.532,5.327,all P ＜ 0.05).There were 4 cases of facial flushing,2 cases of pulsatile headache,3 cases of blood pressure drop,and the symptoms were gradually relieved after slowing down.Conclusion In the acute phase of hypertensive cerebral hemorrhage,nimodipine can reduce the scope of hematoma in a timely manner,significantly improve the efficacy and the quality of life of patients,it is worthy of clinical pronotion.

BACKGROUND: There have been some prospective, randomized, controlled studies regarding the feasibility and safety of laparoscopic gastrectomy for gastric cancer, but controversy exists.OBJECTIVE: To systemically assess the feasibility and safety of laparoscopic gastrectomy for gastric cancer.METHODS: A computer-based online research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy published between January 1994 and December 2009 was performed in PubMed, Ovid Medline, Web of Knowledge, EMbase, Chinese Journal Full-text Database and Wanfang Database. Meta analysis of acquired data was performed through the use of RevMan 5.0 software. The inverse variance method was used to test the significance of continous data, while the Mantel-Haenszel method was used for dichotomous data. The chi-square test was used for evaluation of data heterogeneity. Homogenous data was calculated using the fixed effect model, and heterogeneous data was calculated using freedom model. Statistical data was expressed as 95% confidence interval. Funnel plot was used for sensitivity analysis to show potential publication bias.RESULTS AND CONCLUSION: Five papers that corresponded to inclusion criteria were included in this study. Among 326 cases included, 164 underwent laparoscopic gastrectomy and 162 received open gastrectomy. Meta analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P ＜ 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P ＜ 0.01). But there was no significant difference in terms of time to resumption of oral intake, postoperative complications,postoperative morbidity rate, and tumor recurrence. Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node. The five papers adopted two different modes to remove lymph nodes, so subgroup analysis was also used. Results showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy. All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.

The paper describes the short and medium term (within 2 to 5 years) priorities that any region in China right now faces in working out and implementing its regional health planning, viz. the coordinated development strategy of medicine and health, medical security and social economy. The authors hold that to achieve the coordinated growth of the health cause and society, it is imperative to overcome in the short run logically related obstacles in four aspects: ineffective solution to the apparent problems followed with interest by both the social and health sectors and lack of effective operating conditions accompanying medical insurance reform, both resulting in the lack of a driving force in the reform within hospitals; difficulty in achieving breakthroughts in the development of the health cause; and the probability of a regional health planning becoming a mere formality because of the above factors. In addition, the fact that reform of medical and health institutions in their setup and ownership of property rights lags behind macroscopic social economic reform obscures the explanation of and solution to the above problems. Based on the research results, the paper sets forth the priorities in short and medium term planning.

Objective To study the clinical characteristics in young women with breast cancer.Methods Clinical data on 71 young breast cancer cases (under 35 years) out of a total 810 female cases during a period of 20 years were retrospectively analyzed. Result Delayed medical consultation was more often seen in young patients(56?4)?d vs (35?3)?d; u=2.33; P

Objective To investigate the main technical points of detachable balloon in management of traumatic carotid-cavernous fistulas (TCCF) and evaluate objectively the clinical outcome.Methods A total of 59 patients with TCCF were treated with detachable balloons,which involved 64 embolization procedures.Follow-up ranged from 3 months to 2 years. Results Forty-eight patients with TCCF (81％) were successfully occluded with patency of internal carotid artery.The rest 11 patients were obstructed in both the fistula and the internal carotid artery.Recurrent TCCF was found within three days after embolization in five patients (with a recurrence rate of 8％ ) who underwent further embolization,of whom one patient went blind after the procedtre and the eyesight showed no recovery even after another embolization with balloon for successful occlusion of the fistula; one patient presented with intracerebral hematoma at day 3 postoperatively and underwent emergency embolization again to occlude the internal carotid artery and fistula,with slight paralysis of the left limb. Conclusions Embolization of TCCF with detachable balloon is a reliable treatment,which is characterized by slight injury and high safety.However,the disease' s development should be strictly observed after the treatment.In the case of recurrence of symptoms,brain angiography and CT scanning should be rechecked timely and emergency treatment should be performed.

ObjectiveTo explore the characteristic CT features of benign and malignant submandibular gland lesions.Methods CT scans of 75 cases of submandibular gland lesions verified pathologically after surgery were analyzed retrospectively,including 38 cases of pleomorphic adenoma,22 cases of malignant tumors,11 cases of chronic submaxillaritis,2 cases of myoepithelioma,1 case of neurilemoma and 1 case of hemangioma.Results ( 1 ) All 38 cases of submandibular gland pleomorphic adenoma only occupied a part of submandibnlar gland.Thirty five lesions were on the edge of submandibular gland.The edge of 33 lesions were smooth and the density of 30 lesions were even.Thirty three lesions were slightly or moderately enhanced and 10 lesions showed “target sign” on enhanced CT.( 2 ) There were 22 cases of submandibular gland malignant tumors.Three lesions of lymphoma located at the edge of submandibular gland with smooth edge and even density,and showed mild to moderate enhancement.The remaining 19 lesions showed rough edge and uneven density.Eighteen of the 19 lesions showed ill-defined boundary,2 of the 18 lesions invaded most of submandibular gland and 16 of the 18 lesions invaded the whole submandibular gland.Seventeen lesions were unevenly enhanced,thickened,cirvilinear vessels were seen in 12 of the 17 lesions.Nine cases were accompanied with swollen lymph nodes ( minor diameter greater than 1.0 cm) in neck.(3)There were 11 cases of chronic submaxillaritis,which showed enlargement of the whole submandibular gland with relative smooth edge and relative clear boundary.Most of lesions were moderately and evenly enhanced.Six cases were companied with submandibular duct lithiasis and dilatation.All of 11 cases were accompanied with lymph node enlargement in neck.(4) Two cases of myoepithelioma demonstrated irregular ring enhancement on CT;one case of neurilemoma showed obvious cystic changes and slight enhancement on the edge;1 case of hemangioma showed multiple phleboliths and prolonged contrast enhancement.ConclusionsMost of submandibular gland benign and malignant lesions show some degree of characteristic CT findings.It is relatively difficult to discriminate between lymphoma and submandibular gland pleomorphic adenoma.

Microvascular architecture of the oviduct was observed by SEM in 20 adult female Wistar rats which were not pregnant. The oviduct was supplied by 2-4 tubal branches (0.2-0.3mm in diameter) which were derived from the ovarian artery. The tubal branches entered the wall of oviduct and divided into numerous meandering arterioles (0.02-0.07mm in diameter). Intrinsic microvasculature of the oviduct might be divided into three layers: (1) the subserosal vascular plexus which appeared tortuous and formed reticulate anastomosis, (2) a parallel branching vasculature in the muscle coat, and (3) the subepithelial capillary network. The latter arised from the arterioles which ramified terminally near the apex of mucosal folds and broke up into very dense capillaries. Subepithelial capillary density in the fimbriae was markedly higher than that in the isthmus and uterine part. Intrinsic venules of oviduct were less tortuous and less closely accompanied with the arterioles. In mesoviduct, veins were in closely accompanied with the corresponding arteries. In the wall of oviduct, some capillaries and venules drained to the small veins directly and vertically.

n clinic.

BACKGROUND:Existing evidence has shown that xenogeneic bone derived graft materials have the ability to repair bone defects, but little report is on the comparison of composition of xenogeneic bone and human bone.
OBJECTIVE:To analyze the chemical composition, mineral phase, calcium and phosphorus contents, total protein contents, and appearance of the cancel ous bones of the tibia from pig, bovine and human.
METHODS:Cancel ous bones of the tibia from pig, Banna miniature pig, bovine, young and old people were cut into bone particles of 0.5 cm×0.5 cm×0.5 cm. After degreasing or drying treatment, chemical composition, mineral phase, calcium and phosphorus contents, total protein contents of bone particles were detected using Fourier transform infrared spectroscopy, X-ray diffraction, plasma emission spectroscopy, scanning electron microscopy, and Kjeldahl method, respectively. Nano Measurer 1.2 and Photoshop cs6 were used to measure pore diameter and porosity rate based on the results of scanning electron microscope.
RESULTS AND CONCLUSION:The main inorganic phase of five kinds of cancel ous bones was hydroxyapatite and the main chemical composition was phosphate and carbonate. The calcium content of the bovine cancel ous bonewas lower than that of the other cancel ous bones (P<0.05) and the phosphorus content of the cacel ous bone of young man was higher than that of the pig and bovine cancel ous bones (P<0.01). The total protein content in the cancel ous bones of normal pig and Banna miniature pig was higher than that in the other three kinds of cancel ous bones (P<0.05). The pore diameter of five kinds of cancel ous bones was 400 to 600μm and the porosity rate was 60%to 70%. Moreover, the porosity rate of the bovine cancel ous bone was the highest. Therefore, we conclude that there are some certain differences in the organic and inorganic components of the pig or bovine cancel ous bones as compared with humans.

Objective To investigate the anti-apoptosis effects of heme oxygenase-1 (HO-1) in a mouse model of liver ischemia-reperfusion ( IR ) injury and to analyze the possible mechanisms . Methods A cell model of hypoxia/reoxygenation injury was established after transfecting mouse liver AML12 cells with HO-1 small interfering RNA ( siRNA) . Real-time PCR and Western blot assay were performed to detect the changes of HO-1, B-cell lymphoma 2 (Bcl2) and caspase-3 at the cellular level. The mouse models of liver ischemia-reperfusion injury were established with/without pretreatments with cobalt proporphyrin (CoPP), CoPP+znic proporphyrin ( ZnPP) and/or ZnPP. The levels of aspartate transaminase ( AST) and alanine transaminase ( ALT) in serum samples were measured. Immunohistochemistry was used to analyze the chan-ges of caspase-3. Western blot assay was used to detect the expression of HO-1 and Bcl2 at protein level. The pathological changes of liver tissues were observed under light microscope. The apoptosis of hepatocytes was observed by using Tunel assay. Results Decreased expression of HO-1 and Bcl2 and increased expres-sion of caspase-3 were observed in the model of hypoxia/reoxygenation injury by pre-transfecting the AML12 cells with HO-1 siRNA. Compared with the IR injury group, the CoPP pretreatment group showed lower lev-els of AST and ALT (P<0. 05) and alleviated pathological damages in liver tissues. Moreover, the expres-sion of caspase-3 was inhibited, but the expression of HO-1 and Bcl2 were enhanced. Less apoptotic cells was detected by the Tunel assay (P<0. 05). However, these protective effects could be suppressed by adding ZnPP. Conclusion HO-1 has anti-apoptotic effects in the in vitro model of hypoxia/reoxygenation. CoPP can upregulate the expression of HO-1 and play the role of anti-apoptosis in a mouse model of liver is-chemia-reperfusion injury.