Objective To study the protective mechanism of mild hypothermia from severe traumatic brain injury (sTBI). Methods 160 cases with sTBI were treated under normothermia (NT group, n=80) and mild hypothermia (HT group, n=80) respectively. Their serum level of anti-brain antibody (ABAb) was measured with ELISA, cerebral haemodynamics with transcranial Doppler, and intracranial pressure (ICP) with ICP monitor 1 d, 3 d, 5 d, 7 d and 14 d after injury, while they were assessed with Glasgow coma scale (GCS) and Glasgow outcome scale (GOS). Results The level of ABAb was lower in HT group than in NT group (P<0.05) at every point. The scores of GCS increased (P<0.05), and the volume of systole, mean and pulse index improved more in HT group 5 d after injury (P<0.01). The ICP was lower in HT group 3 d after injury (P<0.01). The score of GOS was better in HT group than in NT group when discharged (P<0.05). Conclusion Mild hypothermia can reduce the level of serum anti-brain antibody, improve cerebral haemodynamics, decrease ICP and improve the prognosis in patients with sTBl.

AIM:To observe the preliminary efficacy of conbercept injected intravitreally for the treatment of wet age-related macular degeneration(wAMD).METHODS:Seventeen wAMD patients (18 eyes) were selected to receive conbercept injection.All patients were given a single conbercept injection every month,3 times.Before and after 1,2,3mo of the injection,the best corrected visual acuity (BCVA),intraocular pressure (IOP,measured by Non-contact tonometer),fundus photography,fundus fluorescein angiography(FFA),indocyanine green angiography(ICG),optical coherence tomography(OCT) examination and the complications incidence were compared.RESULTS:Three months after conbercept injection,the BCVA improved in 15 eyes (83%),stable in 3 eyes (17%).Before treatment,the average central macular thickness was 421.72±54.43μm,at 1 and 2 and 3mo after treatment,the average central macular thickness was 337.89±25.88μm,293.56±26.87μm,266.89±19.10μm respectively.There were significant differences compared with before and after injection(P<0.05).In the final follow up,FFA and ICG showed that the leakage in macular area disappeared in 15 eyes (83%),still existed in 3 eyes (17%),in those 3 eyes the injection was given for one or two times till the leakage disappeared.Elevated intraocular pressure occurred in 2 cases (26mmHg,23mmHg),after 1d down to normal.Another patient showed postoperative envy,given left ofloxacin eye drops after 2d,then back to normal.There was no serious ocular adverse reactions.CONCLUSION:Intravitreal injection conbercept for wAMD can significantly improve the visual function,reduce the macular edema and the leakage with higher safety and less complications.However the prolonged efficacy needs further observation.

Objective To determine the effect of using cytomegalovirus-seronegative blood components in preventing transfusion-acquired cytomegalovirus infection,which laid foundation for the application of blood antibody screening of cytomegalovirus.Methods The documents of studies about the comparison in transfusion-acquired cytomegalovirus ratio between using cytomegalovirus-seronegative blood components with using cytomegalovirus-unscreened /non-WBC-reduced blood were retrieved from the databases of PubMed,MEDLINE,Ovid,ProQuest,EBSCO,Cochrane Library,EMbase,CNKI,VIP,CBM and WanFang Library,and the reference in studies were retrieved by hands at the same time.The documents were screened,extracted and evaluated according to inclusion and exclusion criteria,and then given a Meta-analysis by using Rev Man 5.1 software.Results There were totally 7 controlled studies(430 patients) included.The results of Meta-analysis showed that compared with using cytomegalovirus-unscreened/non-WBC-reduced blood,the effect of using cytomegalovirus-seronegative blood components in preventing transfusion-acquired cytomegalovirus infection had a statistical difference(OR=0.07,95%CI:0.03-0.18,P<0.01).Conclusion Application of blood antibody screening of cytomegalovirus is effective in preventing transfusion-acquired cytomegalovirus infection,especially organ transplantation and neonate patients.

Adolescent ; Adult ; Female ; Heart Rate ; physiology ; Humans ; Locomotion ; Male ; Military Personnel ; Multivariate Analysis ; Regression Analysis ; Weight-Bearing

Post-traumatic stress disorder (PTSD) is a mental disorder characterized by hyperarousal, flashback and avoidance behavior after experiencing traumatic events. This article reviews the diagnostic criteria, pathogenesis and treatment options of this disease.

Objective To predict the occurrence of hypoparathyroidism following total thyroidectomy. Methods In this study, 124 patients underwent total thyroidectomy, 46 for thyroid cancer and 78 for multinodular goiter, additional neck dissection was performed on cancer patients. Serum calcium and parathyroid hormone (PTH) levels were examined preoperatively and at 1 h, 1 d and 2 d postoperatively. The occurrence of postoperative hypoparathyroidism was observed. Receiver operating characteristic curve analysis was employed to identify the best indicator to early predict the occurrence of clinical hypocalcemic symptoms. Results Fifty-eight (46.8%) patients suffered from postoperative transient hypoparathyroidism, with 22 ( 47. 8% ) cases in thyroid cancer group and 36 ( 46. 2% ) in multinodular goiter group ( λ2 = 0. 033, P = 0. 857). One (0.8%) patient in cancer group had permanent hypoparathyroidism. 90 patients (72.6%) had postoperative hypocalcaemia, 58 (46. 8% ) had subnormal serum PTH levels, 40 (32. 3% ) had hypocalcaemia symptoms. Postoperative serum calcium (F=21. 358,P =0. 000) and PTH ( F = 18.253, P =0.000) levels decreased more in cancer group than in goiter group.Receiver operating characteristic curve analysis demonstrated that the percentage of serum PTH level decline at 1 h postoperatively was most predictive and 76. 6% decline was the best cut-off value for the occurrence of clinical hypocalcaemia symptoms ( area under the curve being 0.933 ) with a sensitivity of 89. 7% and a specificity of 87.9%. Conclusions Neck dissection added to total thyroidectomy can decrease the postoperative serum calcium and PTH levels more seriously, but may not increase the incidence of postoperative transient hyperparathyroidism. The percentage of serum PTH level decline at 1 h postoperatively predicts the occurrence of clinical hypocalcaemia symptoms.

OBJECTIVE:To analyze and compare the congruity between Maria and DDW-J standard and Roussel uclaf causali-ty assessment method(RUCAM)for diagnosing drug-induced liver injury(DILI),and evaluate its application. METHODS:In ret-rospective analysis,the clinical data of 122 patients with DILI with RUCAM ≥3 scores was quantitatively scored by Maria and DDW-J standard,χ2 test was conducted for statistical analysis. RESULTS:Among the 122 cases,120 cases(98.4%)were classi-fied as“likely and possible”by DDW-J standard,which was significantly higher than the 58 cases(47.5%)that classified as“pos-sible”by Maria standard,with statistical significance;and compared with Maria standard,DDW-J standard was more closer to RU-CAM scoring results. CONCLUSIONS:DDW-J standard is superior to Maria standard,and close to RUCAM scoring results for DI-LI;RUCAM is still the DILI diagnostic evaluation system with high accuracy and operability.

Objective To investigate the efficacy of normative ankle balance training on chronic ankle instability (CAI).Methods Ninety patients were randomized into control group (17 males,28 females;13-26 years,mean 19.6 years) and experiment group (18 males,27 females;14-27 years,mean 20.3 years) according to the random number table.There were 19 left ankles and 26 right ankles injured in control group,and 19 left ankles and 26 right ankles injured in experiment group.Patients in control group only completed routine muscle strength training.Besides the routine muscle strength training,balance training (rubber band,spongy cushion,balance pedal,rubber balance ball and jump ball) were added in experiment group.The two groups were compared with respect to foot and ankle disability index (FADI),anterior,posterior-median and 45° to posterolateral direction reach distance of star excursion balance test (SEBT) and visual analogue score (VAS).Results After training,comparison of experiment and control groups showed significant differences in FADI (35.16 ± 3.23 and 22.33 ± 1.36),SEBT distance in posterior median direction [(78.59 ± 7.22) ％ and (71.89 ±7.11)％],SEBT distance in 45° to posterolateral direction [(75.79 ± 8.27)％ and (68.95 ±8.03) ％] and VAS [(3.01 ± 0.91) scores and (3.42 ± 1.02) scores] (P ＜ 0.05).For intragroup comparison,FADI,SEBT and VAS in experimental group showed significant differences before and after training (P ＜ 0.05),but only FADI in control group differed significantly before and after training (P ＜0.05).Conclusion Normative balance training can improve CAI patients' self-feelings of dynamic balance and instability with satisfactory therapeutic efficacy,and is worthy to be popularized.

Objective To explore the impact of juxtapapilary duodenal diverticulum on the formation of choledocholithiasis and biliary manometry after surgery.Methods The clinical data of 97 patients with common bile duct stones who successfully underwent ERCP and biliary manometry treatment from May 2011 to March 2014 were retrospectively analyzed.Ninty-seven common bile duct stone patients were divided to two groups,that is,52 cases of juxta-papilary duodenal diverticulum (experimental group) and 45 cases without juxta-papilary duodenal diverticulum (control group).The biliary manometric results before and after EST of both groups were compared.Results The basal pressure of sphincter Oddi of the experimental group before EST [(84.8 ± 26.1) mmHg] was higher than that of the control group before EST [(75.5 ± 14.6) mmHg] (P ＜ 0.05,1 mmHg =0.133 kPa);and that after EST was also higher than that of the control group after the operation[(19.8 ± 14.2)mmHg VS (15.9 ± 9.8)mmHg,P ＜ 0.05].The biliary pressure of common bile duct stone patients with JPD was higher than those without JPD before and after EST but with no significant difference(P ＞ 0.05).The biliary manometry was performed in 81 patients after one month and it was found that the basal pressure of sphincter Oddi of experimental group was still higher than that of the control group [(34.8 ± 17.1) mmHg VS (29.6 ± 15.3)mmHg,P ＜ 0.05].The biliary pressure of common bile of the experimental group was higher than that of the control group [(19.9 ± 11.2) mmHg VS (17.1 ± 13.1)mmHg,P ＜0.05].Conclusion The existence of juxtapapilary duodenal diverticulum increases the pressure of common bile duct and Oddi sphincter and leads to CBD stones.

AIM:To establish a HPLC method for determining contents of tetrahydropalmatine and pepper alkali in Zhitong Capsule(Rhizoma Corydalis,Fructus Piperis,Radix Paeoniae alba,etc.)to control its quality.METHODS:The samples were extracted in water by ultrasonic wave,and then extracted by aether to refine after being acidized by 1 mol/mL HCl.Following that the pH of water solution was adjusted to 9.0-10.0 by NH_3?H_2O,and then extracted by aether again.After that,the aether solution was collected to evaporation to dryness and metered by methanol.The sample solution was determined by high performance liquid chromatography on a Hypersil ODS 2 C_ 18 column(4.6 mm?250 mm,5 ?m)with mobile phase composed methanol-0.1% phosphoric acid water solution(the pH was adjusted to 6.0 by triethylamine)(55∶45).The flow rate was 1.0 mL/min,the column temperature was at 30 ℃ and the signal from 0 to 14.5 minutes were acquired at 280 nm,and that from 14.5 to 22 minutes were detected at 328 nm.RESULTS:The resolution of tetrahydropalmatine and pepper alkali was good,with no miscellaneous peak.The linear range was at 0.196-1.96 ?g(r=0.999 6)for tetrahydropalmatine,0.03-0.3 ?g(r=0.999 7)for pepper alkali.The average rate of recovery of tetrahydropalmatine was 97.74%(RSD= 0.42%,n=6),and that of pepper alkali was 104.51%(RSD=2.01%,n=6).CONCLUSION:The method is simple,reliable,accurate and can be applied to the quality control of the preparation.