AIM: To observe the effect of nimodipine on the severe brain injury. METHODS: Nimodipine was ccsed for acute severe brain injury patients early in 6 hours after wounded. The effect and safety were observed in an open trial. RESULTS: The mortality and morbidity of 20 patients decreased significantly by the use of nimodipine in comparisom with another 20 patients treated normally. CONCLUSION: Nimodipine is benefit to severe brain injury patients.

Objective To investigate the long time prognosis of liver resection or transcatheter arterial chemoembolization(TACE) of Barcelona clinic liver cancer stage C(BCLC-C) patients who have portal vein tumor thrombsis.Methods Totally 86 BCLC-C patients who satisfied our including criteria from our surgical database of People's Hospital of Yichang City from January 2000 to September 2015 were selected as the research object.According to different treatment,86 patients were divided into liver resection group(n=50) and TACE group(n=36).The general information of two groups were compared.Cox multi-factors analysis and overall survival rate were calculated.ResultsThe long-term prognosis of liver resection group was better than that of TACE group(5-year OS:26% vs.0,P<0.001).Multi-factors analysis revealed that multiple tumors (HR:1.510,95%CI[1.120,2.316],P=0.020),AST>40 IU/L(HR:0.615,95%CI[0.488,1.206],P=0.013) as well as HBV-DNA>1 000(HR:1.204,95%CI:[0.920,2.540],P=0.038)were adverse factors for prognosis.ConclusionLiver resection is better than TACE for BCLC-C patients with portal vein tumor thrombosis.However,randomized controlled trial still need to be used to further confirm our conclusion.

OBJECTIVE To investigate the resistant patterns of ESBLs-producing Escherichia coli and Klebsiella spp isolated from 3 hospitals in Xinjiang and to determine the genotypes of ESBLs. METHODS Using 2-fold agar dilution test to determine MICs of ten antibiotics.Using polymerase chain reaction and DNA sequencing to determine ESBLs genotype;using isoelectric focusing to determine the isoelectric points of ?-lactamases produced by strains in which no ESBLs genes were amplified by PCR. RESULTS Strains had low susceptibility to aztreonam,cefotaxime and ceftazidime.The susceptibility to cefepime,cefoperazone/sulbactam,cefmetazole,piperacillin/tazobactam,and meropenem were relatively high.Fifty five strains mainly carried blaCTX-M-1 subgroup gene and blaCTX-M-9subgroup gene,and blaSHV-12 gene were also detected. CONCLUSIONS blaCTX-M-1 Group gene and blaCTX-M-9 group gene are prevalent in three hospitals of Xinjiang,blaSHV-12 gene also plays a part role in leading to resistance of E.coli and Klebsiella spp to ?-lactams.

Objective:To explore the efficacy and safety of anti-tumor necrosis factor alpha (TNFα) monoclonal antibodies (mAbs) for severe/refractory vasculo-Behcet′s disease (BD).Method:The clinical data of severe/refractory vasculo-BD patients treated with anti-TNFα mAbs were retrospectively analyzed. Response of anti TNFα mAbs was analyzed. The dosage changes of glucocorticoid, the level of erythrocyte sedimentation rate (ESR) and hypersensitive C-reactive protein (hsCRP) before and after treatment were recorded, as well as side effects.Result:Sixteen patients were enrolled. Arterial lesions were reported in 12 patients, including 9 with arterial aneurysm, 6 with arterial dilation, 2 with stenosis and 2 with occlusion. Seven patients presented venous thrombosis, including lower extremity veins ( n=6), cerebral venous sinus ( n=2) and inferior vena cava system ( n=2). Two cases had both arterial and venous involvement. Before the application of TNFα mAbs, all 16 patients failed to response to prednisone or its equivalent dose of 40 (7.5-90) mg/d in combination with cyclophosphamide, methotrexate, thalidomide or azathioprine for median 4 (0-156) months. After a mean duration of treatment for (17.1±6.5) months, 15 patients achieved complete remission and 1 patient achieved partial remission. Three patients received surgery without any postoperative complications. After using anti TNFα mAbs, the dosage of prednisone [5(0-12.5)mg/d vs. 40(7.5-90)mg/d, P<0.01], ESR [(7.3±4.6) mm/1h vs. (33.5±26.7) mm/1h, P<0.01] and hsCRP [1.9(0.2-11.4) mg/L vs. 24.3(0.4-113.9) mg/L, P<0.01] were significantly decreased. Side effects were observed in 2 patients. One developed pulmonary infection 12 months after adalimumab with conventional treatment. Another patient had allergy to infliximab then switched to adalimumab. Conclusion:In combination with corticosteroids and immunosuppressants, anti-TNF α mAbs are effective and well-tolerated in severe/refractory vasculo-BD, with a favorable steroid -sparing effect and rare postoperative complications.