Objective To investigate the clinical effects of early aneurysm surgery clipping in the treatment of intracranial aneurysm.Methods 72 patients with intracranial aneurysms were selected.42 patients (44 aneurysms) were taken microsurgical clipping( clipping group),30 patients( 33 aneurysms ) were taken vascular embolization(embolization group).The prognostic evaluation and clinical indicators of two groups were observed.Results There were no significant differences in GOS evaluation when discharge and mRS evaluation after postoperative 3 months in two groups(all P ＞0.05 ).The length of stay,hospital cost and complete occlusion rate of clipping group was ( 17.1 ± 3.2 ) d,( 5.5 ± 1.2) ten thousand yuan,100.0％,respectively,and better than those of embolization group [ (9.1 ± 2.6) d,( 12.1 ± 2.6) ten thousand yuan,83.3 ％ ] ( all P ＜ 0.05 ).There were no significant differences in cerebral aneurysms rupture rate and complication rate between the two group ( x2 =0.01,0.02,all P ＞ 0.05 ).Conclusion The microsurgical clipping has the therapeutic equivalence with embolization group,and has respective advantages and disadvantages.The microsurgical clipping could be the preferred treatment method,especially suitable for application in the primary hospital.

5.Negative nitrogen balance nutritional index in the study group were significantly better than that of the control group(P

Root stem of Anemarrhena asPhodeloides was extracted with hot water,treated with ethanol and dilutealkali to temove protein. The polysaccharide thus obtained was given to mice by gastric gavage. Result showedthat the polysaccharide can marked1y lower the blood sugar and liver glycogen of mice without affecting bloodlipid level. When given intraperitoneally, it also showed hypoglycemic activity- For alloxan diabetic mice, thepolysaccharide can also markedly lower its b1ood sugar by gastric gavage.

Objective To determine the relationship between zinc and nutritional status or immunity in patients with end-stage renal disease undergoing continuous ambulatory peritoneal dialysis (CAPD). Methods Forty-five stable CAPD patients undergoing peritoneal dialysis were enrolled in this study. The dietary zinc intake and serum zinc levels were investigated, and the results were compared with the gender- and age-matched healthy populations (n = 45). The relationship between dietary zinc intake and serum zinc levels and subjective global assessment (SGA) score, blood cell counts, serum albumin (ALB), prealbumin (PA), C-reactive protein (CRP),and lymphocyte subsets were analyzed. Results The percentages of inadequate dietary zinc intake (P= 0. 007)and low blood zinc (P = 0. 036) were significantly higher in CAPD patients than in healthy group. CD8 levels were significantly lower (P = 0. 000) while CD4/CD8 ratio was significantly higher (P = 0. 033) in CAPD patients than in healthy group. In CAPD patients, correlation analysis showed that dietary zinc intake was significantly correlated with serum prealbumin levels (r = 0. 577, P = 0. 000), but was negatively correlated with SGA score (r = - 0.354,P = 0. 015) and CRP (r = - 0.354, P = 0. 015); however, it was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Serum zinc level was significantly positively correlated with hemoglobin (r= 0. 411, P=0.005), hematocrit (r=0.345, P=0.023), WBC (r=0.318, P=0.035), SGA score (r=0.417, P=0. 005), and CRP (r=0.342, P = 0. 027), but was not significantly correlated with lymphocyte subsets and CD4/CD8 ratio. Conclusions Zinc deficiency is common among patients with CAPD. Adequate dietary zinc intake can facilitate protein synthesis and improve the overall nutritional status. High serum zinc concentrations are beneficial for the synthesis of hemoglobin and the improvement of anemia.

Objective To investigate the relationship between plasma albumin and hemoglobin(Hb) levels and prognosis in patients with severe craniocerebral trauma. Methods The clinical data of 124 patients with severe craniocerebral trauma form January 2010 to January 2014 were analyzed retrospectively. The relationship between plasma albumin and Hb levels and prognosis were analyzed. Hb level was obtained in 3 days of admission, and then the patients were divided into Hb <90 g/L group, Hb 90-99 g/L group, Hb 100-110 g/L group, Hb >110 g/L group, and also were albumin <25 g/L group, albumin 25-28 g/L, albumin 29-31 g/L group, albumin>31 g/L group according to the mean albumin level. Multifactor Logistic regression analysis was used to analyze the relationship between Hb, albumin levels and prognosis. Results Among 124 patients, 37 patients (29.8%) were given red blood cell (RBC) transfusion, and 28 patients (22.6%) received albumin treatment. The hospital mortality was 20.2% (25/124). The age, scores of Glasgow Coma Scale (GCS) and Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ), and hospital mortality in different Hb level groups had no significant differences (P>0.05). The age, scores of GCS score and APACHEⅡ score in different albumin level groups had no significant differences (P>0.05), but the hospital mortality in different albumin level groups had significant difference: 31.2%(10/32), 24.2%(8/33), 9.7%(3/31), 14.3%(4/28), P<0.05. Multifactor Logistic regression analysis showed that albumin level was the relevant factor for the severe craniocerebral trauma (P<0.01), the hospital mortality was decreased with the rising of the albumin level, but the risk of death was higher in albumin>31 g/L group than that in albumin 29-31 g/L group. Conclusions 29-31 g/L albumin level is the best for severe craniocerebral trauma patients. There is no significant impact of Hb on the prognosis for severe craniocerebral trauma patients.

Objective To investigate the effects of nasojejunal feeding plus nasogastric tube decompression in severe hypertensive intracerebral hemorrhage complicated with gastroparesis.Methods Fifty-six cases of severe hypertensive intracerebral hemorrhage complicated with gastroparesis admitted to hospital from January 2011 to June 2014 were chosen as study group, while the 52 cases of similar patients admitted to hospital from January 2007 to December 2010 were chosen as control group.Nasojejunal feeding and nasogastric tube decompression were given to the study group.Nasogastric enteral nutrition support therapy was firstly given to the control group conventionally,after 15 days if they still could to be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight, serum albumin, prealbumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.The patients were followed up according to activity of daily liying(ADL) after 3 months.Results There was no significant difference on the average body weigh between two groups before treatment.The average body weight of the study group was significantly higher than that of the control group after 4 weeks treatment((57.2±5.3) kg vs.(52.8±4.9) kg,t=4.33,P＜0.01).The serum albumin, pre albumin and hemoglobin of 3 week, four week after treatment were significantly higher than those of the control group(serum albumin of 3 week: (34.5±3.3) g/L vs.(30.7±3.1) g/L;erum albumin of four week:(37.8±3.8) g/L vs.(34.1 ± 3.4) g/L;serum prealbumin of 3 week:(202.3± 16.7) g/L vs.(179.6 ±15.2) g/L;serum prealbumin of four week: (216.9±17.1) g/L vs.(203.1±15.4) g/L;hemoglobin of 3 week : (119.4± 12.1) g/L vs.(107.7 ± 11.3) g/L;hemoglobin of four week : (126.2± 12.8) g/L vs.(113.5 ±11.9) g/L).Nutritional status of study group was significantly better than that of the control group(t=6.16, 5.32,7.37,4.85,5.18,5.32;P＜0.01), and complications was significantly less than that of the control group (P＜0.05).After three months, the good prognosis rate of study group (80.36％ (45/56)) was significantly higher than that of the control group (6 1.54％ (32/52)), the difference was statistically significant (x2 =4.67, P ＜0.05).Conclusion Nasojejunal feeding plus nasogastric tube decompression for patients with severe hypertensive intracerebral hemorrhage with gastroparesis can improve nutritional status, enhance their body resistance, reduce the incidence of complications, and improve their prognosis.

Objective To investigate the biosynthesis of arbutin by suspension culture of crown gall of transgenic Panax quinquefolium. Methods Hydroquinone in methanol(60 mg/mL) was added to the medium of the crown gall of P.quinquefolium after precultured for 20 d,then they were co-cultured for another 60 h.The product was isolated and purified by column chromatography and its structure was identified by physicochemical properties and spectroscopic data.The dynamic curve of biotransformation was investigated by quantative analysis of arbutin with HPLC.Results The product could be obtained from both of the culture and medium,which was isolated and elucidated as 4-hydroxyphenyl-?-D-glucopyranoside(arbutin).After co-cultured for 60 h,the mole conversion ratio of hydroquinone is 88.4%,the product contents in culture and medium are 63.69 mg/flask and 1.86 mg/flask,respectively,and the excretion ratio of arbutin reaches the highest(2.92%).Conclusion It's the first time around the world that the crown gall of transgenic P.quinquefolium is used as a biotransformation system and arbutin which shows varied pharmacological activites have been got successfully.

Objective To investigate the application value of methylene blue excretion test in early reasonable nutritional support for severe traumatic brain injury.Methods One hundred and thirty-three cases of severe traumatic brain injury admitted to hospital from January 2010 to June 2012 were chosen as treatment group,while the 127 cases of similar patients admitted to hospital from January 2007 to December 2009 were chosen as control group.Patients in treatment group underwent methylene blue excretion test in 3 days,8 days,15 days after injury,and the nutritional support ways were determined according to the elimination time of methylene blue in patients' urine.The control group conventionally receive enteral nutrition support therapy firstly,after 15 days if they still cannot be tolerant of the enteral nutrition,then parenteral nutrition therapy were adopted.The weight,serum albumin and hemoglobin circumstances of the two groups were determined and the complications were recorded.Glasgow coma score (GCS) of 3 months after injury were followed up.Results There was no significant difference on the average body weigh between these two groups before treatment.The average body weight of the treatment group was significantly higher than that of control group after 3 months treatment((56.3 ± 5.5) kg vs.(52.6 ± 5.3) kg,t =5.93,P ＜ 0.01).The serum albumin and hemoglobin of 14 d,21 d after injury were significantly higher than those of the control group (serum albumin of 14 d:(32.7 ±3.4) g/L vs.(28.8 ±3.1) g/L; serum albumin of 21 d:(34.3 ±3.8) g/L vs.(30.7 ±3.3) g/L;hemoglobin of 14 d:(113.4±12.5) g/L vs.(102.2 ±11.6) g/L;hemoglobin of 21 d:(118.5 ±13.3) g/L vs.(106.7 ± 12.4) g/L.Nutritional status of treatment group was significantly better than that of the control groupall P ＜ 0.05).After three months,the effective rate of treatment group (93.23％ (124/133)) was significantly higher than that of the control group (84.25％ (107/127)),the difference was statistically significant (x2 =5.29,P ＜ 0.05).Conclusion Determining the early reasonable nutrition support ways for patients with severe traumatic brain injury according to the elimination time of methylene blue in the urine,can provide comprehensive nutrition to patients,enhance their body resistance,reduce the incidence of complications,and create an important clinical value for improving prognosis.

Objective To investigate the clinical effect of early application of nimodipine on a large area cerebral infarction after severe traumatic brain injury operation.Methods Fifty-one patients with severe head injury after large area cerebral infarction were as treatment group who hospitalized from January 2009 to January 2012,and 48 hospitalized cases as the control group from January 2005 to January 2008.The patients in control group were received drugs to decrease intracranial pressure,and enhance nerve nutrition therapy,while in the treatment group,beside the therapy method of control group,were received nimodipine intravenously by micro-pump for 10 days,and then oral administration for 10 days.Plasma endothelin-1 was detected at 0,5th,7th,14th day days after hospitalization.Dopple was pplied to record the middle cerebral artery (MCA) peak systolic velocity(Vp) of the injured side for 7 d.Glasgow outcome score(GOS) was recorded in the 3 months follow-up.The awakening time was recorded consciousness.Results At 21 st day after treatment,22 cases were died in the treatment group and survival patients with cerebral vasospasm were 14 cases (48.28％,14/29).However,30 cases were died in control group and cerebral vasospasm(CVS) of survival patients was 15 cases (83.33％,15/18),significantly higher than that in treatment group (x2 =5.78,P ＜ 0.05).The variable tendencies of Vp,plasma endothelin-1 and the intracranial pressure were significantly different between the treatment group and the control group (Vp:F group =276.27,Ftime =603.54,F interactive =85.68 ; plasma endothelin-1:F grouP =281.16,F time =608.32,F interactive =87.45 ; intracranial pressure:F grouP =326.58,F time =78.63,F interactive =27.39 ; P ＜ 0.05).Mter 3 months of treatment,the value of GOS was significandy higher in treatment group than that of control group (x2 =4.76,P ＜ 0.05).Furthermore through three months treatment,the effective rate in treatment group was higher than that in the control group (52.94％ (27/51) vs.(31.25％ (15/48)),the awakening periods was shorter than that in control group((20.7 ±6.5) d vs.(27.8 ± 7.6) d,t =3.19,P ＜ 0.05)).Conclusion Early applications of nimodipine treatment after severe traumatic brain injury patients with massive cerebral infarction can significantly improve the clinical efficacy and shorten the duration of coma.