Objective To investigate the effects of surgical method on the falx paraneoplastic parasagittal meningiomas.Methods 30 cases of surgical treatment in sagittal sinus and falx meningioma patients with imaging data,surgical approach,microsurgical resection of the tumor method and efficacy were analyzed.Results 30 patients resected by Simpson standard,Ⅰ grade resection 23 cases,Ⅱ grade resection in 7 cases,no operative mortality.1-5 years of follow-up,2 patients relapsed,all secondary surgical cure.Conclusion To be familiar with microscopic neuroanatomical relationship,using microsurgical resection of the superior sagittal sinus,falx meningioma,tumor removal rate can be increased to reduce the important functional areas of damage,reduce complications and improve quality of life of patients.

According to the theoretical basis of using 5 gripper models of health system reform and high-value policy designing process, to define the over-diagnosis and over-treatment in the process of basic health care utilization in public hospitals of China, basing on the diagnostic framework of the internal and external environment, to explore the causes herein and discriminate the root, direct and intermediate factors that lead to the problem systematically, and identify the formation mechanism of the problem.

Objective To explore a convenient and safety way for surgical treatment of juxtra-papillary duodenal diverticulum.Methods A total of eighteen patients with juxtra-papillary duodenal diverticulum admitted to Hunan Provincial People's Hospital from May 2011 to May 2013 were involved in this study for retrospective analysis.Results Most of patients were old people and the average age was (55.5 ± 11.2) years in this group.All 18 patients accepted diverticulectomy without operation-mortality.No postoperative complications such as bleeding,duodenal fistula,biliary fistula and traumatic pancreatitis were happened.The average operation time was (2.5 ±0.6) hours.The average blood loss was (35.1 ± 14.2)ml.A total of 16 patients had been accepted follow-up survey.Mean length of follow-up was (10.5 ±2.0)months.Good result rate was 100％.Conclusions Do-not-open the duodenum diverticulectomy is the ideal surgical treatment of juxtra-papillary duodenal diverticulum.

Objective To discuss the relativity between serum procalcitonin(PCT) level and renal impairment (RI) in critically ill patients. Methods A perspective study was performed in 60 critically ill patients. They were divided into 2 groups on the serum PCT level within 24 h: abnormal group (PCT ≥ 0.5 μg/L,38 cases) and normal group(PCT < 0.5 μg/L,22 cases). The serum creatinine (SCr) and blood urea nitrogen (BUN) were observed. Acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ ) of the patients were recorded. Calculated the sensitivity and specificity for prediction of RI as well as acute renal dysfunction (ARD). Results SCr [(188.91 ± 199.48) μmol/L]and BUN [(13.03 ±9.19)mmol/L]in abnormal group were significantly higher than those in normal group [(67.40 ± 15.35) μ mol/L and (6.91 ± 2.06) mmol/L](P< 0.01). The sensitivity of PCT forecast RI was 71.79%, and specificity was 52.38%. The sensitivity of PCT forecast ARD was 91.67% , and negative predictive value was 95.45%. Conclusion Serum PCT level has an important value for judgement of RI and ARD in critically ill patients.

Bladder pain syndrome or interstitial cystitis (BPS/IC) is a clinical diagnosis based primarily on refractory suprapubic pain,which is lack of effective treatment and a broad consensus of diagnostic criteria,because its etiology and pathophysiology remains unclear.In this review,it was discussed that recent research advancement regarding to definition,etiology,diagnosis and treatment of BPS/IC,through referring to the latest guidelines and literature on this disorder.

Syndrome of cachexia,which is a common feature of many types of cancer,characterized by loss of adipose tissue and skeletal muscle,is responsible not only for a poor quality of life and poor response to chemotherapy,but also a decreased survival time.It can not be fully explained by the accompanying anorexia,because increasing nutrient support is unable to reverse the wasting syndrome.Although patients with cachexia frequently show an elevated resting energy expenditure,cachexia can occur with a normal energy expenditure.Lipid mobilizing factor and proteolysis inducing factor,two tumor-derived factors,can directly mobilize fatty acids and amino acids from adipose tissue and skeletal muscle respectively.It is important of the knowledge about the roles and mechanism of LMF and PIF in the development of cancer cachexia,which should lead to the development of new therapeutic methods.

Objective To establish the methods for TLC identification and contents determination of Compound Yantongxiao Spray.Methods Flos Lonicera,Borneolum Syntheticum and Menthol in the spray were identified by TLC,and the content of chlorogenic acid was determined by HPLC.Results The TLC characteristic spots of Flos Lonicera,Borneolum Syntheticum and Menthol can be identified.For content determination,the linear range of chlorogenic acid was in 0.08～0.28 ?g(r=0.999 0),the average recovery of chlorogenic acid was 102.34 %(n=6)and RSD was 2.03 %.Conclusions The methods are simple,accurate,specific and reproducible,can be used for the quality control of Compound Yantongxiao Spray.

Objective To investigate the correlation between gut microbiota and hepatitis B virus(HBV) infection at different stage. Methods 84 patients aged 25 ~ 40 were enrolled in the study,the ALT,AST and HBV antigens and antibodies qualitatively detected. Then they were divided into four groups based on HBV related antigens and antibodies qualitative detection according to guideline for chronic HBV infection:48 in the protective antibody positive group where vaccine injection was performed for producing protective antibodies ,14 in the HBV recovery group 9 in chronic HBV infection group And 13 in antibody negative group where vaccine injection was done. Their fecal samples were collected and total DNA were extracted and subjected to enterobacterial repetitive intergenic consensus sequence polymerase chain reaction(ERIC-PCR). After ERIC-PCR,gel electrophoresis and genetool software were used to analyse the differences in the amount of bands and the position of main bands between groups. Results The amounts of bands in the antibody negative and chronic HBV infected groups were significantly smaller than the protective antibody group and HBV recovery group. The position of main band in the protective antibody group and HBV recovery group were wildly spread within groups ,and most main bands in the HBV recovery group were above 282 bp. The main bands in the antibody negative and chronic HBV infected groups were centralized in 60 ~ 70 bp. Conclusions Compared with the protective antibody group and HBV recovery group ,the richness of gut microbiota in the antibody negative and chronic HBV infected groups are significantly decreased and lack of microbiota above 200 bp in ERIC-PCR.

Objective To compare the safety and effectiveness of temporary occlusion techniques with different balloons in performing cesarean section for patients with pernicious placenta previa.Methods The clinical data of 15 patients with pernicious placenta previa,who received cesarean section during the period from March 2014 to April 2016,were retrospectively analyzed.In order to reduce bleeding during operation and to preserve the uterus as far as possible,temporary occlusion of abdominal aorta with balloon was adopted in 7 patients (group A),and temporary balloon occlusion of bilateral internal iliac arteries was employed in 8 patients (group B).The intraoperative radiation dose,the amount of blood loss and blood transfusion during cesarean section,the hysterectomy rate,the postoperative hospitalization days,and the intervention-related complications were documented,and the results were compared between the two groups.Results All the 15 patients were suffered from central type of placenta praevia complicated by extensive placenta accreta.With the help of temporary balloon occlusion technique,the cesarean section was successfully accomplished in all 15 patients.Subtotal hysterectomy had to be done in 7 patients,including 4 patients of group A and 3 patients of group B,and every one patient from each group developed arterial thrombosis of lower limb.The intraoperative radiation dose of group A was significantly lower than that of group B (P＜0.01),besides the amount of blood loss and blood transfusion during cesarean section,the hysterectomy rate,the postoperative hospitalization days,and the intervention-related complications of group A were all lower than those of group B,but because of the limited number of cases these differences were not statistically significant (P＞0.05).Conclusion For the treatment of pernicious placenta previa,temporary balloon occlusion technique-assisted cesarean section is safe and effective.The intraoperative radiation dose in the group using temporary balloon occlusion of abdominal aorta is remarkably lower than that in the group using temporary balloon occlusion of bilateral internal iliac arteries.

Objective To investigate the value of ureteropyeloscopy and B-type ultrasonography in the treatment of staghorn calculi. Methods Pneumatic lithotripsy was performed and the residual stone and stone fragments were removed under the assistance of ureteropyeloscope and B-type ultrasonograph in 40 patients. Results The stone fragments were small enough to remove and the calculi removal rate was 92.5% (37/40). The rate of complications mainly including hemorrhage and residual stones was 7.5% (3/40). Conclusion The application of ureteropyeloscopy and B-type ultrasonography in the treatment of staghorn calculi is safe and less invasive, and can reduce effectively the incidence of residual stones.