ObjectiveTo evaluate the safety and efficacy o f microvascular deco mpression in the management of primary trigeminal neuralgia.Methods We review ed 13 patients with unilateral primary trigeminal neuralgia treated by microvasc ular decompression. Conventional spin-echo (SE) sequence and 3-D fast inflow wit h steady-state precession (3-D-FISP) sequence MRI scans were used preoperatively to find evidence of neurovascular compression. The operation was accessed by re trosigmoidal approach and the nerve root was separated away from pressure vessel s by artificial vascular patch.ResultsDuring operations it w as found that tr igeminal nerves were pressed on by blood vessels in all the cases (by the superi or cerebellar artery in 11 cases; by the basilar artery and the superior cerebel lar artery in 1 case; and by the vein in 1 case). Complete pain relief was achie ved in all the patients without mortality or permanent complications. Eleven pat ients were clinically followed for 6～24 months with a mean of 13 months, and no recurrence was seen. ConclusionsMicrovascular decompression is a safe and effective procedure in the treatment of primary trigeminal neuralgia.

ObjectiveTo evaluate the significance of pirif orm aperture enlarge ment in transsphnoid approach microsurgery for pituitary macroadenomas.MethodsTranssphnoidal approach microsurgery through enlarged pyrifor m aperture was ca rried out in 96 patients with pituitary macroadenoma from March 1997 to October 2000.ResultsAmong the 96 patients, 65 (67 7%) underwent tot al removal of the tumor, 25 (26 0%) underwent subtotal removal (80%～90%), and 6 (6 3%) partial removal (

In recent years the loss of humanity spirit in medicine has been the undeniable fact,which accordingly pro-vokes criticisms from patients and media.To reshape the perfect image of medical circle,it is pressing to transcend theutilitarianism of medical education , enhance the humanity education and develope the spirit of humanity.

Objective To study the effect and adverse drug reaction (ADR) of Diazepam when used to treat acute alcoholism for establishing its rational use. Methods According to the administration of the drug through different routes, 158 patients admitted from Jan. 2000 to Jan. 2006 were divided into two groups- intramuscular group (i.m., n=91) and intravenous group (i.v., n=67). There was no significant difference in age, sex, amount of liquor taken, time of seeing doctor, and drug dosage between the two groups. The effect and adverse drug reaction (ADR) of Diazepam were statistically analyzed. Results No ADR occurred in i.m. group and the effective rate was 92.31%. Although the effective rate in i.v. group was 100%, 3 patients suffered from cardiac arrest, 2 patients were found to have aspiration and apnea suddenly, and the ratio of ADR was 7.46%. Conclusion It is better to use intramuscular injection rather than intravenous injection in treating acute alcoholism with Diazepam, in order to avoid the serious medical incidents.

Objectives To observe the effect of the nourishing kidney and dispersing stagnated hepatoqi decoction (NKD) on symptoms and sex hormone of polycystic ovary syndrome patients with renal deficiency and hepatic stagnation. Methods Fifty six patients were divided into two groups:the NKD group (30 cases, treated with the NKD), and the Diane-35 group (26 cases, treated with Diane-35). Condition of menstruation, acne, hairiness and side effects were observed. The follicle figures and ovary volume were recorded, and the sex hormone were detected before and after treatment. Results Two patients were pregnancy in NKD group. After treatment, the condition of menstrual disorder and acne were improved significantly in both groups (P

Objective To investigate the significance of heat shock protein 60 (HSP60) and heat shock protein 65 (HSP65) on prognosis acute coronary syndrome (ACS) within one year.Methods Eightynine hospitalized patients were collected from department of Cardiovascular disease,the people's hospital of Wuxi city affiliated of Nanjing Medical University and the Second People's Hospital Wuxi City from November 2009 to February 2011,and divided into ACS group (n =50),stable angina pectoris (SAP) group (n =19) and nonCHD group(n =20).HSP60,HSP65 levels in human serum were measured at the time of admission.The followup records of all patients were established to observe the occurrence of coronary events during one year,and analyzed its relationship between with HSP60,HSP65.Results Eighty-four cases were successful followed-up,and lost cases were 5.Eighteen patients occurred cardiovascular events within one year,and their content of serum HSP60 and HSP65 were significantly higher than that of without cardiovascular events (HSP60:(1026.19 ± 253.47) ng/L vs.(845.75 ± 138.52) ng/L,t =2.49,P ＜ 0.05 ; HSP65:(2573.95 ± 768.75) ng/L vs.(2076.38 ± 385.46) ng/L,t =2.58,P ＜ 0.05).In ACS group,the level of serum HSP60 and HSP65 of the patients occurred cardiovascular events was significant higher than that of without cardiovascular events,and there was significant difference(HSP60:(1162.73 ±249.14) ng/L vs.(892.55 ±204.62) ng/L,t =2.19,P ＜ 0.05 ; HSP65:(2714.39 ± 738.44) ng/L vs.(2136.85 ± 472.62) ng/L,t =2.65,P ＜ 0.05).COX regression analysis showed that HSP65 was an independent risk factor for recent cardiovascular events in patients with ACS (RR =1.002,95％CI 1.000-1.004,P =0.035).Conclusion The detection of HSP60,HSP65 in prognostic coronary artery disease prognosis has important value,and HSP65 was an independent risk predictor of ACS in recent cardiovascular events within one year.

Objective To explore the effect of the transplantation of intact follicle by punching with syringe needle on defect eyebrow reconstruction.Methods Fifty-two patients with eyebrow defects due to burn,trauma,resection and inappropriate eyebrow trimming were recruited,35 with bilateral defects and 17 with unilateral defect.The scalps strips from the safe donor area or temporal region were taken and made into 1 to 2 cm long hair with intact follicle under 3 fold magnifier.The recipient area was punched with 21G or 22G syringe needle.Then the hair shaft was clamped with mi croforceps and the follicles were transplanted to the defective area.Results Folliculitis were found in two burn patients after the transplantation and cured by alcohol inunction.Hairs of the rest patients transplanted grew well.The direction and appearance were satisfied.The survival rate of hair was more than 90 ％.Conclusions It is feasible to restore the partial eyebrow defect by intact follicular transplantation by punching with syringe needle and clamping the hair shaft with microforceps.

Objective To investigate whether soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) as the early diagnostic biomarker of acute ST elevation myocardial infarction (STEAMI).Methods Sixty-five patients with STEAMI and 30 patients with stable coranary heart disease or other heart disease(control group) were enrolled as our subjects.Serum sLOX-1 levels were measured.Results The median(P25,P75) of Serum sLOX-1 in the patients with STEMI were 210.0 (130.0,356.0) ng/L,significantly higher than that of control group(65.5 (55.2,85.2) ng/L,Z =6.17,P ＜ 0.001).Logistic regression analysis revealed that sLOX-1 alone was an independent factor associated with STEAMI (B =0.036,P ＜ 0.001).The area under the ROC curve of sLOX-1 for detecting STEMI was 0.895,and 95％ CI was 0.831-0.959 (P＜0.001).Taking sLOX-1 =87.5 ng/L as cut-off value,the sensitivity was 89.6％ and specificity was 82.4％for the diagnosis of STEAMI.Conclusion Serum sLOX-1 was significantly higher in the STEAMI and it might served as the early diagnostic marker for STEAMI.

Objective To compare the short-term prognostic value of glycohemoglobin (HbA1c) and admission plasma glucose in non-diabetic patients with acute ST-elevation myocardial infarction.Methods Eighty-four non-diabetic patients with acute ST-elevation myocardial infarction from January 2010 to June 2011 were included.Both HbA1c and plasma glucose was measured on admission.Cardiovascular event was followed up in 30 days.Results The average of HbA1c and admission plasma glucose was as cut-off point.The patients were divided into HbA1c ＜ 5.5％ group (40 cases) and HbA1c ≥5.5％ group (44 cases) according to HbA1c level.The patients were divided into admission plasma glucose ≤ 8.6 mmol/L group (42 cases) and admission plasma glucose ＞ 8.6 mmol/L group (42 cases) according to admission plasma glucose.The incidence of cardiovascular event in 30 days in admission plasma glucose ＞ 8.6 mmol/L group was higher than that in admission plasma glucose ≤ 8.6 mmol/L group [19.0％ (8/42) vs.2.4％ (1/42)],and there was significant difference(P＜ 0.05).There was no significant difference in the incidence of cardiovascular event in 30 days between HbA1c ≥5.5％ group and HbA1c ＜ 5.5％ group (P ＞ 0.05).Admission plasma glucose showed weak correlation with blood creatine kinase isoenzyme MB peak (r =0.233,P ＜0.05).Conclusion In non-diabetic patients with acute ST-elevation myocardial infarction,elevated admission plasma glucose levels are associated with higher cardiovascular event in 30 days.

ObjectiveTo investigate the effects of Akt3 gene knockout on neuropathic pain behaviors induced by chronic constriction injury of sciatic nerve (CCI).MethodsExperiment was divided into two groups:Akt3 knockout group (Akt3-/-,n =12),wild type group (WT,n =12 ).Randomly numbered,the right sciatic nerve of mice were received the operation of chronic constriction injury.Paw withdrawal mechanical threshold (PWMT)and paw withdrawal thermal latency (PWTL) were tested on day 1 before operation and day 1,3,5,7,10,14,17,21 afterCCI.ResultsThe basic values of PWMT(right:(1.09±0.20)g,(1.17±0.22)g;left:(1.17±0.15)g,(1.22±0.23)g,P＞0.05) andPWTL(right:(6.18±1.11)s,(6.20±1.25)s;left:(5.82±0.91)s,(5.92± 1.71 ) s,P ＞ 0.05 ) had no statistically significant differences between two groups.On day 1 after operation,compared with basic values,the PWMT and PWTL of the right paw in both Akt3-/- group and WT group decreased significantly (P ＜ 0.05 ),and at least lasted up to day 21.The PWMT( 3d:(0.42 ± 0.22 ) g,(0.72 ± 0.36) g ; 17d:(0.29 ±0.15)g,(0.49 ±0.19) g;21d:(0.27 ±0.18)g,(0.56 ±0.15)g,P＜0.05) and PWTL(5d:(2.43 ±0.68)s,(3.13±0.52)s;17d:(2.43±1.26)s,(3.84±1.29)s ;21d:(2.14±1.23)s,(4.07±1.26)s,P＜0.05 ) of the right paw in Akt3-/- group was significantly lower than those in WT group.The PWMT and PWTL of the left paw in Akt3-/- group and WT group had no obvious differences (P ＞ 0.05 ). However.compared to left paw,the PWMT and PWTL of the right paw of the two groups were obviously lower (P ＜ 0.05 ).ConclusionThe neuropathic pain induced by CCI increased in Akt3 gene knockout mice.