Objective To investigate the expression of chemokine CCL27,CCL28 and their receptor CCR10 in mouse periph-eral blood in the acute phase of epilepsy.Methods The peripheral blood of acute epileptic mice at different time points(10 min,30 min,1 h,2 h)was collected,real-time PCR was used to detect the mRNA expression level of CCL27 and CCL28.The heparin anti-coagulation peripheral blood at the same time points(10 min,30 min,1 h,2 h)of normal and acute phase of epileptic mice were col-lected and flow cytometry was used to investigate the expression of CCR10 in peripheral blood lymphocyte.Results The mRNA expression level of CCL27,CCL28 in peripheral blood and the expression of CCR10 in lymphocytes were found significantly in-creased at 2 h in epileptic mice than those of normal(P <0.01).Conclusion The immune function disorder occured in peripheral blood in early epilepsic pathological process and might be associated with the subsequent inflammatory reaction and neuron apoptosis.

Objective To study the expression changes of IL-1β、FN-α6、IFN-γ and TNFR-m18 in peripheral blood within 2 hours in epileptic mice. Methods Semi quantitative real-time PCR was used to test the mRNA expres?sion level of IL-1β、FN-α6、IFN-γand TNFR-m18 in peripheral blood from normal and pilocarpine-induced epileptic mice at different time points (10 min, 30 min, 1 h and 2 h). Results The mRNA expression level of IL-1βincreased at 30 min(1.8±0.07), 1 h(2.9±0.98)and 2 h(1.45±0.11)after pilocarpine-induced status epilepticus comparing with that of control and SE 10 min(0.81±0.09)(P<0.05). The IFN-α6 mRNA expression level was lower at 10 min(0.59±0.05, P<0.05) than that of control. IFN-γmRNA expression level was higher at 10 min(2.85±0.11) than that of control and at oth?er time points during SE(P<0.01). TNFR-m18 mRNA expression level was higher at 1h(2.84±0.15) than that of control, and at other time points during SE(P<0.01). Conclusion The immune system of epileptic state is active, the imbalance of cytokine expression in peripheral blood may be related to the immune pathological process of acute stage of epilepsy.

Objective To study the advantage and major features of minimally invasive management of neoplasms in the fourth ventricle. Methods Twenty-eight cases of the fourth ventricle neoplasms underwent craniotomy through the cerebellomedullary fissure approach. Postoperative treatment and follow-up information were studied. Results Of the 28 studied cases, total resection was achieved in 23, and subtotal resection in 3. No approach-related complications such as cerebellar mutism, injury of posterior cranial nerves and hemiplegia occured. Conclusion The minimally invasive management of neoplasms of the fourth ventricle by cerebellomedullary fissure approach is safe and effective.

Objective To investigate the relationship between polymorphisms of N-acetyltransferase 2(NAT2)genes and anti-tuberculosis drug induced hepatic-injury(ADIH).Methods A 1:1 matched case-control study was conducted.One hundred and six cases fulfilling the criteria of ADIH were selected as ADIH group from the patients who received anti-tuberculosis therapy.whereas those patients without any hepatic inj ury related elinical symptoms during three months of follow-up period were selected as control.The genetic polymorphisms of the loci,NAT2481C/T,NAT2-590G/A and NAT2-857G/A,were determined by polymerase chain reaction and restriction fragment length polymorphism technique(PCR-RFLP)in patients who received antituberculosis therapy.The major environmental factors and genotypes were analyzed by univariate and multivariate conditional Logistic analyses.Results The T,AA allele frequencies of NAT2-481C/T,NAT2-590G/A and NAT2-857G/A were 7.5%,28.8%and 17.9%respectively in ADIH group,and 6.6%,18.9%and 17.5%,respectively in the control group.Univariate analysis demonstrated that the frequency of NAT2 slow acetylation genotype in ADIH group was significantly higher than that in control group with a crude OR(95%CI)of 2.250(1.140-4.441).Among 6 potential risk factors,i.e.education level,occupation,body mass index(BMI),smoking,drinking and the type of tuberculosis,the low BMI and drinking were two risk factors for ADIH.In multivariate analysis,ADIH remained associated with acetylation genotype after adjusting for BMI and drinking status.The adjusted OR(95%CI)was 2.246(1.086-4.644).Conclusion NAT2 slow acetylation genotype may be associated with the occurrence of ADIH.

Objective To investigate the treatment effect of excision via transoral-nosal-sphenoidal approach on pituitary adenoma and management of postoperative complications.Methods One hundred and four pituitary adenoma patients,admitted to our hospital from January 2010 to December 2014 and microsurgically treated via transoral-nosal-sphenoidal approach,were chosen in our study.The clinical data of these patients and microsurgical treatment efficacy were analyzed retrospectively and postoperative complications were concluded.Results Total resection was observed in 82 patients (78.8％) and subtotal resection in 22 (21.2％).Forty-two patients got vision improvement with an improvement rate of 80.7％.Hormonal readiness recovered to normal level in 34 patients (44.7％);hormonal readiness being decreased but still higher than normal level was noted in 38 (50.0％).The major postoperative complications included diabetes insipidus,cerebrospinal fluid rhinorrhea,electrolyte disturbance,hypopituitarism and hemorrhage.The symptoms and signs of patients were improved in varied degrees,and the postoperative complications were controlled.Conclusions The transoral-nosal-sphenoidal approach is an ideal method to resect pituitary adenoma and active management of postoperative complications is essential to the prognosis of patients.

Objective To investigate the clinical application value of 3D printing technique in the treatment ofintracranial aneurysms.Methods Eight patients with intracranial aneurysms,admitted to our hospital from May 2014 to June 2015,were chosen in our study;three dimensional reconstructions of anatomical models were accomplished by computer aided technology.By rapid prototyping,the intracranial aneurysm models were manufactured,operation project were formulated and preoperative sham-operation was enforced to supervise the intracranial aneurysm clipping.The clinical data and clipping efficacy were retrospectively analyzed.Results Eight patients with 11 intracranial aneurysms at stage Ⅰ were treated successfully with aneurysm clipping via unilateral craniotomy without rupture of aneurysms.Preoperative sham operation shortened the time of operation and reduced the postoperative complications.Glasgow outcome scale scores at hospital discharge indicated that good recovery was noted in 7 patients and mild disability in one.Postoperative CTA or DSA did not show residual aneurysms.Conclusions Three-dimensional printing technology can overall,intuitively,exactly display three-dimensional shape of intracranial aneurysms and spatial relation of anatomic structure.It has important role of supervising treatment of intracranial aneurysms and broad application perspective,thus deserves generalization.

Objective To study the demands among community patients with chronic diseases for continuing nursing care .Methods Totals of 200 patients from five community health service centers were recruited into the study and investigated with self-designed questionnaire .Results Out 200 questionnaires , totals of 178 questionnaires were taken back , with effective rate of 89%.Among 178 patients, 21.4%(38/178) of patients chose “good understanding of continuing nursing care”, 80.9%(144/178) of patients chose“hoping to continue to receive care after discharge”;38.2%(68/178) of patients were “not sure the effect of continuing nursing care”;77.5%(138/178) of patients worried about their own expense for continuing nursing care .The demands for continuing nursing care included knowledge of safe medication and diseases , blood pressure control and self-monitoring, dietary guidelines, knowledge related to the disease , blood lipid and blood glucose control and monitoring, rehabilitation exercise and so on .Only 8.4%(15/178) of patients hoped that nursing care after discharge was provided by community nurses .Conclusions Community patients have a high demand for continuing nursing care , while difficulties exist in implementing of continuing nursing care at present .It is necessary to make fully use community nursing human resources to develop continuing nursing care model of hospital-community-family.

Objective:To investigate the serum and follicular fluid levels of sterol regulatory element-binding protein 1c(SREBP-1c), leucine-rich α-2-glycoprotein 1(LRG1) and the correlation with insulin resistance(IR) in non-ovarian etiology infertility patients and polycystic ovary syndrome(PCOS) patients with or without IR.Methods:Forty-nine PCOS patients and 66 infertility patients with non-ovarian etiology were collected in this retrospective study, homeostasis model assessment for insulin resistance(HOMA-IR) was used to evaluate IR, and were divided into control group( n=36), IR group( n=30), PCOS alone group( n=28) and PCOS-IR group(PCOS with IR group, n=21). The concentrations of serum, follicular fluid LRG1 and SREBP1c levels in each group were compared, and their correlation with relevant hormones and glycolipid metabolism were analyzed. Results:The levels of serum, follicular fluid LRG1 and SREBP1c in IR group, PCOS alone group and PCOS-IR group were significantly higher than those in control group; The PCOS-IR group showed a more significant increase in the levels of serum, follicular fluid LRG1 and SREBP1c( P<0.05). Correlation analysis showed that serum, follicular fluid LRG1 was positively correlated with body mass index, fasting plasma glucose(FPG), fasting insulin(FINS), triglycerides(TG), and HOMA-IR( P<0.05). Serum, follicular fluid SREBP1c was positively correlated with body mass index, FPG, FINS, TG, total cholesterol, LDL-C, LH, total teststerone, DHEAS, FAI, and HOMA-IR( P<0.05). Binary logistic regression analysis showed that serum SREBP1c was a risk factor for PCOS( P<0.05). Conclusion:The serum and follicular fluid levels of LRG1 and SREBP-1c were elevated in PCOS patients, especially in those with IR. The elevated levels of serum and follicular fluid LRG1 and SREBP-1c may be associated with IR and glucose-lipid metabolism abnormalities in PCOS patients. Serum LRG1 and SREBP-1c levels may serve as new indicators for predicting IR, early diagnosis, and intervention in PCOS patients.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.