Objective To discuss effective methods for treating hypertensive intracerebral hemorrhage at the different sites. Methods Different operative methods were adopted in 85 cases of hypertensive intracerebral hemorrhage at the different sites from January 2001 to August 2003 in this hospital. Small fenestration and hematoma clearance under local intensify anesthesia was conducted in 40 cases of hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia; small incision trepanation with suction and drainage of hemorrhage under local intensify anesthesia was used in 26 cases of hemorrhage in the medial area of the basal ganglia without brain hernia; craniotomy and hematoma clearance under general anesthesia was adopted in 11 cases of preoperative brain hernia and 6 cases of cerebellar hemispheric hemorrhage; lateral ventricle external drainage was adopted in 2 cases of brain stem hemorrhage involving into the fourth ventricle and also in these cases with ventricle involved. Results The overall mortality rate was 12 9% (11/85). There were no deaths in cases of hemorrhage without brain hernia,under the cortex, in the cerebellum, in the brain stem or in the lateral area of the basal ganglia.The mortality was 29 0% (9/31) in cases of hemorrhage in the medial area of the basal ganglia and 45 5% (5/11) in cases of preoperative brain hernia, respectively. Conclusions Small fenestration and hematoma clearance under local anesthesia is effective for hemorrhage under the cortex or in the lateral area of the basal ganglia and without brain hernia. Provided surgical treatment is early and adequate, the prognosis of cerebellar hemorrhage is excellent. Small incision trepanation with suction and drainage under local anesthesia exerts no appreciable effect on hemorrhage in the medial area of the basal ganglia.

Objective To observe and classify the structure of the circle of Willis by using magnetic resonance angiographic(MRA)method. Methods A total of 2104 MRA head images from October 2013 to May 2015 in Shenyang Weikang Hospital was retrospective analyzed ,and the structure was classified by anterior circle or posterior circle according to the actual situation of the cerebral basilar artery. Results According to the origin of anterior cerebral artery and whether there was anterior communicating artery or not ,anterior circle was classified into three types:type Ⅰ,type Ⅱ and type Ⅲ. Type Ⅱ was classified into two subtypes,namely,type ⅡR and type ⅡL. Posterior circle,on the basis of whether there was posterior communicating artery or not,was classified into three types,which were type Ⅰ,type Ⅱ and type Ⅲ. According to the origin of posterior cerebral artery,type Ⅰ was classified into four subtypes,including type ⅠB,type ⅠC,type ⅠRC and type ⅠLC;type Ⅱ was classified into eight subtypes,including type ⅡBR,type ⅡBL,type ⅡCR,type ⅡCL,type ⅡRCR,type ⅡRCL,type ⅡLCR and type ⅡLCL;type Ⅲ was classified into four subtypes,including type ⅢB,type ⅢC,type ⅢRC,type ⅢLC. Conclusion There is a correlation among the different types of cerebral basi-lar artery,and each type of artery has their own sources of blood supply and the traits of communication compensation. When the anterior circle and posterior circle were both type Ⅲ,the complete ring structure of cerebral basilar artery,namely the circle of Willis,was formed. The existing rate of the circle of Willis was about 10.7%. Understanding of the differences among the individual types of arteries has great significance to the prevention and treatment of the cerebrovascular disease.

Objective To evaluate the performance of virtual touch tissue quantification imaging (VTQ) for differential diagnosing in uterine hysteromyoma and adenomyoma. Methods Blood flow parameters and SWV (shear wave velocities) from 42 regular hysteromyomas,14 abnormal hysteromyomas and 25 uterine adenomyomas were compared and analyzed through color Doppler. Results The SWV of regular hysteromyomas was on average of (2.72 ± 0.31) m/s;that of abnormal hysteromyomas (1.88 ± 0.25) m/s;while the SWV of uterine adenomyomas was on average of 1.91 ± 0.27 m/s. The mean SWV in regular hysteromyomas group was significantly higher than that in abnormal hysteromyomas group and uterine adenomyomas group (P < 0.05). There was no significant difference of SWV between abnormal hysteromyomas group and uterine adenomyomas group (P > 0.05).The resistance index and SWV of uterine hysteromyomas and adenomyomas had positive correlation (r = 0.753,0.544,0.506,P < 0.05). Conclusion VTQ can quantify the stiffiness of uterine hysteromyoma and adenomyoma.

Objective To study the protective effect of fluvastatin on cardiac remodeling and cardiac function, and to investigate its effect on Von Willebrand factor (VWF). Methods The rat model of cardiac heart failure (CHF) was in-duced by isoproterenol injection (170 mg/kg) via subcutaneous. Eighteen model rats were randomly divided into fluvastatin (20 mg ·kg-1·d-1) group, placebo group and control group. Rats were treated with normal saline in placebo group and control group. After 6-week treatment, the structure and function of hearts were measured by echocardiography in three groups. The ventricular weight index, the serum levels of VWF and B-type natriuretic peptide (BNP) were measured by ELISA assay. The levels of VWF mRNA in cardiac muscle were measured by RT-PCR. Results Compared with control group, the val-ues of left ventricular end-diastolic diameter (LVEDD) and left ventricular end systolic diameter (LVESD) were significantly increased in placebo group and fluvastatin group, while values of left ventricular ejection fraction (LVEF) and left ventricular ejection fraction shortening (LVFS) were significantly decreased (P＜0.05). The values of left ventricular wet weight/body weight (LVRW) and right ventricular wet weight/body weight (RVRW) were increased in placebo group and fluvastatin group. The expression of VWF mRNA in cardiac tissues was enhanced significantly (P＜0.01). Compared with placebo group, the values of LVEDD, LVRW and RVRW were significantly decreased in fluvastatin group. The expression of VWF mRNA in cardiac tissues was significantly decreased (P＜0.01), and the values of LVEF and LVFS were significant increased in fluvas-tatin group (P＜0.05). The level of VWF was positively corrected with BNP(r=0.996). Conclusion Fluvastatin could im-prove the cardiac function and cardiac remodeling, which may be by reducing the level of VWF and improving endothelial function.

Objective to analyze the basic situation of university and college teachers′psychological empowerment,and investigate the effect of perceived organizational support,organizational identification,supervisory commitment on psychological empowerment. Methods the instruments which were used include perceived organizational support questionnaire(POS),organizational identification questionnaire(OIQ),supervisory com-mitment scale(SCS)and psychological empowerment scale(PES). A total number of 1 500 teachers were recruited conveniently from 6 university and colleges. Results the average score of psychological empowerment was 60.09±14.21. Positive correlation was found among perceived organiza-tional support,organizational identification,supervisory commitment and psychological empowerment(P < 0.05). Perceived organizational support, organizational identification and supervisory commitment explained 86.5% of variance of psychological empowerment. Conclusion Overall level of university and college teachers′psychological empowerment is in moderate or above degree. Perceived organizational support,organizational identifi-cation,and supervisory commitment can predict a deep level of psychological empowerment.

Objective To evaluate the efficacy and safety of combination chemotherapy with vinorelbine and cisplatin in the treatment of metastatic breast cancer resisting to anthracycline and taxane.Methods 20 patients with advanced metastatic breast cancer were given following regimen:Vinorelbine 25mg/m2 was given intraveniously in day 1 and day 8,cisplatin 75mg/m2 was given intraveniously in day 1 or 25mg/m2 was given intraveniously in day1 to day 3,repeated every 3 weeks.Evaluation of response and adverse reactions were practiced every 2 cycles.Results 20 patients were evaluable,among them,2 cases reach CR,8 cases PR,4 cases SD and 6 cases PD,with a median followup of 6 months(4 ～ 18months),16 patients survived and 4 patients died.The median time to progression and the median survival time was 5 months(3 ～ 15 months) and 8 months(4 ～ 18 months) respectively.The treatment well tolerated,The main toxicity was myelosuppression and gastrointestinal reaction with WHO grade Ⅲ～Ⅳ gastrointestinal reaction,neutropena and thrombocytopenia being in 25% 、65% and 10% .Conclusion The regimen of NP is safe and effective in treating advanced metastatic breast cancer resisting to anthracycline and taxane.In addition,it was able to improve survival rate and adverse reactions could be tolerated.

Objective To evaluate the effects of different doses of dexmedetomidine on the median effective concentration (EC50) of propofol given by target-controlled infusion (TCI) at loss of consciousness (LOC).Methods Eighty ASA Ⅰ or Ⅱ patients of both sexes,aged 18-64 yr,with body mass index ≤25 kg/m2,scheduled for operations under general anesthesia,were randomly allocated to one of four groups(n=20 each): control group (group C) and dexmedetomidine 0.4 μg/kg group (group D1),dexmedetomidine 0.5 μg/kg group (group D2) and dexmedetomidine 0.6 μg/kg group (group D3).Dexmedetomidine 0.4,0.5 and 0.6 μg/kg were infused intravenously over 10 min in groups D1-3,while the equal volume of normal saline was given instead of dexmedetomidine in group C.Propofol was then given by TCI and the EC50 was determined by up-and-down sequential trial.The target plasma concentration was set at 2.0μg/ml in the first patient in each group.The ratio of the target plasma concentration between the two consecutive patients was 1.1.Loss of response to eyelash stimulation and verbal command (2 times) was considered to be signs of LOC.The EC50 and 95％ confidence interval (CI) of propofol causing LOC were calculated.Complications such as bradycardia,hypotension and respiratory depression were recorded.Results The EC50 (95％ CI) of propofol causing LOC was 2.59 (2.51-2.67),2.09 (2.02-2.16),1.82 (1.70-1.95) and 1.60 (1.49-1.72) μg/ml in groups C and D1.3 respectively.The EC50 of propofol causing LOC was significantly lower in groups D1-3 than in group C.Dexmedetomidine significantly decreased the EC50 of propofol required for causing LOC in a dose-dependent manner in groups D1-3 (P ＜ 0.05).The incidences of bradycardia and hypotension were significantly lower in groups D1.3 than in group C (P ＜ 0.05).Compared with group D1,the incidence of bradycardia was increased in groups D2,3 and the incidence of hypotension was increased in group D3 (P ＜ 0.05),There was no significant difference in the incidences of bradycardia and hypotension between groups D2 and D3 (P ＞ 0.05).No patients developed respiratory depression.Conclusion The optimum dose for dexmedetomidine infused intravenously when combined with propofol given by TCI is 0.4 μg/kg and it can decrease the EC50 of propofol administered by TCI at LOC with no adverse reactions.

Objective To explore the relationship between the MRI enhancement ratios of liver parenchyma in hepatobiliary phase with gadobenate dimeglumine (Gd-BOPTA)and liver function.Methods Fifty-nine patients who underwent Gd-BOPTA-enhanced MRI were retrospectively enrolled in the study.The enhancement ratio of signal to noise ratio and enhancement ratio of the contrast ratio were calculated.The relationships between the enhancement ratio and CTP grading and MELD score were analyzed.Results The signal enhancement ratios in hepatobiliary phase in patients with CTP A classification were higher than those with CTP B classi-fication (P <0.01).Meanwhile,the ratios in patients with MELD scores less than 10 points were higher than those with MELD scores more than 10 points (P <0.01).Conclusion The MR enhancement degree of liver parenchyma in the hepatobiliary phase with Gd-BOPTA may reflect the liver function.

OBJECTIVE To investigate the prevention measures of antibiotic-associated diarrhea(AAD) with microecological modulators.METHODS As control group,344 hospitalized adult patients with severe abdomen and/or lung infection but without gastroenteric disease received combined antibiotics treatment for more than five days.other 141 patients with same disease were divided into two test groups randomly.The patients received combined antibiotics treatment plus Bifid Triple Viable capsule(Pei-Fei-Kang)(group A) or Bacillus(licheniformis) capsule(Zheng-Chang-Sheng)(group B).The incidence of AAD in two test groups compared(respectively) to that of(control) group.(RESULTS) In control group,the incidence of AAD for more than 60 years old patients((22.31%)) was(significantly) higher than that of less than 60 years ones(8.88%)(P

Based on the field questionnaire survey in different grade undergraduates in some medical colleges , this paper summarized the main performance of network moral abnormality in medical college students , and further analyzed the internal and external causes , thus put forward the countermeasures of strengthening medical college students′network moral education: innovate moral education methods and improve the moral quality of college students;strengthen the network legal system propaganda education , enhance the students′self -discipline con-sciousness;play a role of main channel and enhance the actual effect of network moral education ;meet the require-ments for the internet age and the construct a new administrative team; strengthen the position consciousness , es-tablish network moral education platform;strengthen the guidance function , carry out various kinds of network mor-al education.