Objective To explore the operative modes of the chronic subdural hematoma in the old people. Methods The three approaches that the trepanation and drainage,the trepanation and irrigation and the bipunctate trepanation and irrigation were performed to treat the chronic subdural hematoma in the old people. The efficacy was analyzed through the clinical observation and CT inspection. Results All the three approaches were very efficacious,but the trepanation and drainage was the best one among them. Conclusion The trepanation and drainage of the chronic subdural hematoma in the old people is very efficacious and simple. For the low density or equal density hematoma,the best choice is the direct trepanation and drainage.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Child ; Facial Paralysis ; therapy ; Female ; Humans ; Male ; Middle Aged ; Young Adult

Objective:To compare the therapeutic effects between the Governor Vessel-regulating, liver-soothing and mind-calming needling and the routine acupuncture therapy for insomnia due to liver fire disturbing the heart.
Methods:A total of50 cases with insomnia were randomly divided by the random numberl table into the two groups, 25 cases in each group. The observation group was treated with the Governor Vessel-regulating, liver-soothing and mind-calming needling, while the control group was treated with the routine acupuncture therapy. The two groups were treated for five sessions per week, ten sessions as a course. After 3-course treatment, the therapeutic effects and the improvement of Pittsburgh sleep quality index (PSQI) were observed.
Results:After treatment for three courses, the total effective rate was 100% in the treatment group and 92% in the control group. The difference in the therapeutic effect between the two groups was statistically significant (P<0.05). After the treatment, thesleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, sleeping disturbances, daytime dysfunction, and total PSQI scores in the patients of the two groups were obviously improved in comparing those before treatment, with significant differences (allP<0.01). After treatment, the inter-group differences in the sleep latency, sleep duration, habitual sleep efficiency, subjective sleep quality, and total PSQI scores were statistically significant (all P<0.01); the differences in the scores of sleeping disturbances and daytime dysfunction is not statistical significant (all P>0.05).
Conclusion:Thetherapeutic effect of Governor Vessel-regulating, liver-soothing and mind-calming needling is better for insomnia due to liver fire disturbing the heart than the routine acupuncture therapy.

Though the primary data on fully covered self-expandable metal stents (FCSEMS) in the treatment of benign biliary strictures caused by chronic pancreatitis and anastomotic stricture following orthotopic liver transplantation is encouraging,the risks including stent translocation,biliary infection,pancreatitis and inability to remove stents should be considered before replacing plastic stents with FCSEMS for the first-line treatment of benign biliary strictures in routine practice.FCSEMS is effective in treating benign pancreatic ductal strictures,but it is also associated with a high rate of stent translocation.To overcome this problem,FCSEMS with better conformability and flared ends need to be designed.There is a theorectial risk of pancreatic ductal infection caused by the blockage of side branches of the pancreas by covering membrane of the stents.However,no such complication was reported.Given the uncertain long-term efficacy and safety of FCSEMS for benign pancreatic ductal strictures,their use may be reserved for the management of retractory,symptomatic benign strictures only in selected groups of patients.

Tuberculosis (TB) remains a very common disease in most of the low- and middle-income countries. As a result of high disease burden, TB control measures in these countries are usually concentrated on intensifying active disease case-finding and early treatment of infectious TB. On the contrary, in countries with low disease burden, the focus is on contact investigation to identify latently infected individuals and prophylactically treating them to prevent disease reactivation and transmission. These two strategies are deemed important for the effective TB control. Nonetheless, WHO cautions that targeted contact investigation and latent TB infection (LTBI) treatment should only be undertaken by countries that have the operational capacity/resources and have achieved ≥ 85% treatment success rate of active TB. The screening of LTBI is further challenged by the lack of a “gold standard” test to identify and validate individuals with this condition. Tuberculin skin test (TST) is still the preferred investigation as it is cheap, widely available and validated in many trials. The sensitivity and specificity of the newer test—interferon gamma release assay (IGRA) for LTBI screening has been encouraging in low prevalence countries. However, the evidence supporting such usage remains uncertain in high burden settings. Diagnosis of LTBI should adhere to the strict criteria outlined in the guidelines to avoid misdiagnosing active TB as LTBI. The treatment of the latter involved only one or two anti-TB drugs. It has been demonstrated that in the properly conducted contact screening and LTBI treatment, chances of the emergence of multi-drug-resistant TB is very low.
Tuberculosis ; Poverty ; Antifungal Agents ; Itraconazole

SUMMARY: To investigate the influences on semen parameters and fertilizing capacity of immuno- globulin(Ig) isotypes and regional distribution of antisperm antibody (ASA) on the human sperm surface. Sixty-seven ASA-positive patients were compared with 96 ASA-negative donors. ASAs in semen showed significant negative effects on both semen parameters and fertilizing capacity; in those with ASAs in the sperm head and/or tail, the reductions were significant. In the head as well as the tail, there was close correlation between fertilizing capacity and both IgG and IgA. Both semen parameters and fertilizing capacity are significantly affected by the presence of ASA in semen. In particular, antibodies IgG to sperm head and/or tail, and antibodies IgA to sperm tail appeared to have a highly detrimental effect on fertilizing capacity.
Antibodies* ; Head ; Humans ; Immunoglobulin A ; Immunoglobulin G ; Semen* ; Sperm Head ; Sperm Tail ; Spermatozoa ; Tissue Donors

Objective To investigate the effects of case-based learning (CBL) applied in the clinical probation of anesthesiology.Methods Totally 313 undergraduates from the department of anesthesiology were randomly divided into 2 groups:CBL group (n =157) and LBL group (n =156).CBL methods were used to teach students in CBL group while traditional teaching methods were used to teach students in LBL group.After the causes being finished,a combination of theoretical examination and questionnaire were used to evaluate the teaching effectiveness between the two groups and a questionnaire was used to evaluate the recognition of teachers on CBL method.Data were managed by SPSS 17.0 software package.Quantitative data between groups were compared by t-test,enumeration data between groups were compared by chi-square test.Results Students in CBL group acquired higher score (86.7 ± 5.4) than those in LBL group (75.8 ± 4.5).82％ students in CBL group considered that their overall quality was improved while 42％ students in the LBL group thought so (P ＜ 0.05).75％ of faculties preferred the CBL methods.Conclusions Effect of CBL methods is better than traditional teaching methods and it's preferred by faculty and students.

Objective To explore the effect of biliary stenting combined with ademetionine on malignant obstructive jaundice.Methods According to the digital table,60 patients of malignant obstructive jaundice were randomly divided into the control group and the observation group.The patients in the control group were treated with biliary stenting individually,and the observation group received biliary stenting and combined treatment with ademeotionine.The variety of liver function and C-reactive protein were observed.Results The liver function and index of Creactive protein of patients in the observation group were significantly superior to those in the control group (all P ＜0.01).Conclusion The treatment of malignant obstructive jaundice by biliary stenting combined with ademetionine is effective.The mechanism may be related to the effect of ademetionine on promoting cytothesis,glutathione synthesis and eliminating free-radicals.

Objective:To confirm the correlations between the soma ofthe traditional Chinese Medicine and the objective index about Homeostasis model assessment-Insulin Resistance index(HOMA-IR)and the function about beta Cell ofislet(HOMA-?)with Impaired glucose regulation(IGR),to explore the basis for the syndrome ofthe traditional Chinese Medicine and insulin function.Methods:According from the epidemiological investigation,we had a Oral Glucose Tolerance Test and insulin releasing test to the 1 500 persons who came from downtown area、county、small towns、village,in accordance with the soma ofTCM,then investigate and analysis the correlations who meet the diagnosis ofIGR.Results:①In all 322 cases,each ratio ofthe group about signal soma、twice soma、three soma is 74.8%、19.5%、8.1%,Ahead somas are mild, deficiency ofQi, deficiency ofYang, deficiency ofQi and Yang,phlegmatic hygrosis.②The BMI ofmild group is higher than the deficiency ofQi,deficiency ofYang,deficiency ofQi and Yang group(P

Objective To investigate the success rate of fluoroscopy-guided subclavian vein catheter implantation (SVCI) in children with hematologic diseases,to improve the visualization of the position of the catheter head,and to reduce the incidence of procedure-related complications.Methods Fluoroscopyguided SVCI was performed in 183 sick children (aged 1-16 years) with confirmed hematologic disease.The success rate of the catheter implantation,the number of needle puncturing,the operation time,the fluoroscopy time and the occurrence of procedure-related complications were recorded.Results Successful fluoroscopy-guided SVCI was accomplished in all 183 sick children,with a success rate being 100％.Successful SVCI was obtained with ＜3 times of puncturing in 151 sick children (82.5％),with 4-6 times of puncturing in 25 sick children,and with 7-10 times of puncturing in 7 sick children.The catheter tip was successfully positioned at the junction of the superior vena cava with the right atrium in all sick children.The operation time ranged from 5 min to 25 min with a mean of (10.38±4.04) min.The fluoroscopy time varied from 16 seconds to 607 seconds with a mean of (65.46±55.86) seconds.During the procedure,artery was wrongly punctured two times in two sick children.The mean follow-up time was 35 days.Cather-related infection occurred in 2 sick children.No local hematoma at puncture point,nor hemopneumothorax or catheter-related thrombosis occurred.Conclusion Fluoroscopy-guided SVCI has high technical success rate in children with hematologic diseases.For a successful procedure of SVCI,less number of needle puncturing is needed by using this technique.The satisfaction rate for the placement of catheter tip is high and the incidence of complications is low.Therefore,fluoroscopy-guided SVCI is a safe and effective method.