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

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.

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.

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 investigate the effects of different fine particulate matter (PM2.5) components (water-soluble, organic, water-soluble+organic) in vivo on the NOS/NO system in the endothelial cells from rat thoracic aortas. Methods Three PM2.5 components were used to inject by vein in rat tail. ELISA and immunohistochemical technique were used to examine the change of NOS/NO system in the blood-serum and the endothelial cells from rat thoracic aorta. Results Compared with control group, three PM2.5 components increased NO level of rat blood-serum [control, (38.00±5.40) μmol/L; water-soluble group, (44.66±16.59) μmol/L, t =3.58, P< 0.05; organic groups, (58.28±12.30) μmol/L, t =12.85, P <0.01; mixtural component group, (84.02+19.24) μmol/L, t =31.39, P<0.01]; increased iNOS level of rat blood-serum [control, (17.47±5.33) U/ml; water-soluble group, (21.87±4.63) U/ml, t =4.92, P <0.05; organic groups, (25.27±6.58) U/ml, t = 6.22, P<0.05; Mixtural component group, (32.79±5.86) U/ml, t =32.84, P <0.01]. Mixtural component decreased eNOS level of rat blood-serum [(12.58±4.59) pg/ml vs (17.47±2.97) pg/ml, t =5.91, P <0.05], no significant difference on eNOS level of blood-serum among other component groups (P >0.05). Three components decreased the expression of eNOS protein in the endothelial cells from rat thoracic aorta(control, 164.68±4.80; water-soluble group, 185.43±5.63, t =4.26, P <0.05; organic groups, 194.07±9.77, t =5.26, P <0.05; Mixtural component group, 209.24±15.43, t =43.19, P <0.01), increased the expression of iNOS protein (control, 160.17±5.79; water-soluble group, 134.78±8.22, t =5.21, P <0.05; organic groups, 134.78±8.22, t =5.98, P <0.05; Mixtural component group, 81.62 ±10.59, t =34.98, P <0.01) in the endothelial cells from rat thoracic aortas.Conclusion Three components of PM2.5 induced the dysfunction of endothelial cells and disorder of NOS/NO system in the endothelial cells.

Objective The aim of this study was to observe the outcome and evaluate the clinical efficacy of pulsed electromagnetic fields (PEMF) on pain management in patients with osteoporosis.MethodsA total of 58 patients with osteoporosis were treated with PEMF stimulation.Pains as main indicators of their symptom were evaluated before and after treatments.The clinical outcomes were assessed by observing the visual analogue scale (VAS).Statistical analysis was carried out to support the data.Results After PEMF treatment,the patients exhibited significant pain relief from mean VAS of 6.97±1.83 to 3.36±1.69(t-test,P＜0.05 ).Of the 58 patients,28 obtained significant symptom alleviation and 18 obtained moderate symptom alleviation,while 8 obtained slight alleviation,indicating the total clinical efficacy of 93%(54/58).Conclusion The current study provides the clinical outcomes indicating that PEMF may help to release the pain from primary osteoporosis and it might be an applicable supplementary treatment method for the osteoporosis related pain.