Objective To analyse the efficacy of microvascular decompression for hemifacial spasm (HFS) caused by vertebral basilar artery compression. Methods A total of 141 patients with HFS treated by microvascular decompression in our hospital were collected in this study. The improvement of the symptoms after operation was compared between patients with HFS caused by vertebral basilar artery compression (28 cases) and patients with HFS caused by non-vertebral basilar artery compression (113 cases). Results There was no significant difference in the effective rate between the two groups of HFS (96.43%vs. 98.23%,P=0.49) with mean following-up 13.81 ± 1.57 months. And there was no significant difference in the delayed cure rate after surgery between two groups (37.04%vs. 20.72%,χ2=1.38, P>0.05). Conclusion Microvascular decompression is a safe and effective method for the treatment of HFS caused by compressed vertebral basilar artery.

Objective To study the effect of limited fluid resuscitation (LFR) on coagulation in patients with severe traumatic brain injury (sTBI) and investigate its clinical significance.Methods Seventy-nine patients were assigned to low volume group (≤ 2 000 ml,40 cases) and high volume group (＞ 2 000 ml,39 cases) according to the random number table.LFR was performed for all patients.Prothrombin time (PT),partial thromboplastin time (APTT),thrombin time (TT) and fibrinogen (FIB) level were measured in both groups at different time points.Mean heart rate,blood pressure,blood gas values and blood electrolytes were monitored.Meantime,NICU days,hospital length of stay and incidence of multiple organ dysfunction syndrome (MODS) were recorded.Glasgow Outcome Scale (GOS) was evaluated.Results In constrast to high volume group,PT,APTT and TI were shortened and FIB was elevated in low volume group (P ＜ 0.05).But there were no significant differences between the two groups in NICU days [(13.84 ±3.02)d vs (15.28 ±3.79)d],hospital length of stay [(36.85 ±6.73)d vs (40.01 ± 7.21) d],MODS incidence (15.0％ vs 17.9％) and mortality (27.5％ vs 38.5％) (P ＞ 0.05).The chances of good recovery in low volume group was higher than that in high volume group (22.5％ vs 7.3％) (P＜0.05).Mean heart rate,blood pressure,blood electrolytes,and blood gas values did not differ significantly between the two groups (P ＞ 0.05).Conclusion For patients with sTBI,low volume LFR can ameliorate coagulation disorders and improve prognosis,indicating a safe and effective therapy.

OBJECTIVE： To systematically evaluate the efficacy and safety of duloxetine in the treatment of major depressive disorder （MDD）， and to provide evidence-based reference for clinical drug use. METHODS： Retrieved from the Cochrane Library， PubMed， Embase， CNKI databases， CBM and VIP databases， randomized controlled trials（RCTs） about duloxetine （trial group） versus placebo （control group）in the treatment of MDD were collected. After literature screening and data extraction， the quality of included studies was evaluated by using Cochrane systematic evaluator manual 5.1.0. Rev Man 5.3 software was used for Meta-analysis. RESULTS： A total of 8 RCTs were included， involving a total of 2 772 cases. Meta-analysis showed that the decrease of Montgomery-Asberg Depression Rating Scale [MD＝－3.97，95％CI（－4.71，－3.24），P＜0.000 01]， the decrease of Hamilton Anxiety Rating Scale[MD＝－2.12，95％CI（－3.66，－0.57），P＝0.007]， the decrease of Clinical Global Impression-Severity [MD＝－0.47，95％CI（－0.73，－0.21），P＝0.000 4]， the decrease of Clinical Global Impression-Improvement Scale [MD＝－0.58，95％CI（－0.92，－0.25），P＝0.000 6] and the decrease of Sheehan Disability Scale [MD＝－2.82，95％CI（－4.55，－1.09），P＝0.001] in trial group were significantly more than control group. The incidence of nausea， dry mouth， constipation， vomiting， dizziness， drowsiness， insomnia， hyperhidrosis and anorexia in the trial group was significantly higher than control group （P＜0.05）. There was no statistical significance in the incidence of serious ADR， diarrhea， headache and dyspepsia between 2 groups （P＞0.05）. CONCLUSIONS： Duloxetine shows significant therapeutic efficacy for the treatment of MDD， but it will increase the occurrence of common mild ADR.