OBJECTIVE:To explore the effects of omeprazole combined with Huxue huayu tongluo formula on the efficacy and relevant indexes of diabetic gastroparesis gastric motility disorder. METHODS:92 patients with diabetic gastroparesis gastric motili-ty disorder were randomly divided into observation group and control group. All patients were given diabetes dietary guidance and exercise guidance,and patients with combined metabolic disorders and hypertension were given lipid lowering,antihypertensive and other conventional treatment;based on it,control group was orally given 20 mg Omeprazole enteric-coated capsule,once a day;observation group was additionally given 300 ml Huxue huayu tongluo formula,150 ml once,twice a day. The treatment course for both groups was 14 d. Clinical efficacy,fasting blood glucose,glycated hemoglobin,whole blood viscosity level,moti-lin,gastrin,half gastric emptying time (GET1/2) before and after treatment,and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05);before treatment,there were no significant differences in the fasting blood glucose,glycated hemoglobin,whole blood viscosity level,motilin,gastrin and GET1/2(P>0.05);after treatment,fasting blood glucose,glycated hemoglobin,whole blood viscosity level,motilin,gastrin and GET1/2 in 2 groups were significantly lower than before,and observa-tion group was lower than control group,the differences were statistically significant(P<0.05);and there were no adverse reac-tions during treatment. CONCLUSIONS:Based on the conventional treatment,the efficacy of omeprazole combined with Huxue huayu tongluo formula is superior to omeprazole alone for diabetic gastroparesis gastric motility disorder,it can significantly reduce blood glucose and improve hemodynamics,with similar safety.

Objective To analyze the complications ofventriculoperitoneal shunt in the treatment of pediatric hydrocephalus,and improve operative method,in order to reduce postoperative complications and improve the clinical curative effect.Methods A total of 39 infants with hydrocephalus who underwent adjustable shunt were retrospectively analyzed,including surgical methods,results,and complications,and put forward counter measures.Results Thirty cases of postoperative clinical symptoms obviously improved compared with preoperative,head CT review were clearly seen with ventricle retraction.Nine cases suffered with complications after operation.Obstruction of shunt tube was found in 4 cases,shunt exposed in 3 cases,and postoperative infection in 2 cases.Conclusions Ventriculoperitoneal shunt complications related to surgery itself.Improved surgical techniques,and taking appropriate treatment measures can effectively reduce the incidence of complications.

Objective To investigate the value of serum D-dimer in evaluating the severity and the prognosis of patients with acute spontaneous subrachnoid hemorrhage.Methods The clinical data of 157 patients with acute spontaneous subrachnoid hemorrhage were collected,and the level of D-dimer in elbow vein serum were measured.The severity of the disease was judged by Hunt-Hess classification,and the patients,brain CT scans were scored according to the modified Fisher scale.The patients were followed up for 3 months.Based on the modified RANKIN scale (mRS scale),patients were divided into unfavorable prognosis group (3≤ mRS ≤5) and good prognosis control group (1 ≤ mRS ≤2).Results In the 157 cases of spontaneous subrachnoid hemorrhage patients,there were 45 cases in the unfavorable prognosis group and 112 cases in the good prognosis control group.The level of D-dimer in the unfavorable prognosis group was significantly higher than the level of control group and there were significant differences between them (P ＜ 0.01).By the Spearman correlation analysis,the level of D-dimer was positively correlated with Hunt-Hess score (r =0.831,P ＜0.01),and it was also positively correlated with unfavourable prognosis mRS scale (r =0.834,P ＜0.01).Furthermore,regression analysis showed that high level of D-dimer was an independent risk factor for the poor prognosis of patients (OR =1.011,95％ CI:1.007-1.016,P ＜ 0.01).Through the receiver operating characteristic curve (ROC) analysis of the D-dimer in patients with poor prognosis,the area under ROC curve was 0.964 (95％ CI:0.93-0.98,P ＜ 0.01),sensitivity and specificity were 88.9％ and 99.1％,respectively.The cut-off point of D-dimer content was 739 μg/L.Conclusions The level of D-dimer in patients with acute spontaneous subrachnoid hemorrhage was closely related to the severity of the diseases,and high level of D-dimer was an independent risk factor for the prognosis of patients.

Objective To retrospectively analyze and compare the intraoperative and postoperative clinical efficacies between the interhemispheric approach and pterional approach in craniotomy anterior communicating aneurysm clipping surgery.Methods A total of 21 cases of anterior communicating artery aneurysms with subarachnoid hemorrhage undergoing surgery of craniotomy clipping from January 2012 to December 2016 in the Department of Neurosurgery of Shengjing Hospital of China Medical University,in which 13 cases were treated by pterional approach and 8 cases were treated by interhemispheric approach.Two kinds of operation approaches were compared in operation time,intraoperative aneurysm rupture rate,intraoperative bleeding volume,average length of stay,incidence rate of postoperative fection,and Glasgow Outcome Scale (GOS).Results There were no significant difference in intraoperative aneurysm rupture rate,intraoperative bleeding volume,inicidence rate of postoperative infection rate,and GOS scores (P ＞ 0.05).But the opreration time and average length of stay in interhemispheric approach group were significantly shorter than the pterional approach group (P ＜ 0.05).Conclusions Approach of interhemispheric was a safe,effective,and convenient approach for the craniotomy of clipping in anterior communicating artery aneurysm.