0.05). The positivity rate of anti-HCV in patients with liver cirrhosis was 7.1%.

Objective To study the effect of hydrogen sulfide (H2S) on acute cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) and explore its mechanism.Methods (1) A total of 48 adult male SD rats were randomly allocated into a normal group,a SAH group,a low dose NaHS group and a high dose NaHS group (n=12).Rat models of SAH were induced by injecting autologous blood into the prechiasmatic cistern.Rats in the later two groups were given 0.7 mg/kg and 2.8 mg/kg NaHS,respectively,0.5 h after modeling.Neurological scale scores were assessed 24 h after modeling;HE staining,TUNEL and immunohistochemical double-staining were employed to detect the morphology of approximated A2 blood vessel of anterior cerebral artery (ACA),tube wall thickness and endothelial cell apoptosis,respectively.(2) Brain microvascular endothelial cells (BMECs) were chosen and divided into blank control group,100 μmol/L OxyHb prevention group,25 μmol/L NaHS pretreatment group and 100 μmol/L NaHS pretreatment group.The cells were collected and observed 24 h after treatment,and then,the number of endotheliocytes was counted,and the Caspase-3 protein expression was detected by Western blotting.Results (1) The neurological scale scores (8.5±2.4) were significantly lower,the vessel wall ([43.5±6.2] μm) was significantly thickened,the lumen area ([30 488±938) μm2) was obviously reduced,and the number of TUNEL positive cells ([36.51±11.45]％) was remarkably increased in the SAH group as compared with those in the normal group (16.1 ±1.7,[25.8±3.5] μm,[51707± 1422] μm2 and [2.86±0.75]％ in turn,P＜0.05).The neurological scale scores (11.6±1.9 and 15.4±2.3) were significantly higher,the vessel wall ([34.7±3.7] and [31.7±4.6] μm) was significantly thinned,the lumen area ([41 463±1104] and [45 244±1217] μm2) was obviously increased,and the number of TUNEL positive cells ([17.14±5.36] and [8.10±4.62] ％) was remarkably reduced in the low dose NaHS group and high dose NaHS group as compared with those in the SAH group (P＜0.05).The neurological scale scores in high dose NaHS group were significantly higher than those in the low dose group and the number of TUNEL positive cells was signficantly smaller than that in the low dose group (P＜0.05).(2) The number of apoptotic endothelial cells ([40.56±9.85] ％) and the expression of Caspase-3 (0.395±0.122) in OxyHb prevention group were significantly larger/higher than those in the blank control group (P＜0.05).The number of apoptotic endothelial cells and the expression of Caspase-3 in the low dose group ([16.65± 6.35]％ and [0.223±0.083]) and high dose group([14.12±6.65] ％ and [0.208±0.104]) were obviously reduced as compared with those in the OxyHb prevention group,with significant differences (P＜0.05).Conclusion H2S can effectively expand cerebral vasospasm,and its vasoprotective mechanism may be through inhibiting vascular endothelial cell apoptosis.

Objective To compare the clinical effect of the small bone flap craniotomy and traditional craniotomy in the treatment of elderly patients with hypertensive striatocapsular hemorrhage .Methods According to the digital table ,80 patients with hypertensive striatocapsular hemorrhage were randomly divided into control group and treatment group ,40 cases in each group .The treatment group was treated with small bone flap craniotomy ,and the control group was treated with traditional craniotomy .The operative incision length ,intraoperative blood loss ,operation time,hematoma clearance rate,rebleeding rate,GCS score,postoperative pulmonary infection rate and GOS score in the 1 month after treatment were compared between the two groups .Results The operative incision length , intraoperative blood loss, operative time, GCS score after 1 week, pulmonary infection of the treatment group were (7.0 ±1.5)cm,(100 ±35)mL,(1.5 ±0.6)h,(12.5 ±1.4),25.0％,respectively,which of the control group were (18.0 ±4.5)cm,(500 ±85) mL,(2.2 ±0.8) h,(10.5 ±1.1),47.5％,respectively,the differences between the two groups were statistically significant (t=303.791,P=0.000;t=244.467,P=0.000;t=24.366,P=0.003;t=3.294,P=0.031;χ2 =4.381,P=0.036).The hematoma clearance rate,rebleeding rate of the treatment group were 90.0％,7.5％,respectively,which of the control group were 85.0％,10.0％,respectively,there were no statistically significant differences between the two groups (χ2 =0.457,P=0.499;χ2 =0.157,P=1.692).The prognosis of the patients in the treatment group was significantly better than those in the control group (Z=-2.022,P=0.043). Conclusion The small bone flap craniotomy in the treatment of hypertensive striatocapsular hemorrhage has the advantages of less trauma , shorter operative time , less intraoperative bleeding , high hematoma clearance rate , low rebleeding rate,low complication rate and good prognosis .

According to the locations of main hematomas,60 patients with hypertensive basal ganglia hemorrhage were surgically treated through different approaches from June 2014 to September 2017.Thirty six cases with anterior hematoma near the Sylvian point were treated through transsylvian-transinsular approach,24 cases with the posterior hematoma far from the Sylvian point were treated through translower-rolandic-point (transLRP) transinsular approach (n =11) or transsuperior-temporal-sulcus (transSTS) transinsular approach (n =13),respectively.All patients were followed up for at least 6 months and evaluated by Glasgow Outcome Scale.Fourteen patients showed good recovery,25 patients showed moderate disability,18 patients showed severe disability,one patients showed vegetative survival and two patients died.