Objective After acute craniocerebral trauma , to a certain extent , arterial blood lactate and lactate clearance rate reflect the illness severity .We aimed to investigate the prognosis value of arterial blood lactate and lactate clearance rate in patients with craniocerebral trauma . Methods 94 cases with craniocerebral trauma treated in the Department of Emergency of Nanjing General Hospital of Nanjing Military Regionfrom February 2015 to November 2015 were retrospecively analysed .GCS ( Glasgow Coma Scale ) score, arterial blood lactate , blood pressureand heart rate were measured once patients admitted to hospital and 6 hours later ,arterial blood lactate was measured again to calculated the arterial blood lac-tate clearance rate .Based on the GCS score , we divided the patients into mild group (13-15), medium group (9-12) and severe group (3-8).We also divided the patients into death group and survival group according toprognosis .We compared arterial blood lactate and lactate clearance rate betweeeneach group respectively . Results There were significant differences in arterial blood lactate (F=19.99,P<0.01) and 6h lactate clearance rate(F=6.21,P<0.01)be-tween lighter group , medium group and severe group .The initial arterial blood lactate of death group was significantly higher than sur-vival group[(4.20 ±1.36)mmol/L vs (1.58 ±0.93)mmol/L], the difference was statistically significant (t=-9.78,P<0.01). The 6 h lactate clearance rate of death group was significantly lower than survival group [(31.73 ±12.84)%vs (46.25 ±12.01)%], the difference was statistically significant (t=4.55,P<0.01). Conclusion Arterial blood lactate and 6 h lactate clearance rate can evaluate the severity and prognosisof illnessin patients with craniocerebral traumaand have important application value in clinical work .

Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.

Objective To explore the incidence of early complications within 72 hours among patients with six kinds of acute organophosphorus pesticide poisoning,thus to provide reference for the clinical treatment.Methods The retrospective study analyzed the clinical data of 335 cases with acute oral organophosphorus pesticide poisoning treated in Emergency Department of 307 Hospital of PLA from July 2008 to December 2015.Patients were divided into six groups according to the results of serum toxicology tests:acute phorate group (group A),acute dichlorvos group (group B),acute omethoate group (group C),acute dimethoate group (group D),acute phoxim group (group E) and acute parathion group (group F).The incidence of complications among the six groups were compared.The main analysis method was ranks test.Results There were no significant differences among the six groups in the incidence of cerebral edema,liver injury,kidney injury,myocardial injury,gastrointestinal hemorrhage and acute pancreatitis (P ＞ 0.05),while the mortality and the incidence of sudden cardiac arrest (SCA),respiratory failure,circulatory failure,multiple organ dysfunction syndrome (MODS),coagulation disorders and capillary leak syndrome (CLS) were significantly different among the six groups (P ＜ 0.05).The incidence of SCA wihin 24 hours in acutedichlorvos group reached up to 17.8％,and in other groups was as follows:acute parathion group (11.1％),acute dimethoate group (8.9％),acute phorate group (7.8％) and acute omethoategroup (1.5％).However,no one developed SCA in acute phoxim group.The total incidence of circulatory failure in all patients was 10.1％;dichlorvos group 31.1％ and dimethoate group (22.2％) had higher rates than other groups.The incidence of respiratory failure in all groups reached over 20％,while the total incidence was 36.7％,whereby,acute phorate group with a high of 46.7％,acute dichlorvos group with 44.4％,acute parathion group with 44.4％ and acute dimethoate group with 42.2％,respectively.The total incidence of coagulation disorders was 9.6％,while the incidences of the acute dichlorvos group (24.4％),acute phorate group (11.6％) and acute parathion group (11.1％) were higher than 10％.CLS confined to occur in acute dichlorvos group (11.1％) and acute phorate group (2.5％).However,MODS occurred mainly in acute dichlorvos group (28.9％) and acute parathion group (22.2％).Conclusions The incidences of early complications among the six groups are different,while acute oral dichlorvos poisoning patients tend to occur SCA.Within 72 h of poisoning,acute phorate poisoning group is more prone to respiratory failure,and acute dichlorvos poisoning group is more likely to develop coagulopathy disorders,circulation failure,CLS and MODS.Those patients in acute omethoate and acute phoxim poisoning groups have less risk to develop life-threatening complications except respiratory failure.