Objective To explore and analyze the safety , feasibility and efficacy of CT-guided minimally invasive positioning hole drainage in the treatment of hypertensive intracerebral hemorrhage .Methods 100 cases with hypertensive intracerebral hemorrhage were selected as the research subjects , according to a random number table method,the patients were randomly divided into the control group and observation group ,50 cases in each group.Pa-tients in the observation group were given early CT-guided minimally invasive positioning drill drainage 6-12h after the onset,and patients in the control group received conservative treatment .Results After treatment,daily living activi-ties of patients graded as grade Ⅰ,Ⅱin the observation group were 17 cases,19 cases,which were significantly more than those in the control group (6 cases,9 cases),while the number of grade Ⅲ15 cases in the control group was sig-nificantly more than 7 cases in the observation group .The excellent rate of the observation group was 86%,which was significantly higher than 60%of the control group .The time of consciousness recovery ,average catheter time ,hospital stay in the observation group were (11.2 ±2.2)h,(4.1 ±1.5)d,(6.2 ±2.4)d,which were significantly shorter than those in the control group [(17.4 ±2.8)h,(6.2 ±2.1)d,(11.1 ±1.8)d].The total effective rate of the ob-servation group was 82%,which was significantly higher than 52% of the control group (χ2 =10.15,P<0.05). Conclusion Early minimally invasive drilling drainage under CT guidance positioning in the treatment of patients with hypertensive intracerebral hemorrhage has significant effect ,it is safe and can improve the survival and life quali-ty of patients after surgery ,which is worth promoting .

Objective:To establish the medical equipment archives management system to adapt to the Finance Ministry new hospital financial system. Methods:According to the new financial system requirements, implement the new file management strategy, as adjusting the original classification, management object and process. Results: After the implementation of the new management strategy, medical equipment archives management and new financial system in our hospital realize synchronous in January 1, 2012, thethree Zhang cardsystem optimizing, and the results have been applied to the existing hospital medical equipment management software, greatly improving the efficiency of management, provides a strong basis for medical equipment economic benefit and social benefit evaluation. Conclusion:The medical equipment archives were giving full play to improve the quality of medical care.

Objective To analyze the differences of clinical results between CAS and routine NCAS localization in TKA and to evaluate the safety and reliability of CAS in TKA in order to take advantages and avoid disadvantages of this new technology.Methods From October of 2004 to October of 2005,18 cases(20 joints)of TKA in Group Ⅰ which were perform utilizing computer assisted imaging guidance system(CAS)and there were 7 males and 11 females with an average age of 67 years.From October of 2003 to October of 2004,17 cases(22 joints)of TKA in Group Ⅱ which were performed with conventional method previously(NCAS)and there were 5 males and 12 females with an average age of 65 years(56-78).The differences between two groups in clinical results,mechanical axes,soft-tissues balance,coincidence,blood loss,and operating time were statistically analyzed.Results All cases were followed for an average of 10 months(3-12).The mechanical axes error was 2-3 degrees in CAS group and 3-6 degrees in NCAS group.Soft-tissues balance angle was within 2 degree in CAS group and 2-4 degrees in NCAS group.The distance variable was 2-4 mm in CAS group and 5-7 mm in NCAS group.The blood loss was 550-700 ml in CAS group and 700-900 ml in NCAS group.The surgery time was 75-100 min in CAS group and 45-60 min in NCAS group.There were statistically significant differences between two groups.There were no major complications such as fat embolism occurred in both groups.Conclusion Utilizing computer assisted imaging guidance in TKA can obtain reliable and sound clinical results with better mechanical axes and soft-tissues balance.It is a safe and reliable procedure in TKA.

Type 1 diabetes mellitus(T1DM), which is an autoimmune disease, mostly affect people with hereditary susceptibility under the joint participation of environmental factors.It is known to coexist with other autoimmune disorders such as celiac disease(CD). The prevalence of CD is higher in patients with type 1 diabetes compared with the general population.Most patients affected with both T1DM and CD are atypical for CD at diagnosis, and may be misdiagnosed and subsequently suffered from the delayed treatment.These patients are more likely to develop symptomatic hypoglycemia, or poor blood glucose control, leading to an increased risk of chronic complications and seriously affecting the quality of their life.Thus, screening for CD is recommended in patients with T1DM.Anti-tissue transglutaminase antibody is the preferred biomarker for CD screening in children and adolescents over 2 years of age, with a sensitivity of 95% to 100% and a specificity of 94% to 100%.And a low-carbohydrate diet is often combined with a gluten-free diet.

Objective To investigate the application value of Atlas titanium cable in the treatment of comminuted patellar fractures (CPF).Methods 80 patients with CPF in our hospital from January, 2010 to January, 2013 were randomly selected and divided into observation group (n=40) and control group (n=40) by digital random method.Observation group adopted Atlas tita-nium cable internal fixation treatment while control group adopted the improved tension band steel wire in the hollow compression screws fixation treatment.Preoperative (t0), postoperative 1 month (t1), 6 months (t2) and 1 year (t3) Bostman patellar injury curative effect score (BPICES), operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay, treatment costs and complications of two groups were compared.Results Preoperative BPICES of two groups had no statistical significant difference (p>0.05).Compared with t0, t2 and t3 BPICES and the rate of optimal curative effects, two groups increased; Compared with the control group, t2 and t3 BPICES and the rate of optimal curative effects of observation group also increased, and the difference was statistically significant (p<0.05).Operation time, intraoperative blood loss, postoperative knee joint exercise time for the first time, length of hospital stay of observation group were (52.26 ±10.29) min, (70.48 ±10.49) ml, (4.78 ±1.48) d and (5.98 ±1.06) d respectively, which were lower than the (79.95 ±8.42) min, (123.36 ±21.18) ml, (9.14 ±4.48) d and (11.18 ±2.68) d of the control group;Therapy cost of observation group was (16 284.47 ±2 145.78) Yuan, which was higher than the (9 892.48 ±1 456.42) Yuan of the control group (p <0.05).Compared with control group, peptide wire/wire Piercing the skin, pain, infection, skin irritation, slippery bursa phlogistic, internal fixation of fracture parted, fracture end separation and other complications total incidence of observation group were lower (p<0.05).Conclusion Atlas titanium wire trea-ting of patients with CPF had shorter operation time and hospitalization time , less postoperative complications.It can promote the rapid recovery of knee joint function, but its cost is higher.Thus it is suitable for CPF patients with better economic conditions .

Objective To explore and analyze the effect of standard large trauma improved operation ( slow decompression ) and standard large trauma conventional surgical procedures ( sudden decompression ) in the treatment of elderly patients with severe craniocerebral injury ( SCCI) .Methods 100 elderly patients with SCCI were randomly divided into the control group and the observation group ,50 cases in each group .The control group was treated with conventional methods ( standard large trauma traditional surgical treatment ) , the observation group was treated with standard large trauma surgery improved operation .The effects and postoperative complications were observed and recorded.Results 1d,3d,5d,15d after operation,the intracranial pressure of the two groups were (272.3 ±19.1)mmHg, (285.4 ±18.2) mmHg,(218.2 ±18.3) mmHg,(168.4 ±17.3) mmHg;(302.1 ±23.1) mmHg,(310.3 ± 19.2)mmHg,(221.1 ±19.2)mmHg,(148.2 ±16.4)mmHg,which were changed significantly compared with preop-eration,the intracranial pressure gradually decreased as time passed ,the decrease of intracranial pressure in the con-trol group was more obvious than the observation group .The incidence rates of epilepsy ,cerebral infarction ,hydroceph-alus in the observation group were 2.0%,6.0%,0.0%,which were significantly lower than those in the control group (30.0%,36.0 %,26.0%),the differences between the two groups were significant (χ2 =14.85,13.56,14.96,all P<0.05).The number of patients with good prognosis ,the residual in the observation group were significantly more than the control group , while the number of severely disabled and vegetative state patients in the observation group were significantly less than the control group ,(χ2 =4.88,3.93,4.33,7.44,all P<0.05).Conclusion Standard large trauma improved operation ( slow decompression ) can effectively reduce intracranial pressure in elderly patients with severe fluctuations ,reduce the incidence of complications ,improve treatment prognosis ,it should be popularized in clinical practice .

Objective To explore the role of TRAIL receptors expression on peripheral blood mononuclear cell (PBMC) in the apoptosis of PBMC,and the relation of the expression of TRAIL receptors with the severity of liver damage in chronic hepatitis B patients.Methods The expressions of DR4,DRS,DcR1 and DcR2 in 55 patients and 30 cases of control were assayed by RT-RCR and floweytometery.The relationship of the expression of TRAIL receptors with the severity of liver damage were analized.Results The level of DcR1 in the PBMC of chronic hepatitis B patients was much lower than that of control group (P＜0.05).There was close relation between the expression of DcR1 and liver damage (P＜0.05).The level of DcR1 was negatively correlated with ALT but positively correlated with serum albumin.Conclusion The expression level of DcR1 on PBMC in chronic hepatitis B patients was down-regulated,which may contribute to the increased apoptosis of PBMC in chronic B hepatitis patients.The expression of DcR1 can reflect the degree of liver injury in chronic hepatitis B patients to some degree.

Objective To evaluate the preoperative diagnosis and treatment of primary duodenal adenocarcinoma ( PDA). Methods Clinical data of 89 PDA cases undergoing laparotomy from 1985 to 2009 in three hospital in Beijing and Zhengzhou were analyzed retrospectively. Results The prevalence rate of PDA is comparatively low and its clinical manifestations are not specific. The correct diagnostic rate of auxiliary examination were 93% by endoscopy,90% by gastrointestinal X-ray air barium double radiography,82% by MRCP,42% by BUS,70% by CT/MRI. The most common location of the adenocarcinoma(65% ) was at the second portion of the duodenum. Among 67 PDA cases 48 cases underwent pancreatoduodenectomy, 19 cases received segmental deodenectomy. The 5 year's survival rate was 47% and 50% respectively. Conclusions Endoscope and X-ray radiography are mainstays for the diagnosis of PDA. Early diagnosis and radical operation are the key to improve the resection rate and the long term survival.

Objective To evaluate the treatment experience on primary retroperitoneal neoplasms involving large blood vessels.Methods In this study 82 patients with primary retropetropeal neoplasms were treated surgically from 1990 to 2010 and the clinical data of these patients including preoperative radiological examinations and surgery were retrospectively analyzed.Result The sensitivity and specificity of preoperative imaging examination for identifing large blood vessel involvement was 70％ and 73％respectively.Compared with those of no large blood vessel involvement,patients with large blood vessels involvement had a lower rate of tumor complete removal,more intraoperative blood loss and longer operation time( P ＜ 0.05).In group of large vascular involvement,patients undergoing complete tumor resection were all alive after 12 months,and none of those undergoing palliative resection survived more than 9 months.Conclusions Preoperative imaging allows precise evaluation on the status of large blood vessel involvement in patients of retroperitoneal tumors.Involving large vessels often predicts inability in total resection of retroperitoneal tumors.

ObjectiveTo determine the protein and mRNA expression levels of interleukin-17 (IL-17) and proportions of Th17 cells in peripheral blood of patients with atopic dermatitis (AD),and to analyze their clinical significance.MethodsVenous blood samples were obtained from 63 patients with AD and 30 normal human controls.Enzyme linked immunosorbent assay was performed to measure the plasma level of IL-17 protein,real time fluorescence reverse transcription (RT)-PCR to detect the mRNA expression level of IL-17 in peripheral blood,flow cytometry to determine the percentage of Th17 cells in peripheral blood mononuclear cells(PBMCs).Spearman's rank correlation analysis was performed to assess the relationship of peripheral blood Th17 cell percentage and IL-17 levels with disease severity in patients with AD.Results The percentage of Th17 cells in PBMCs was 1.83％ ± 0.47％ in patients with acute AD,significantly higher than that in normal human controls (0.85％ ± 0.45％,t =4.128,P ＜ 0.01 ) and in patients with chronic AD ( 1.12％ ± 0.69％,t =2.439,P ＜ 0.05).There was a significant increase in the plasma level (98.37 vs.63.75 ng/L,U =168,P ＜ 0.05) and mRNA expression level of IL-17 in peripheral blood in patients with AD compared with normal controls.Both the Th17 cell percentage and plasma IL-17 level were positively correlated with eczema area and severity index(EASI) score in patients with AD (r =0.681,P ＜ 0.01;r =0.427,P ＜ 0.05).ConclusionsThere is an elevated proportion of Th17 cells and an abnormal expression of IL-17 protein and mRNA in peripheral blood from patients with acute AD,which are positively correlated with disease severity,implicating the possible roles of IL-17 and Th17 cells in the pathogenesis of AD.