Two hundred and twenty patients with hypertensive basal ganglia hemorrhage (HBGH)undergoing cranial drilling operation and placement of soft catheter for drainage were enrolled.Among all patiems,the operation was performed at ≤6 h of disease onset in 92 cases (ultra-early group),6-24 h in 74 cases (early group) and ＞ 24 h in 54 cases (selective group).The surgery-related complications,nearterm outcome and long-term outcome were compared among three groups.In ultra-early group,recurrent hemorrhage was observed in 26 cases (28％),which was higher than that in other two groups.In selective group,there were 11 cases (20 ％) of well recovered,19 cases (35％) of moderate deformity,16 cases (30％) of severe deformity,5 cases(9％) of vegetative state and 3 fatal cases(6％) indicating that the nearterm outcome was worse than those other two groups.However there was no significant difference in longterm outcome among three groups.The rapid minimal invasive cranial drilling and soft catheter drainage is a safe and effective operation for HBGH patients and the optimal time for operation is 6-24 hours.

Aim To investage the regulatory effect of alizarin on renal interlobar arterial smooth muscle cells. Method The effect of alizarin on BKCa channels was observed by whole-cell patch clamp recording tech-nique. Results Selective BKCa channel blocker ibTX inhibited alizarin-induced outward current(P<0. 05);single smooth muscle cells were incubated in extracel-lular fluid with no Ca2+ 30 minutes, selective L-Ca2+channel blocker nimodipine, selective calcium ion che-lating agent BAPTA-AM and ryanodine inhibited the a-lizarin-induced BKCa channels current, too ( P <0. 05 ) . Conclusion Alizarin relaxes renales interlobar arterial smooth muscle via activation of L-Ca2+ channel firstly, which lead to Ca2+ flowed into cytoplam, and rising of Ca2+ in cytoplam ryanodine receptor indirect-ly, and BKCa is activated at last.

Objective To explore the correlation between epicardial adipose tissue(EAT) thickness and cardiovascular risk factors in patients with coronary artery disease.Methods According to the results of coronary angiography,84 cases of patients undergone coronary angiography were divided into the normal control group(28 patients),coronary artery disease group with single-vessel lesion (28 patients),coronary artery disease group with multi-vessels lesion(28 patients),respectively,then measured the EAT thickness and carotid intima-media thickness(IMT) by high-frequency ultrasound.A correlation analysis was carried out between the EAT and IMT and cardiovascular risk factors.Results In either coronary artery disease group with single-vessel lesion or multi-vessels lesion,the thicknesses of EAT and IMT were significantly higher than those in the normal control group(P ＜0.01),and the difference between group of single-vessel lesion and multi-vessels lesion was also statistically significant (P ＜0.01).A correlation analysis between the EAT and IMT and cardiovascular risk factors showed that there were significantly positive correlations between EAT and the IMT,age,weight,waist circumference,body mass index,low-density lipoprotein,Creactive protein (r = 0.124～0.790,P ＜0.05 or P ＜0.01),and the significantly negative correlation between EAT and high-density lipoprotein (r = - 0.203,P ＜ 0.05).Correlation between EAT and the IMT was 0.678,0.713,0.737 in the normal control group,group with single-vessel lesion,group with multivessels lesion,respectively.Conclusions There were favorable correlation between EAT and carotid IMT in cardiovascular risk factors.The more severity of coronary heart disease,the more high correlations of EAT and IMT.EAT can be a valuable index in evaluating coronary artery disease.

Objective To review the diagnosis and treatment of epithelioid angiomyolipoma of the kidney. Methods Five cases of epithelioid angiomyolipoma of the kidney were retrospectively analyzed in the aspects of imaging and pathologic characteristics. There were 3 males and 2 females with average age of 46 years (ranging from 26-64 years). There were 3 patients complained of pains of lumber. Two cases were found renal masses in routine physical examination. The mass diameter was 2.9-10. 1 cm. Two cases were diagnosed as angiomyolipoma and three as malignant tumors as kidney cancer, tumor of the adrenal gland or tumor of the liver with ultrasound and CT scan. Four of the 5cases accepted partial nephrectomy and 1 with radical nephrectomy. Results Epithelioid angiomyolipoma of the kidney was composed of abnormal thick parietal vessel, smooth muscle and adipose tissue in different proportional. The cytoplasm of epithelioid cells was acidophilia or lucency, which had acidophilia particles and abundant blood vessels. Epithelioid cells were round or polygon, surrounded to blood vessels, distributed in lipoid. The SMA, Vimentin and HMB45 were positive by immunohistochemisty. The post-operative histological diagnosis showed that all cases were epithelioid angiomyolipoma of the kidney. All patients were followed up for 2 to 12 months. No patients had locally recurrence or distant metastasis. Conclusions The diagnosis of epithelioid angiomyolipoma of the kidney relies on histopathology results. The immunohistochemical staining could be helpful for diagnosis and differential diagnosis.

Objective To investigate the value of electromagnetic navigation in microsurgical resection of intracranial cavernous hemangioma of different locations.Methods The microsurgical resection of intracranial cavernous hemangioma of different locations with the guide of electromagnetic navigation of COMPASS Cygnus system,There were 47 cavernous hemangioma of 43 patients,including of multiple cavernous hemangioma of 3 cases,one case had 3,the other 2 cases had 2 ; Including 25 deep in the cerebral cortex(including of 4 deep in the cerebellar cortex),twenty shallow in the cerebral cortex,two were in the orbital apex,including of 4 deep in the sensorimotor cortex,four deep in the language center,and 2 deep in the visual center.Results All 47 cavernous hemangioma of 43 patients,the accuracy was 100％.The resection rate was 100％,including of 16 patients were removed with a straight incision.There was no one with the neurological dysfunction worse postoperative,with no deaths,with 1 case of normal perfusion pressure breakthrough and was cured by conservative treatment.Thirty cases were discharged within 1 week.The blood loss of 30 cases was less than 50 ml.The average registration error of navigation was 1.6 ± 0.4 mm.Conclusion The surgical incision and surgical approach can been designed with the help of electromagnetic navigation system before operation,and can accurately resect the lesions simultaneously avoid brain function area,protect the normal brain tissue,reduce postoperative complications,with the help of the electromagnetic navigation system intraoperative in real time.It is suitable for minimally invasive surgery for intracranial cavernous hemangioma.

Objective To observe the clinical efficacy of L-carnitine combined with trimetazidine in the treatment of chronic heart failure.Methods The clinical data of 700 patients with chronic heart failure were retrospectively analyzed.According to different treatment methods,they were divided into four groups:A,B,C,D.181 cases of A group used L-camitine combined with trimetazidine treatment on the basis of routine treatment.177 cases of B group received L-carnitine treatment on the basis of routine treatment.175 cases of C group received trimetazidine treatment on the basis of routine treatment.167 cases of D group received conventional treatment.Then,the clinical efficacy of the four groups was compared.Results The total effective rates of A,B,C,D groups were 83.43％,76.84％,73.71％,62.28％,respectively.The total effective rate of A group was obviously higher than the other groups,the difference was statistically significant(x2 =22.40,P ＜0.05).There was no significant difference in total effective rate between B group and C group (x2 =0.46,P ＞ 0.05),but both B and C groups were obviously better than group D (x2=4.37,5.13,all P ＜ 0.05).The data before and after treatment in four groups were significantly improved,such as 6MWT,NT-proBNP,LVEF and FS(A group:t =33.856,37.474,17.722,31.250,B group:t =27.328,31.559,6.863,25.581,C group:t =23.430,32.640,9.524,16.923,D group:t =15.863,9.602,3.061,10.169,all P ＜ 0.01).In the above four indicators,those in A group were obviously better than B group,C group and D group (F =5.884,38.621,4.357,13.770,all P ＜ 0.01).Conclusion L-carnitine combined with trimetazidine can improve the abnormal metabolism of myocardium,optimize the energy metabolism pathway of myocardium,improve the short-term cardiac function of patients markedly.L-carnitine combined with trimetazidine is worthy of promoting joint use.

Rabies is an infectious disease caused by rabies virus and rabies vaccination is the most effective way to prevent rabies. With the continuous development of biotechnology and manufacturing process, the quality of rabies vaccine has been significantly improved; especially domestic human diploid cell rabies vaccine comes into the market, which means rabies vaccine steped into the human cell era in China. The appearance of domestic golden standard human diploid cell rabies vaccine made the dream of Chinese people to be vaccinated with high quality rabies vaccine became a reality. This article summarizes the domestic and overseas research achievements of rabies vaccine.

Rabies vaccine has gradually evolved from the birth of nerve tissue vaccine to cell vaccine, and vaccination time has been simplified from the initial implementation of 14-21 needles to current 4-5 needles. Four types of vaccination procedures are recommended by WHO for rabies pre and post-exposure prophylaxis: two types of intradermal (ID) multipoint injection and two types of intramuscular (IM) injection. The most commonly used vaccination procedures are the 5-dose regimen (" 1-1-1-1-1" regimen i. e. Essen regimen) and 4-dose regimen (" 2-1-1" regimen i. e. Zagreb regimen). Vaccination according to the above vaccination procedures recommended by WHO could effectively prevent human rabies. The vaccination procedures of rabies vaccine approved in China are Essen regimen and Zagreb regimen.

Neonatal tetanus has been basically eliminated in China, but the incidence of non-neonatal tetanus is still high. Tetanus after trauma is the main type of non-neonatal tetanus. The correct application of tetanus toxoid containing vaccine (TTCV) has been neglected in the prevention of tetanus after trauma in China. On May 9, 2019, National Advisory Committee of Experts on Immunization Planning (NIAC) reviewed and approved the first guidelines for the use of TTCV and passive immune preparation after trauma, which clarified the basic process of treatment of tetanus after trauma, as well as the pointer to the use of TTCV and passive immune preparation after trauma. The main measure to prevent tetanus after trauma is to use TTCV for active immunization, and to use passive immune preparation for those without TTCV immune history. Through the construction of the top-down control and prevention system of tetanus, the change of the concept of tetanus immunoprophylaxis of medical staff is promoted. Active immunization is the main measure, but passive immunization is an added measure for the prevention of tetanus after trauma, which is of great significance to reverse the mistake of prevention of tetanus in China.

Objective To reflect the main influencing factors of career development for Chinese nurses. Methods Databases including PubMed, Embase, Cochrane Library, CNKI, VIP, CBM and Wanfang Data were searched to collect literature on the main influencing factors of career development for Chinese nurses. The literatures were screened according to the inclusion and exclusion criteria. After extracting data and appraising the quality of the included studies,Meta-analysis was conducted by Revman 5.0 and Stata 12.0 software. Results Of the 494 identified studies, 8 studies were included. The summary effect size and 95％CI were found for psychological capital 0.44(0.16-0.73), self-efficacy0.35 (0.22- 0.48), positional titles 0.20(0.14- 0.27), hospital scale- 0.19(- 0.26-- 0.13), years of work experience 0.17(0.09-0.25), stress-0.17(-0.24--0.09) respectively. Conclusions Psychological capital, self-efficacy, positional titles, hospital scale, years of work experience and stress are the main influencing factors related to nurses′ career development. Nursing managers should pay attention to and actively develop nurses' psychological capital, use of different professional titles and seniority nurses reasonably, and reduce the work pressure to promote the nurse career development.