Objective To explore the risk factors of the chronic subdural hematoma(CSDH) drilling drainage recurrence.Methods The clinical data of 252 CSDH patients were retrospectively analyzed.All patients underwent trephination and drainage treatment,there were 40 cases with postoperative recurrence of hematoma.Multivariate logistic analysis of linear regression was used to analyze the risk factors for postoperative hematoma recurrence.Results In this study,of 252 CSDH patients received trepanation and hematoma,the probability of recurrence was 15.9 ％ (40/252).Single factor analysis showed that the size of hematoma,CT shows the density of hematoma,postoperative drainage volume,operation time,review the CT intracranial pneumatosis,age,hematoma midline shift could increase the recurrence possibility.Logistic multivariate analysis showed that he size of hematoma,CT shows the density of hematoma,postoperative drainage volume,age were independent risk factors of recurrence of hematoma drainage in patients with CSDH after drilling.Conclusion The influence factor of recurrence of hematoma in CSDH patients received trepanation and drainage is complex,we should strengthen the intraoperative,postoperative nursing and operation to reduce postoperative recurrence of CSDH.

The article chiefly explore the mechanism and treatment procedure on points emotional freedom technique (PEFT), The research methods include related literatures in combination with the Traditional Chinese Jing-Luo Theory, traditional Chinese psychology theory, modern psychotherapy theory and clinical practice. The mechanism of PEFT is clarified, and the features and treatment procedure of PEFT are summarized. PEFT was operationally simple and structuralized, and has significant characteristic of Traditional Chinese Medicine and definite effect.

Objective The poor sleep quality of epileptic patients may be partly due to the occurrence epileptiform discharges (EDs).We observed the number of interictal discharges in each sleep stage and explored the associations between EDs and sleep phases in epilepsy patients.Methods Two hundred and forty epileptic patients and 213 healthy volunteers were enrolled in the current study.For all subjects,video-electroencephalogram monitoring and 24 h-night polysomnography were conducted to detect EDs and analyze the sleep structures.Results EDs were detected in 88.7％ (213/240) of epilepsy patients with the most frequent cases from the temporal lobe.The EDs detected during waking,sleeping,or both waking and non-rapid eye movement (NREM) sleep stage accounted for 20.6％ (44/213),40.4％ (86/213),and 38.9％ (83/213) of the total patients,respectively.The total sleep time and time spent in REM were similar between the epileptic patients and healthy volunteers.However,epileptic patients spent a significantly longer mean sleep time in NREM Ⅰ-Ⅱ ((304 ±39) min versus (225 ±29) min,t =3.51,P =0.000) and less in NREM Ⅲ-Ⅳ ((49 ± 7) min versus (133 ± 17) min,t =2.30,P =0.000) than healthy volunteers.Furthermore,asymmetric sleep spindles and fragmentary sleep structure as well as high inversion frequency were found in epilepsy patients,respectively.Conclusion Combination of long-term video electroencephalogram with polysomnography is a useful method to analyze associations between EDs and the sleep-wake cycle.This strategy can also help identify the nature of sleep disorders in epileptic patients,which may improve the treatment efficacy.

RAGE (receptor for advanced glycation end products) is a multiligand receptor on the cell surface.Ligand-RAGE inter-actions activate several signal transduction pathways that propa-gate cellular oxidative stress and inflammatory response.RAGE expressed on the CD4 + T cells has been identified as a central transduction receptor which affects the activation,proliferation, migration and differentiation of the cells.In addition,blockade of RAGE suppressed the development of multiple immune-related
disorders mediated by CD4 + T cells.These studies highlight the importance of RAGE and its ligands for CD4 + T cells.This arti-cle briefly reviews the role of RAGE and its ligands on the prolif-eration,migration and differentiation of CD4 + T cells and sum-marizes the related research progress.

Objective To evaluate the effect of early nursing interventions on the dysphagia of strok e patients.Methods The randomized controlled trials (RCT) on early nursing interventions were collected using the database such as Chinese Science and Technology Periodical Database (VIP),China national knowledge internet (CNKI) and Wanfang Database.The results were analyzed with RevMan5.2 Software.Resuits Six studies were included in the study.The dysphagia recovery rate was significandy increased in the intervention group.Conclusions Early nursing interventions can effectively promote the dysphagia function recovery of stroke patients.

Objective To invent a set of novel veno-venous bypass (VVB) device based on magnetic anastomosis technique which can be used in ex situ liver resection, and verify its clinical value and performance in animal models.Methods Each VVB device was constructed using three magnetic rings and an inverted Y-shaped tube with magnetic rings on each end.The magnetic ring was made of NdFeB with electrode cutting, and the tube was made of polyvinyl chloride (PVC) and preconditioned with heparin coating on the surface of the lumen.Ten dogs underwent the ex situ liver resection, and VVB was established via magnetic anastomosis technique with the novel VVB device during the operation.The time for completing VVB was recorded, and the hemodynamic indexes including the venous flow velocity, carotid pressure, central venous pressure and portal pressure was detected.The changes of intestinal lumen and kidney were also observed.Results It only took 6 ～ 10 minutes to establish VVB by the novel VVB device in the operation,and the hemodynamics stability was maintained smoothly during the anheptic phase.The shunt index of inferior vena cava and portal vein was 76.2％ and 75.5％, respectively.The congestion of intestinal canal and kidney were also alleviated during the anheptic phase.Conclusions It could reduce the time to establish VVB with magnetic anastomosis technique in ex situ liver resection.This study showed that utilizing the novel VVB device for intraabdominal VVB during the anheptic phase could be helpful to maintain the hemodynamics stability.

Objective To research the protective effect of insulin(IN)on lipopolysaccharide(LPS)- induced impairments of rat cardiomyocytes H9c2,and the role of uncoupling protein 2(UCP2)in this process. Methods Using randomized controlled grouping,after cultured for 24 h,H9c2 cells were randomly divided into 5 groups as follows:con-trol group,LPS stimulation group(LPS group),LPS + 70 IU/ L IN group(IN 70 IU/ L group),LPS + 350 IU/ L IN group(IN 350 IU/ L group),and LPS + 700 IU/ L IN group(IN 700 IU/ L group). H9c2 cells in IN group were treated with 70 IU/ L,350 IU/ L or 700 IU/ L IN 15 min before LPS stimulation,and H9c2 cells in control group were treated with an equal volume of saline. After that,cells in group LPS and IN were treated with LPS for 24 h. Lactate dehydro-genase(LDH)in the culture was determined with LDH detecting assay kit. The activity of reactive oxygen species (ROS)and superoxide dismutase(SOD),and content of malonaldehyde(MDA)were determined by colorimetric detec-tion. Cell viability was evaluated by cell count kit - 8. The expressions of UCP2 in transcription and translation levels were detected through transcription polymerase chain reaction and Western blot respectively. Results The levels of LDH,MDA,and intracellular ROS in LPS group significantly increased compared with control group[LDH:(829. 3 ± 75. 3)U/ L vs(223. 5 ± 23. 6)U/ L,MDA:(60. 90 ± 5. 73)nmol/ mgprot vs(19. 70 ± 1. 99)nmol/ mgprot,ROS:(410. 2 ± 81. 6)U/ well vs(94. 3 ± 18. 5)U/ well,all P ﹤ 0. 05)],while the cell viability and SOD activity significantly decreased[cell viability:0. 822 ± 0. 058 vs 1. 012 ± 0. 023,SOD:(49. 20 ± 5. 81)U/ mgprot vs(89. 80 ± 2. 57)U/ mg-prot,all P ﹤ 0. 05]. And the mRNA and protein expressions of UCP2 in LPS stimulation group were up - regulated (1. 867 ± 0. 130 vs 1. 028 ± 0. 097,0. 288 ± 0. 018 vs 0. 180 ± 0. 008,all P ﹤ 0. 05). 350 IU/ L and 700 IU/ L IN inter-vention significantly decreased the levels of LDH,MDA and intracellular ROS[LDH:(568. 2 ± 35. 7)U/ L,(622. 8 ± 27. 6)U/ L vs(829. 3 ± 75. 3)U/ L,MDA:(29. 20 ± 4. 20)nmol/ mgprot,(42. 10 ± 2. 32)nmol/ mgprot vs(60. 90 ± 5. 73)nmol/ mgprot,ROS:(270. 3 ± 46. 8)U/ well,(301. 5 ± 16. 9)U/ well vs(410. 2 ± 81. 6)U/ well,all P ﹤ 0. 05], increased the cell survival and the levels of SOD activity[cell viability:0. 960 ± 0. 029,0. 906 ± 0. 039 vs 0. 822 ± 0. 058,SOD:(75. 20 ± 2. 21)U/ mgprot,(61. 20 ± 3. 38)U/ mgprot vs(49. 20 ± 5. 81)U/ mgprot,all P ﹤ 0. 05]. And IN with 350 IU/ L and 700 IU/ L increased the mRNA and protein expression of UCP2(3. 830 ± 0. 265,2. 855 ± 0. 215 vs 1. 867 ± 0. 130,0. 464 ± 0. 215,0. 355 ± 0. 006 vs 0. 288 ± 0. 018,all P ﹤ 0. 05). Compared with 70 IU/ L and 700 IU/ L IN group,350 IU/ L IN group had better results. Conclusions IN attenuates LPS - induced oxidative injury in H9c2 cells,which is probably mediated through up - regulating the expression of UCP2.

Objective To discuss the effectiveness between arthroscope cleaning combined with exercise therapy and exercise therapy in senile osteoarthritis patients.Methods Two hundred and ten senile osteoarthritis patients were divided into operation group and non-operation group by random digits table method with 105 cases each.Patients in operation group received the arthroscope cleaning and exercise therapy,and patients in non-operation group received the exercise therapy alone.The visual analogue score (VAS) and international knee documentation committee knee evaluation form (IKDC) score before treatment and 1,6 and 12 months after treatment were compared.Results A total of 210 patients received the analysis of result without drop-out.There were no statistical differences in VAS and IKDC scores before treatment and 6 and 12 months after treatment between operation group and non-operation group (P ＞ 0.05).The VAS and IKDC scores 1,6,12 months after treatment were significantly improved compared with those before treatment in operation group,and there were statistical differences (P ＜ 0.05).The VAS and IKDC scores 6,12 months after treatment were significantly improved compared with those before treatment in non-operation group,and there were statistical differences (P ＜ 0.05).According to the IKDC score,in operation group 15 patients were excellent,61 patients were fine,19 patients were general and 10 patients were bad after treatment,and good effectiveness rate was 72.38％ (76/105).In non-operation group,14 patients were excellent,59 patients were fine,20 patients were general and 12 patients were bad after treatment,and good effectiveness rate was 69.52％ (73/105).There was no statistical difference in the good effectiveness rate between 2 groups (P ＞ 0.05).Conclusions Exercise therapy with guidance can significantly improve the function of senile knee joint osteoarthritis,and ease joint pain symptoms.Arthroscope cleaning combined with exercise therapy can relieve the joint acute inflammatory symptoms,but it has no significant clinical effectiveness in long-term treatment of osteoarthritis.

Objective To explore the efficacy and safety of biological mesh during female anterior pelvic organ reconstruction.Methods The 68 consecutive women with symptomatic anterior vaginal wall prolapse in Beijing hospital from January 2010 to June 2013 were divided into two groups:6 cases underwent anterior vaginal wall repair with biological mesh,and 32 cases underwent vaginal approach to paravaginal repair.Preoperative and postoperative pelvic evaluations were performed with the POP-Q system.Patients were followed up at 1,3,6,12,24 months after operation.Objective cure was defined if the lateral sulci of the anterior vaginal walls were at grade 0 and firmly apposed to the lateral pelvic sidewalls.Results Among 68 patients,38 had grade Ⅲ and 30 had grade Ⅳ anterior vaginal wall prolapse.In all patients the anterior vaginal repair was performed successfully.The indexes of operation time,amount of bleeding,the postoperative retention time of catheter and hospital stay had no difference between biological mesh and vaginal approach groups [(88.1±18.3)min vs.(88.0±17.4)min,(140.3±77.6) ml vs.(141.3±64.9) ml,(5.30±1.79) d vs.(4.90±2.34) d,(5.53±2.00)d vs.(5.50±2.08)d,t=0.01,0.05,0.64,0.06,respectively,all P＞0.05].No complication happened during and after operation.No one relapsed in biological mesh group and 4 cases relapsed in paravaginal repair group.The relapse rate between two groups is statistically different(x2 =4.79,P＜0.05).Conclusions The anterior vaginal repair with biological mesh is effective during female anterior pelvic organ reconstruction,but the long-term outcome of biological mesh in pelvic floor construction needs further study.

Objective To investigate the effect of Jinqi Jiangtang tablet on the activation of T helper type 17 (Th17) and the expressions of interleukin (IL)-17 and IL-23 in kidney of diabetic rats. Methods A total of 45 male SD rats were randomly divided into normal control group (NC, n=15) and experimental group (n=30). Diabetes was induced by tail vein injection with streptozotocin (STZ, 45 mg/kg). The well-established 28 diabetic model rats were then randomly divided into diabetes group (DM, n=14) and Jinqi Jiangtang tablet administration group (Jinqi, n=14). The rats in Jinqi group were given Jinqi Jiangtang tablet solution by gavage at a single dose of 2.1 g·kg-1·d-1 for 18 weeks, while NC group and DM group were given 0.9%NaCl in the same way. All rats were sacrificed after 18 weeks. The circulating Th17 frequencies were assessed using flow cytometry. Serum IL-17 and IL-23 levels were measured by enzyme-linked immunosorbent assay. The pathological changes in kidney were studied by electron microscope. The expressions of IL-17 and IL-23 in kidney were detected using immunohistochemistry. Results (1) Compared with the group NC, the circulating Th17 frequencies were significantly increased in group DM and group Jinqi. The circulating Th17 frequencies were significantly lower in group Jinqi than those in group DM. (2) Compared with the group NC, the serum IL-17 and IL-23 levels were significantly increased in group DM and group Jinqi. The serum IL-17 and IL-23 levels were significantly lower in group Jinqi than those in group DM. (3) In group DM, irregular thickening of glomerular basement membrane, fusion of epithelial cell foot processes and mesangial expansion were observed by electron microscope. The above-mentioned pathological changes were improved inthe group Jinqi. (4) Compared with the group NC, the expressions of IL-17 and IL-23 in the renal cortex were significantly increased in group DM and group Jinqi, and those were significantly lower in group Jinqi than those in group DM. Conclusion The activation of Th17 and the increased expressions of IL-17 and IL-23 in kidney play a potential role in diabetic nephropathy. Jinqi Jiangtang tablet can improve diabetic nephropathy through inhibiting the activating Th 17 and decreasing the expression of IL-17 and IL-23 in kidney.