Objective To investigate the relationship between the levels of serum glial fibrillary acidic protein (GFAP) ,ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) ,CT findings and outcome in patients with severe traumatic brain injury .Methods En-zyme linked immunosorbent assay (ELISA) was conducted to detect the serum level of GFAP and UCH-L1 in 62 patients with se-vere traumatic brain injury at the time of 12 h and 36 h after the trauma .CT scans of the brain were obtained within 12 h of injury . Outcome was assessed by glasgow outcome scale (GOS) at 6th month .The relationship between GFAP ,UCH-1 ,CT findings and outcome were analyzed .56 healthy persons were selected as control group .Results The concentrations of serum GFAP and UCH-L1 of patients were significantly higher than those of the control group (P< 0 .05) ;GFAP levels were higher in patients with mass lesions than in those with diffuse injury while UCH-L1 levels were higher in patients with diffuse injury (P< 0 .05) ;the levels of GFAP and UCH-L1 of patients with unfavourable outcome(GOS 1 - 3 scores) were significantly higher than those of patients with favourable outcome(GOS 4 - 5 scores) ,and the concentrations of biomarkers were significantly negatively correlated with outcome . Conclusion Serum levels of GFAP and UCH-L1 are good predictors for severity and outcome in severe traumatic brain injury (TBI) .The levels of GFAP and UCH-L1 could reflect different injury pathways which were different in patients with mass lesions and diffuse injury remarkbly .GFAP and UCH-L1 could provide better characterization of subjects for specific types of cellular dam -age than that obtained with CT alone .

Objective To evaluate the efficacy and toxicity of the docetaxel combined with nedaplatin or cisplatin in the treatment of patients with advanced head and neck carcinoma.Methods 58 patients with advanced head and neck carcinoma were enrolled into the study.These patients were divided into nedaplatin group (27 patients:docetaxel 75mg/m2 on day 1 and nedaplatin 80mg/m2 on day 1 of the 21-day cycle) and cisplantin group( 31 patients:docetaxel 75mg/m2 on day 1 and cisplatin 25mg/m2 on day 1-3 day of 21-day cycle).Each patient should complete two cycle.Results The response rate in nedaplatin group was 59.2％ and in cisplantin group was 54.8％,the difference was statistically significant between the two groups( P ＞ 0.05 ).The rate of white blood cell and plate let reduction in nedaplatin group was 55.5％,40.7％,respectively,and those in cisplantin group was 51.6％,35.4％,respectively,the difference was statistically significant between the two groups ( call P ＜ 0.05 ).The rate of vomit in nedaplatin group was 29.6％,which was lower than that of cisplantin group (64.5％) ( x2 =4.02,P ＜ 0.05 ).Conclusion In the treatment of advanced head and neck carcinoma,the combination of docetaxel and nedaplatin had the same efficacy as the combination of docetaxel and cisplatin,and they appeared to be more-tolerated.

Objective To investigate the effects of peroxisome proliferator-activated receptor gamma (PPARγ) agonist pioglitazone on delayed neuronal death,apoptosis of neurocytes,and expression of intercellular adhesion molecule-1 ( ICAM-1 ) following traumatic brain injury (TBI) in rats.MethodsThirty-six Sprague-Dawley rats were randomized into sham injury group,control group and pioglitazone treatment group,with 12 rats in each group.TBI model was established by modified Feeney method.Treatment grouP received intragastric administration of pioglitazone at a dosage of 10 mg/kg,and the sham injury group and the control group were lavaged with isometric 0.2％ dimethyl sulphoxide.Paraffin sections of brain tissues collected at 48 hours after TBI were employed to observe delayed neuronal death,apoptosis of neurocytes and expression of ICAM-1 by Nissl staining,TUNEL staining and immunochemistry respectively.Results( 1 ) Cell loss rate of Nissl body in the treatment group [ ( 38.59 ± 1.97 ) ％ ]was significantly lower than that of the control group [ (51.25 ± 4.01 ) ％ ] ( P ＜ 0.05 ),but was higher than that of the sham injury group [ (8.65 ± 1.23 ) ％ ] ( P ＜ 0.01 ).(2) The number of apoptotic neurocytes of the treatment group (31.67 ± 4.76) was significantly lower than that of the control group (45.33 ± 4.68 ) ( P ＜ 0.05),but was higher than that of the sham injury group ( 16.83 ± 2.04 ) ( P ＜ 0.01 ).(3) The mean optical degree of ICAM-1 positive expression of the treatment group (0.26 ± 0.04) was significantly lower than that of the control group (0.31 ± 0.04) ( P ＜ 0.05 ),but was higher than that of the sham injury group (0.10 ± 0.02 ) ( P ＜ 0.01 ).ConclusionsThe PPARγagonist pioglitazone can reduce the apoptosis of neurocytes and protect neurons after TBI.Meanwhile,its suppression of ICAM-1 expression is probably a mechanism of the suppression of inflammatory reaction and neural protection.

Objective To investigate the common reasons for intracranial hemorrhage after cranioplasty ,and to analysis the sig‐nificant perioperative factors of intracranial hemorrhage after cranioplsty .Methods Eight hundred and seventy two cases of cranio‐plasty were retrospectively analyzed ;the postoperative intracranial hemorrhage and perioperative risk factors were conducted with multiple linear regression analysis .Results Among the 872 cases ,46 cases suffered intracranial hemorrhage .We found three signifi‐cant perioperative factors of intracranial hemorrhage after cranioplasty :suspension for epidural ,not completely hemostasis and ex‐cessive drainage in ventriculoperitoneal shunt .Conclusion To avoid the three risk factors as far as possible could effectively reduce the incidence of intracranial hemorrhage after cranioplasty .

To observe the clinic effects and complication of Ahmed glaucoma valve(AGV) implantation in refractory glaucoma by using the 23G syringe needle direct puncture the sclerotic tunnel.METHODS: Forty-four cases ( 44 eyes ) of refractory glaucoma underwent AGV implantation by useing the 23G syringe needle direct puncture the sclerotic tunnel. The intraocular pressure ( lOP ) , visual acuity, and complication of post - operation were contrasted with those of pre-operation.RESULTS:The success rate was 84. 1%, the mean preoperative lOP in research group was 52. 1±10. 1mmHg, and the last follow up mean lOP was 15. 6 ± 6. 9mmHg. Compared with the preoperative visual acuity, 11 eyes increased, 27 eyes had no changes and 6 eyes decreased. The main post-operative complications included shallow anterior chamber ( 4 eyes ) , choroidal detachment ( 3 eyes), drainage tube shift (1 eye), hyphema (6 eyes), drainage tube blockage ( 1 eye ) , expulsive choroidal hemorrhage (1 eye), and fiber wrap of drainage tray (5 eyes) .CONCLUSlON:AGV implantation by direct puncture the sclerotic tunnel is feasible and easy. lt avoids of making sclerotic petal and the xenogenic sclera transplanting, simplified the operation technique, prevent the leakage of around tube. The shallow anterior chamber rate is lower. lt is an effective procedure for refractory glaucoma.

Objective To investigate relation of anxiety, depression and quality of life for patients with anus-saving surgery of rectal cancer. Methods Sixty patients with rectal cancer accepted anus-saving surgery were investigated with self-designed survey, hospital anxiety and depression scale(HADS)and the MOS 36 items short form health survey(SF-36). The correlation between patients with anxiety and depression and the quality of life used pearson correlation analysis. Results Colorectal cancer confirmed anal postoperative elderly patients with anxiety and depression and quality of life were negatively correlated (r value of 0.312 and 0.495 respectively, P<0.05). The postoperative SF-36 was (64.2 ± 11.76), 36.67%and 36.00%patients were evaluated to anxiety and depression respectively . Conclusion In order to reduce patients' anxiety and depression and improve their quality , nursing staff should actively protect elderly patients with anal rectal cancer, psychological emotional support, guide them to adopt measures, such as relaxation therapy so as to improve their quality of life.

Objective To discuss the influence of psychological education on the resourcefulness of perioperative breast cancer patients. Methods Two hundred breast cancer patients from a first-class hospital in Fujian province were randomly assigned to the control group, in which routine care was done, and an intervention group, in which psychological education curriculum was employed at three stages on the basis of routine care. The resourcefulness scale was used in both two groups before and after the intervention to evaluate the score of individual and social resourcefulness and the total score of resourcefulness in these two groups. Results As to the control group, the score on individual resourcefulness and the total score on resourcefulness before and after the intervention had no significant differences (P>0.05), but the difference in the social resourcefulness scores before and after the intervention was statistically significant (P<0.05). The differences in the scores on the individual resourcefulness, social resourcefulness and the total score on resourcefulness in the intervention group before and after the intervention were all statistically different (P<0.001). What′s more, the scores of individual resourcefulness, social resourcefulness and the total score of resourcefulness between these two groups after the intervention were statistically different (P<0.001) as well. The scores of the intervention group were significantly higher than those of the control one. Conclusion The psychological education can significantly improve the resourcefulness level of perioperative breast cancer patients, which can help individuals to manage stress effectively.

Objective: To explore the relationship between lower extremity atherosclerosis disease (LEAD) and cardiovascular risk factors in elder people.
Methods: A total of 700 consecutive patients receive lower extremity Color Doppler ultrasound in our hospital from 2013-05 to 2014-11 were investigated. The patients were divided into 3 age groups: Young and middle group, n=83, Elder group, n=377 and Senile group, n=240. Based on ultrasound scoring system, the patients were divided into 4 groups: Normal group, n=112, Mild atherosclerosis (Mild) group, n=81, Moderate group, n=466 and Severe group, n=41. The cardiovascular risk factors among different groups were compared.
Results: Multivariate unconditional logistic regression analysis showed that age, smoking, history of diabetes, uric acid (UA), ankle-brachial index (ABI) were the independent risk factors for LEAD (B=0.144, 1.496, 0.963, 0.004, -2.510; 95% CI: 1.120-1.190, 2.257-8.824, 1.456-4.716, 1.001-1.007, 0.012-0.534;P=0.000, 0.000, 0.001, 0.006, 0.009 respectively. Ordinal logistic regression analysis indicated that age, male gender, smoking, ABI, UA, history of hypertension were related to the severity of atherosclerosis (B=0.130, 0.737, 0.592, -3.365, 0.003, 0.735; 95% CI: 0.097-0.162, 0.222-1.252, 0.052-1.132, -4.674 to -2.055, 0.001-0.005, 0.313-1.157;P=0.000, 0.005, 0.032, 0.000, 0.005, 0.001 respectively. Compared with Young and Middle groups, Elder and Senile groups had increased rates of moderate and severe arteriosclerotic lesions; compared with Elder group, Senile group presented the higher incidence of moderate and severe lesions, allP<0.01. With elevated age, the severity score of LEAD increased accordingly,P<0.01.
Conclusion: Lower extremity atherosclerosis lesions were more severe in elder patient, and it was particularly severe in senile patients.

Objective To study the molecular characters of porA and porB genes which encode outer membrane proteins (OMP), and predominated clonal complex of Neisseria meningitidis isolates from Guangdong province. Methods Eighteen Neisseria meningitidis isolates from Guangdong province during year 1967 to 2007 were recovered and reconfirmed by API NH biochemical system, and serogrouped by antiserum. The characters of porA and porB gene were analyzed by DNA sequencing. The allele profiles and the sequence types (ST) were determined by multilocus sequence typing (MLST). Based on their allelic profiles, the evolution relationship was analyzed by PHYLIP software. The predominant clonal complex was determined through comparing with the information of reference strains from the PubMLST database. Results For porA gene, type 20 was more frequently in the variable region (VR) 1 and type 9 in VR2 before year 2004. However, for porB gene, type 4 was more frequently in VR Ⅰ, type7 in VR Ⅳ, type 11 in VR Ⅴ,and type 10 in VR Ⅵ, respectively. The multi-types character was presented in VR Ⅴ and VR Ⅵ after2004. VR Ⅶ and VR Ⅷ can not be found among all the isolates except for one W135 isolate in 2007. Among the seven housekeeping genes, the polymorphism of abcZ was the lowest one with 4 allele numbers, while pgm was the highest one with 13 allele numbers. The predominant clonal complex was ST-5 before 2004. The ST-4821 clone complex appeared in 2004 and caused cases every year since then. More important, highly invasive ST-11 clonal complex firstly appeared in Guangdong in 2007. Conclusion The molecular characteristic of OMP genes presents polymorphism for the Neisseria meningitidis isolates from patients in Guangdong province during 1967 to 2007. ST-5 is the predominant clonal complex before 2004 and the highly invasive clonal complex is circulating in recent 3 years. It suggests that the surveillance based on laboratory should be further enhanced.

To explore the possibility to type the Brucella strains isolated in Guangdong province with analytical method to detect the fatty acid components and to collect the basic data of fatty acid components of Brucella strains, 29 strains of Brucella were selected for analysis on the bacterial fatty acid components and the cluster analysis on the collected data was performed with Sherlock analysis soft-ware (MIDI). It was demonstrated that the main fatty acid components of Brucella strains isolated in Guangdong province were 19∶0 cycloω8c acid, 16∶0 acid and 18∶0 acid. The content of 19∶0cycloω8c acid was highest in B.abortus, followed by B.melitensis and lowest in B.suis.-In addition, the content differences of 19∶0cycloω8c and 18∶0 acid between B. melitensis and Brucella suis were statistically significant; and that of 19∶0cycloω8c and 18∶0 acid between strains isolated in 1965 and those isolated in recent 3 years was statistically significant. It was also shown that the fatty acid components of Brucella strains were stable, but the contents of fatty acid components were different in different species.-It is evident that at certain euclidean distance, 3 species of Brucella can be differentiated in species level.