Objective To explore the clinical diagnosis and treatment of nervous system damage caused by invasive fungi nasosinusitis.Methods 7 patients with nervous system damage caused by invasive fungi nasosinusitis were selected,and the clinical,imaging and pathological data of the patients were reviewed retrospectively.Laboratory tests were used in patients with cerebrospinal fluid (CSF).Imaging used CT or MRI examination.Results In the past history of the patients,no one with nasosinusitis.5 patients immunocompromised and 2 cases had no special medical history.All patients were diagnosed with neurological damage after admission.Under the microscope,fungal cultures showed Aspergillus in 4 cases,Mucor in 2 cases,Cryptococcus in 1 case.In the imaging,all patients had sinus lesions,base of skull destruction in 4 cases.Used surgical interventions and drug for 7 patients,6 cases recovered and 1 case died.Conclusion Using antibiotics and glucocorticoid for a long time or suffered from diabetes and tumour may have higher incidence of invasive fungi nasosinusitis and damage the nervous.It is one of the leading causes of patients with immune deficiencies deaths.

The pathophysiological mechanism of spinal cord injury is very complex.In order to find out the clinical treatment for spinal cord injury,the suitable design of a spinal cord injury experimental model is critically important to explore the mechanism in treatment the spinal cord injury,by which the transplantation of bone marrow mesenchymal stem cells could be conducted,Nowadays,several methods have already existed on the design of spinal cord injury experimental model,including contused model,tension model,compression model,cutting model or resorption model,and ischemia model,and the way of bone marrow mesenchymal stem cells transplantation,including call suspension stereotaxis injection,lumbar puncture cell suspension injection,and intravenous cell suspension injection.The possible mechanisms of bone marrow mesenchymal stem cells in treatment of spinal cord injury were as follows:① bone marrow mesenchymal stem cells could move to the damage department and differentiate into neural cell phenotype;② bone marrow mesenchymal stem cells could play the role of bridge-mediation;③ bone marrow mesenchymal stem cells could inhibit the apoptosis of the nerve cells after transplantation.Animal experiments proved that there are broad prospects of clinical application of bone marrow mesenchymal stem calls for the treatment of spinal cord injury.

BACKGROUND:Soft-tissue defect in plastic surgery is a major problem,and currently all of methods used for clinical treatment have certain shortcomings.OBJECTIVE:To investigate the research status of adipose tissue engineering,to analyze the current deficiencies in the application of the program,and to outlook its possible future in clinical application.METHODS:A computer-based online search was conducted jn Medline and CNK J with the key words of"adipose tissue engineering.mesenchymal stem cells,derived from adipose tissue"in both Chinese and English from January 1 991 to May 2009.The related articles about fat tissue and tissue-engineered building were included,but the duplicated studies were excluded.RESULTS AND CONCLUSION:A total of 342 documents were retrieved firstly.According to the inclusion criteria,33 articles were included in the final analysis During the exploration of treatment for soft-tissue defect,tissue engineering technology provided a new method by combining the seed cells amplifying in vitro with biomatedal to repair some tissue or organ defects,reconstruct physiological function,and finally to achieve the ultimate goal of non-damage repairment of organic defect and reconstruction of morphology,structure and function Nowadays there are several successful strategies of constructing adipose tissue in treatment for soft tissue defect,which will fill in the blanks in the repairment of adipose tissue defect.

Objective To analyze the related influence factors on the prognosis of hypertensive cerebral hemorrhage in basal ganglia with operation treatment,provide the basis for clinical prevention and treatment.Methods 80 patients for treatment of hypertensive cerebral hemorrhage were selected.By a retrospective study,we collected the clinical data and postoperative following -up data,status,complications,and observed the postoperative recovery.Sta-tistical different hypertension,preoperative breaking into the ventricle,disturbance of consciousness,operation time and preoperative hematoma volume of the prognosis.Results In 80 patients,48 cases(60.00%)of patients has good prognosis;moderate disability,taking care of themselves life 10 cases(12.50%);severe disability,life can not take care of 9 cases(11.25%);plant survival of 5 cases(6.25%)and 8 cases of death(10.00%).22 cases of patients with brain hemorrhage again,3 cases postoperative pulmonary infection,6 cases of secondary organ dysfunction.Poor prognosis of preoperative ventricle prognosis and disturbance of consciousness of patients was 88.26%(18 /23)and 63.64%(21 /33),which was higher than the preoperative without breaking into the ventricle and no disturbance of consciousness 24.54%(14 /57)and 36.36%(21 /33),the difference was statistically significant(χ2 =10.38,9.76, P <0.05).The timing of surgery,the prognosis of 48h patients was 69.23%(9 /13),which was higher than that of less than 6h and 6 48h patients,the difference was significance(χ2 =10.06,P <0.05).Patients with poor preopera-tive hematoma volume >60mL was 47.62%(20 /42),which was higher than the preoperative hematoma volume 40 -60mLpatients31.38%(12 /38),the difference was statistically significant(χ2 =9.12,P <0.05).Conclusion It has obvious effect on surgery operation prognosis of patients with hypertensive cerebral hemorrhage,including optimal time for operation;bleeding time,intraventricular hemorrhage,disturbance of consciousness and bleeding volume.If the clinical treatment in the prevention and treatment to improve the survival and quality of life of patients with cerebral hemorrhage.

Objective To evaluate the clinical effects of percutaneous kyphoplasty ( PKP ) for osteoporosis vertebral compression fractures . Methods From January 2011 to June 2013, 65 patients underwent PKP .The evaluation was based on the visual analogue scale (VAS), vertebral height, and Cobb’s angle recorded at 3 days and 6 moths postoperatively.The duration of follow-up after operation was 6-12 months. Results The PKP operation was successfully completed in all the 65 cases.The VAS reduced from 6.62 ±0.63 before operation to 3.22 ±1.20 at 3 days (P =0.000) and 2.12 ±1.15 (P =0.000) at 6 months postoperatively.The vertebral height was increased from (15.26 ±1.19) mm before operation to (18.14 ±1.29) mm at 3 days (P=0.000) and (17.65 ±1.37) mm (P=0.000) at 6 months postoperatively.The Cobb’s angle was decreased from 16.25°±2.66° before operation to 6.34°±1.68°at 3 days (P=0.000) and 7.13°±1.82°(P=0.000) at 6 months postoperatively. Conclusion Percutaneous kyphoplasty can relieve pain and improve the functions .

Objective Recent studies show that, tesaglitazar can reduce vascular plaque lipid deposition and inflammatory response in mice.This paper aims to investigate the effects of tesaglitazar, the peroxisome proliferator-activated receptor α/γ( PPARα/γ) agonist on serum lipid, serum nitric oxide ( NO) and heart type inducible nitric oxide synthase ( iNOS) mRNA expression in diabetic mice. Methods Thirty female 3-week-old clean grade mice were fed with ordinary adaptive diet for 7 days.The diabetic mouse model was established by feeding these mice with high-glucose-high-fat diet for four weeks and then taking small doses of streptozotocin( STZ) .These mice were randomly divided into two groups by means of ran-dom number table:control group and tesaglitazar group.Control group continued to be fed with high-glucose-high-fat diet, whereas te-saglitazar group was administered with tesaglitazar orally( high-glucose-high-fat fodder mixed with 20μg/kg tesaglitazar) .After 6 weeks′administration, body weight, total cholesterol(TC), triglyceride(TG), low density lipoprotein cholesterol(LDL-C), high density lipo-protein cholesterol(HDL-C) and blood glucose(Glu) levels were measured.Serum NO content were detected with nitrate reductase method, and the expression of iNOS mRNA in heart were detected by RT-PCR. Results Compared with control group[(3.62 ± 0.45)、(2.58 ±0.34)、(1.35 ±0.26)、(19.55 ±3.40) mmol/L], serum levels of TC、TG、LDL-C and Glu in tesaglitazar group [(2.93 ±0.38)、(1.87 ±0.41)、(1.07 ±0.30)、(14.33 ±2.08)mmol/L] were significantly decreased, difference was statistically significant(P<0.01).However, the levels of HDL-C were increased obviously campared with the control group[(1.32 ±0.21) mmol/L vs (1.05 ±0.24)mmol/L, P<0.01];The serum NO content in control group were significantly higher than that in tesaglita-zar group[(75.60 ±8.06)μmol/L vs (41.35 ±5.82)μmol/L] , difference was statistically significant(P<0.01); The ralative quantitative expression of iNOS mRNA in treatment group was significantly lower than that in control group[(0.435 ±0.064) vs (0.568 ±0.067)], difference was statistically significant(P<0.01). Conclusion Tesaglitazar can reduce the production of NO by means of inhibit excessive expressions of iNOS mRNA in diabetic mice.It can also improve the levels of serum lipid, and can delay the progression of atherosclerosis.

Objective To investigate the safety and feasibility of operation on complex laparoscopic cholecystectomy. Methods The clinical data of patients underwent complex laparoscopic cholecystectomy since 1990 in our hospital were retrospectively analyzed. Results Except 2 patients treated by abdominal operation, other patients were treated by laparoscopic cholecystectomy successfully. Conclusion The complex laparoscopic cholecystectomy is safe and feasible with sufficient evaluation before operation and proper management during operation.

Objective To investigate the safety of laparoscopic cholecystectomy(LC) under the use of cardiac pacemaker for the patients with cholelithiasis and serious cardiac arrhythmia.Methods The clinical data of 8 cases undergoing LC under the use of vvI cardiac pacemaker were analysed.Results All the 8 cases undergoing LC by cardiac pacemaker had successful results. There was no cardiac accident or complication of the pacemaker in perioperative period in this series, and the postoperative course was smooth . Conclusions LC is safe under the use of cardiac pacemaker, if the decompensation of heart is controlled and the anaesthesia and operation are estimated correctly.

Objective To evaluate the long term effects of laparoscopic surgery on duodenal ulcer with acute perforation. Methods From 1995, Twenty-five patients with duodenal ulcer perforation and diffused peritonitis were diagnosed definitely by TV laparoscopic technique, and the perforations were sutured and repaired by greater omentum under laparoscopy. Six cases of them were performed parietal cell vagotomy simultaneously. After operation the drain was put into abdominal cavity and H2 receptor blocking agent, proton pump inhibitor or plus antihelicabater pylori therapy were used. Results All operations of 25 cases were accomplished under laparoscopy. Whatever operative complications had not happened. Average operation times were 55 minutes. The total hospital days were 6 in average. Postoperative follow-up ranged from 0. 5 -3 years, no duodenal ulcer recurred. Conclusion The laparoscopy adopted in treating duodenal ulcer perforation is a procedure with minimal invasion and scarceness of postoperative complication; its clinical effectiveness is as good as laparotomized operation.

Objective To evaluate the value of endoscopic treatment for severe acute biliary pancreatitis (SABP). Methods A total of 36 patients with SABP, who received emergency operation were enrolled into this study. Among the patients, 16 received endoscopic naso-biliary drainage (ENBD) because of acute cholecystitis or cholecystolithiasis; 11 underwent endoscopic sphincterotomy (EST) and ENBD due to stenotic papillitis or choledocholithiasis; 4 were treated with EST using needle knife and ENBD due to difficulties in inserting bow knife and cannula catheter into the common bile duct; and 2 experienced the guide wire entering into the wirsung’s duct for over 3 times, when the cannula catheter was inserted into the common bile duct. Thus, the sphincter of Oddi was incised by bow knife to expose the opening of the cystic duct, and then ENBD was performed. Open surgery was performed in 3 cases because of failure of ENBD. In all the patients, systemic medical treatment was carried out after the operations.Results ENBD was completed in 33 cases, among which 29 (81%) patients were cured and 4 (11%) patients died. The operation failed in 3 cases. After the operation, 3 patients developed peripancreatic infection. No hemorrhage of the duodenum papilla, duodenal perforation, or cholangitis occurred in this series. The mean hospital stay was 22 d (15-75 d). 26 of the cured patients were followed up for 12-36 months (mean, 18 months), no recurrence of the symptoms of pancreatitis was found. Conclusions Endoscopic treatment combined with systemic medical therapy may reduce the course of disease and increase the cure rate for patients with SABP.