Objiective:to summarize the early treatment of severe bifrontal intraparenchyma contusion associated with central herniation. Mehthod:clinical presentation of 41 cases of secere bifrontal contusion associated with central herniation were analyzed retrospectively. Resolts:12 cases had good overcome,13 mild morbidty,2 severe mordity,1 were in persistent vegetative state,3 mortality.Conclusions: Attaches great importance to patients with severe bifrontal brain contusion associated with central herniation,close observation of patients with their consciousness,pupil and changes in vital signs;attend that it is premature to stop dehydrating agent,too fast,to review the head dynamic CT,the right to master surgical indications.Early removal of necrotic brain tissue and cranial decompressive craniectomy to be effective in improving the cure rate of patients.

Objective To investigate the impact of the different mode of delivery on postpartum lactation.Methods 1 678 pregnant women in our hospital were divided into cesarean section group(798 cases) and natural delivery group(880 cases).Open milk after delivery,breast fullness,the number of neonatal sucking and post-natal self-assessment milk water were compared between the two groups of pregnant women,and the impact of the mode of delivery on postpartum lactation was analyzed.Results Whether or not began to lactation (721/77cases),and the time of labor to beginning to lactation [(33.45 ± 9.68) h],and whether or not having breast fullness feeling (512/286 cases),and the time of labor to breast fullness feeling[(57.12 ± 13.90) h] in cesarean section group had significant difference with those of spontaneus labor group [(845/35 cases),(30.12 ± 10.25) h,(690/190 cases),(52.98 ±15.09) h] (x2 =21.613,t =2.452,x2 =41.813,t =2.818,all P ＜ 0.05).There was no significant difference in selfrating milk score [(2.02 ± 0.45) points vs (2.45 ± 0.51) points],and newborn sucking times 4 ～ 6d postpartum [(5.21 ±1.21) times vs (5.89± 1.82)times](t =2.012,2.532,all P ＜0.05).Conclusion Efficiency of the breast-feeding was affected by the impact of the mode of delivery.Rationalized breastfeeding guidance was necessary to strengthen for pregnant women by cesarean section.

Bacause of few side effects,low expenditure,the adaptability for long－ term treatment and the ability of treating both principal and secondary aspect of disease of chinese herbs,to cure osteoporosis by chinese herbs and the combined treatment of traditional chinese and western medicine has become a hot task in china.It has been demonstrated that the chinese herbs can prevent and treat osteoprosis effectively.Many research also show that the chinese herbs can increase the intestine calcium absorption,decrease PYH and increase 1,25(OH)2D3 level.This review intends to show and summarize the progress made all those years.

Objective To compare the diagnostic clinical significance between loop electrosurgical excision procedure (LEEP) and colposcopical biopsy for cervical intracpithelial neoplasia(CIN). Methods 130 cases of pa-tients diagnosed as CIN under colposcopical biopsy were treated by LEEP in court of gynecology clinic. The conven-tional pathologic diagnosis was recorded in all conization specimens. Results The coincidence rate between colpo-scopical biopsy and LEEP biopsy in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ (not comprised carcinoma in situ) was 55.26%,66.10% ,78.79% respectively;The total coincidence rate was 66.15%. The accuracy of colposcopic biopsy for diag-nosing CINⅢ was higher than that for CIN Ⅰ and CIN Ⅱ,but there was no statistical difference. Conclusion Colpo-scopical biopsy for cervical lesions can be achieved for the frist time the results of pathology, have limitations. LEEP biopsy can compensate partially the deficiency of colposcopic biopsy. In a dear diagnosis of CIN, LEEP biopsy and colposcopical biopsy may complement each other, and achieve thcrpeutic effects.

Osteoarthritis (OA) is the most common form of arthritis, and is the major cause of pain and chronic disability worldwide, causing enormous social and economic burden.Once OA was considered as a 'wear-and-tear' condition and obesity is considered to be one of the most powerful predisposing factors of OA in the weight-bearing joints.However, studies have also linked obesity to OA in non-weightbearing areas, suggesting systemic effects exerted by metabolic factors other than simple local biomechanics perhaps play a role in the high prevalence of osteoarthritis in obese population.Recent studies have shown that systemic metabolic abnormalities, including obesity, diabetes, hypertension, lipid metabolism disorders, atherosclerosis and cardiovascular disease, play an important role in OA pathological process.Metabolic diseases promote the incidence and development of OA through a variety of ways, inducing causing low-grade systemic inflammation, increasing release of adipokines, anabolic cytokines and inflammatory mediators, leading to glucose and lipid metabolism disorders of chondrocytes, upregulating of cartilage extracellular matrix degrading enzymes, raising oxidative stress injury, increasing apoptosis of articular chondrocytes and reducing the cartilage and subchondral bone nutrition supply.These metabolic changes ultimately accelerate the damage of cartilage and promote the incidence and development of OA.Further research on OA and metabolic diseases, has the potential to provide new ideas and methods for the prevention and treatment of OA.

Objective To determine the risk factors for postoperative acute kidney injury (AKI) in the patients undergoing cardiac transplantation.Methods Forty patients with end-stage heart failure (both sexes) , aged 13-66 yr, weighing 45-84 kg, of ASA physical status Ⅳ or Ⅴ (NYHA Ⅲ or Ⅳ), undergoing heart transplantation, with normal kidney function before operation, were selected.According to whether or not AKI occurred within 7 days after operation, the patients were divided into either AKI group or non-AKI group.Factors including age, gender, body weight, complications (including hypertension and diabetes mellitus), preoperative blood glucose, hemoglobin, serum creatinine, cardiac output, ejection fraction, pulmonary arterial systolic pressure, intraoperative cardiopulmonary bypass (CPB) time, transfusion of allogeneic red blood cells, and urine volume within 24 h after operation were recorded.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify postoperative AKI-related risk factors for this type of patients.Results A total of 39 patients were enrolled in this study.Of the 39 patients, 14 patients suffered from AKI after operation, and the incidence was 36％.The results of logistic regression analysis showed that preoperative pulmonary hypertension and CPB time ＞ 180 min were the independent risk factors for AKI after cardiac transplantation.Conclusion Preoperative pulmonary hypertension and CPB time＞180 min are the independent risk factors for postoperative AKI in the patients undergoing cardiac transplantation.

Wake-up stroke (WUS) patients are those who go to sleep without stroke symptom and wake up with stroke symptom. WUS is very common in clinical practice. One out of every five new ischemic strokes is WUS. These patients are usually excluded from thrombolytic therapy because their exact onset time is unknown. The latest research have shown that reperfusion therapy is safe and effective in selected WUS patients based on multimodal imaging. This article reviews the imaging -guided reperfusion therapy for WUS.

There is no specific diagnostic tools or marker for detection of asthma in children.However,A large number of studies have shown that atopic disease and positive family history are the important risk factors.It is helpful for the asthma early diagnosis,proper management and prevention through the analysis of the relationship between childhood asthma and atopic disease as well as positive family history.

Objective To explore the influencing factors of heart failure among patients with continuous ambulatory peritoneal dialysis(CAPD).Method Clinical data were collected from the histories of 158 patients receiving CAPD to investigate the factors inducing heart failure for the purpose of finding out the potential independent influencing factors using t test or chi-square test for univariate analyses and logistic regression in multivariate analyses.Results The incidence of heart failure was 36.71%among the enrolled CAPD patients.Single factor analysis showed that level of volume management,age,hemoglobin,serum pre-albumin, cholesterol and c-reactive protein were related to heart failure.Analysis of multiple variables logistic regression revealed that levels of volume management,serum pre-albumin and blood urea nitrogen were related to heart failure.Conclusions It is an easy,effective and cheaper way for nurses to increase patients’ability of volume control.The strategy including remedying malnutrition and decreasing the level of uremic toxins might be effective for delayed exacerbation of cardiac function among CAPD patients.

Objective To observe and analyze curative efficacy of Desloratadine Citrate Disodium in combination with endoscopic sinus surgery and its effects on serum TIgE, ECP and inlfammatory factors in patients with chronic sinusitis.Methods 90 patients with chronic sinusitis who received therapy in our hospital from January 2015 to June 2016 were collected as research objects to be randomly divided into the control group and the observation group equally. The control group was given endoscopic sinus surgery, and the observation group was given Desloratadine Citrate Disodium in combination with endoscopic sinus surgery. Then, visual analogue scale (VAS) was applied to assess the severity of subjective symptoms of the disease. Three months after the surgery, the curative efifcacy, scores of visual analogue scale (VAS) relfecting clinical symptoms, levels of serum TIgE, ECP and inlfammatory factors were compared between the two groups.Results All patients undergone successful surgery. The observation group had a total therapeutic efifciency ratio of 95.6%, which was signiifcantly higher than that of 82.2% in the control group (P < 0.05). In comparison with the control group, the observation group had lower VAS scores of nasal discharge, nasal obstruction, cheek pain, headache, hyposmia [(1.84 ± 0.89) vs (3.12 ± 1.03) points, (1.87 ± 0.81) vs (2.55 ± 1.14) points, (1.24 ± 0.86) vs (1.88 ± 0.79) points, (1.15 ± 0.54) vs (1.97 ± 0.83) points, (1.84 ± 0.73) vs (2.18 ± 0.84) points], lower levels of serum TIgE, ECP [(58.62 ± 7.36) vs (64.39 ± 7.18) kU/L, (4.25 ± 0.84) vs (5.01 ± 1.07) ng/L)] and inflammatory factors of TNF-α, IL-6, IL-8 [(1.27 ± 0.46) vs (2.62 ± 0.53) ng/ml, (5.13 ± 1.24) vs (9.54 ± 2.23) pg/ml, (282.63 ± 32.42) vs (315.84 ± 35.89) ng/L)] with statistical differences (allP < 0.05).Conclusion Desloratadine Citrate Disodium in combination with endoscopic sinus surgery is effective for chronic sinusitis, which can signiifcantly relieve clinical symptoms, reduce levels of serum TIgE, ECP and alleviate inlfammatory reaction.