ObjectiveTo identify the relevant factors of expansion of contusive cerebral hemorrhage following unilateral decompressive craniectomy in patients with severe craniocerebral injury and discuss their relation with prognosis.MethodsA total of 161 consecutive patients with craniocerebral injury undergoing unilateral decompressive craniectomy were prospectively studied.Their initial cranial CT data (data after injury,data before operation,and data after first operation) were recorded.Mortality or Glasgow Outcome Scale (GOS) at 6 months after injury was used as the criteria for evaluation of prognosis.ResultsThe volume of increased contusive cerebral hemorrhage among the patients after craniectomy was (18.66 ± 22.69) ml.The Rotterdam score of their initial cranial CT after injury was significantly associated with the occurrence or not of expanded contusive cerebral hemorrhage following decompressive craniectomy and the expanded hematoma volume.The expanded volume of contusive cerebral hemorrhage ( ＞ 20 ml) after craniectomy showed significant relevance to mortality and poor prognosis six months later.The magnitude of external cerebral herniation ( ECH ) on the initial post-operative CT was associated with the prognosis. ConclusionsThe severity of patients with craniocerebral injury manifested by the initial cranial CT may predict the risk of expansion of contusive cerebral hemorrhage following decompressive craniectomy.The expansion volume of contusive cerebral hemorrhage and ECH are correlated with mortality and poor prognosis.

The changes of immunoreactive TRH (TRH-ir) in cerebrospinal fluid (CSF) and plasma before and after acute traumatic head injury were determined with radioimmunoassay (RIA) on a feline model of acute experimental head trauma. The results showed that the concentrations of TRH-ir in experimental animals pre- and 2, 4, and 6h post-injury were 119.48?51.77, 460.71 ?178.72, 377.27? 139.33, and 280.17?110.46pmol/L in CSF, and 122.58?28.87,1158.89?163.18, 909.69?160.55, and 545.38?132.80pmol/L in plasma, respectively, while those in control animals measured at the corresponding time were 112.22?53.42, 105.36?49.64, 100.63?52.89, and 104.52?52.42pmol/L in CSF, and 113.57 ?25.79, 107.32?26.60, 119.84?31.53, and 117.21?28.95pmol/L in plasma, respectively. The contents of TRH-ir in CSF and plasma in the experimental group after traumatic head injury were significantly higher than those, in the control group (P

The fetal spleen cells were transplanted following the injection of S180 carcinosarcoma into the muscle,abdominal cavity,peripheral veins and portal vein in mice.The size inhibitory rate of the transplanted tumor and natural killer activity were evaluated 30 and 60 days after the injection.It was found that the growth of transplanted tumor was dramatically inhibited and natural killer activity was increased 30 days after the transplantation.But 60 days after the transplantation only portal venous transplanted tumor showed a satisfactory function of inhibiting tumor growth and natural killer activity maintained at a high level.These results indicated that portal vein was the best approach for the spleen cell transplantation

To improve the AIDS's knowledge level and intervention ability of peer lecturers in college, from the accumulation idea and activity type of experience value on Moso Teach, the author carried out systematic resource construction around the course design principles and objectives, at the same time one quantitative scoring system including learning degree and sharing degree was constructed. Through voluntary enrollment and selection among the students, the first group of peer lecturer training on AIDS prevention were set up, and 28 students were collected to experience the "mixed" application of the course. After the evaluation, it was found that there were positive functions in promoting the ability of AIDS prevention in the peer lecturer training course based on experience value of Moso Teach as the driving force and quantification. According to the problems exposed in the construction, the author put forward improvement strategies from the aspects of scoring system, off-line activities and resource optimization.

The paper describes the short and medium term (within 2 to 5 years) priorities that any region in China right now faces in working out and implementing its regional health planning, viz. the coordinated development strategy of medicine and health, medical security and social economy. The authors hold that to achieve the coordinated growth of the health cause and society, it is imperative to overcome in the short run logically related obstacles in four aspects: ineffective solution to the apparent problems followed with interest by both the social and health sectors and lack of effective operating conditions accompanying medical insurance reform, both resulting in the lack of a driving force in the reform within hospitals; difficulty in achieving breakthroughts in the development of the health cause; and the probability of a regional health planning becoming a mere formality because of the above factors. In addition, the fact that reform of medical and health institutions in their setup and ownership of property rights lags behind macroscopic social economic reform obscures the explanation of and solution to the above problems. Based on the research results, the paper sets forth the priorities in short and medium term planning.

Objective:To observe expression and diversity of glycogen synthase (GSK)-3 and ribosome S6 protein kinase (P70S6K) in skeletal muscle of insulin resistance (IR) rat induced by high fat food and to approach the effect and significance of GSK-3 and P70S6K in IR occurrence.Methods:Forty Wistar rats aged four-week were randomly divided into normal control, high-glucose, high-fat and high-fat high-glucose groups. 8 weeks after feeding, insulin sensitivity of the rats was evaluated by hyperinsulinism euglycaemic clamps technique (ring clamp experiment), GSK-3 and P70S6K in rat skeletal muscle were measured by Western blot and epididymis fat pad weight, blood glucose, insulin, triglyceride (TG), cholesterin (TC), free fatty acids (FFAs) and hsCRP levels were also determined.Results:IR was induced, body weight (P

Objective To evaluate the effciency of different embolic agents inducing the changes of the liver morphology and function in the selective portal vein embolization (PVE).Methods Forty five Spraque-Dawley rats were used in this experiment.Five were served as a control group and forty were randomly divided into 4 groups of 10 rats each.Right PVE was performed in each group by one of four different embolic agents respectively.Five rats from each group were sacrificed and dissected to inspect the morphological changes on 14th and 21st day after the procedure.The results of different groups were analyzed according to the weight ratios of the right lobe to the whole liver and the whole liver to the body,and the results were compared to each other and those of the control group using statistical Student“ t ”test. Results After the procedure,the embolized lobe was turned gray immediately with no significant differences between groups.Both on the 14th and 21st day after the procedure,the right lobe of the liver from the rats of group 1,2,3 were atrophied apparently with lots of spotty yellow scars in different sizes.There was no significant change of the embolized right lobe from group 4.By statistical analysis,the embolization using Lipiodol-ethanol 2∶1 mixture in group 2 resulted in better atrophy than group 1 ( P 0.05) and more than the gelfoam pieces ( P

Objective To explore the surgical treatment for acute ulceration of gastric carcinoma.Methods The clinical data of 68 patients with ulceration of gastric carcinoma were analyzed retrospectively.All the cases,60 male patients and 8 females with average age of 58 years,were admitted from Jan.1990 to Jan.2007,and divided into three groups randomly,i.e.repair gastrectomy group(control,n=27),partial gastrectomy group(n=21) and radical cure group(n=20).Of the 68 patients,30 cases were diagnosed as ulceration of gastric carcinoma before surgical operation,25 cases were diagnosed as suspected ulceration of gastric carcinoma and 13 cases were misdiagnosed as gastric ulcer.All the cases were undergone operation.The ulcerations located at the superior part(6 cases),middle part(12 cases) or inferior part(50 cases) of stomach.38 cases were on Borrmann Ⅱ,and the other 30 cases were on Borrmann Ⅲ.The postoperative survival time of the patients in partial and radical gastrectomy groups was compared with that of the patients in repair group.Results Twenty-seven patients underwent repair of ulceration;21 patients received partial gastrectomy and 20 received radical gastrectomy(R2 distal subtotal gastrectomy 8 cases,R3 distal subtotal gastrectomy 12 cases).Postoperative complication occurred in 7.4% of the total cases and the mortality was 5.9%.One-,3-and 5-year survival rates were 3.7%,0 and 0 in repair gastrectomy group;52.4%,23.8% and 0 in partial gastrectomy group;and 75.0%,55.0% and 10% in radical cure group.Their Survival time were 5.93?4.95 months in repair gastrectomy groups,28.33?16.44 months in partial gastrectomy groups and 35.25?20.36 months in radical cure groups,respectively(P

Objective To identify the factors enhancing the contusive brain hemorrhage following unilateral decompression craniectomy in patients with severe traumatic brain injury (TBI),and to explore the relationship between the initial Rotterdam CT score and clinical outcomes.Methods A prospective study of 291 consecutive patients with TBI admitted from Jan 2008 through Dec 2012 was carried out.Patients treated with unilateral decompression craniectomy were enrolled for study.Patients without preoperative or postoperative cranial CT imaging were excluded.Of them,235 patients were followed up.Gender,age,the causes of injury,preoperative general condition including Glasgow Coma Scale (GCS) score,pupillary response,laboratory data and the initial CT scans before operation,contusion hematoma size in CT scans following operation and Glasgow Outcome Scale (GOS) score were recorded.With t test,x2 test and nonparametric rank sum test,differences in the above listed variables were compared between patients with enlarged hematoma size group and those without change in hematoma size.A Classification And Regression Tree (CART) was used to predict the size of hematoma.Correlation analysis was used to find the relationship between the Rotterdam CT scores and GOS scores.Results The differences in age (t =2.034,P =0.043),first Rotterdam CT score (Z =4.838,P ＜ 0.01),GCS score (Z =4.440,P ＜ 0.01),pupillary response (Z =3.235,P =0.001),the length of time elapsed between the trauma occurred and the decompressive craniectomy (Z =3.874,P ＜ 0.01),glucose level (Z =3.880,P ＜ 0.01) and cerebrum hernia magnitude (Z =2.529,P =0.012) were significant between the patients with hematoma expanded (n =120) and those without change in hematoma size (n =115).The results of the CART indicated that Rotterdam score got from the initial head CT,glucose level and the length of time elapsed between trauma occurred and decompressive craniectomy were strong predictors of the risk for expanded hemorrhagic contusions following decompressive craniectomy.Both age and size of the removed bone-flap also could predict the risk of postoperative expansion of hemorrhagic contusions.The overall predictive accuracy of the CART model was 83.3％.Correlation analysis results indicated that Rotterdam CT score was negatively correlated with GOS (r =-0.333,P ＜ 0.01).Conclusions Initial Rotterdam CT scores,glucose level and the length of time between trauma and decompressive craniectomy may predict the risk of contusions expansion following decompressive craniectomy.Rotterdam CT score was negatively correlated with GOS.

Objective To evaluate the application of operations of preserving spleen in the treatment of splenic injury. Methods Serial operations of preserving spleen were performed in 78 cases in the past 10 years. 18 treated with simple splenorrhaphy,15 with ligation of splenic artery and splenorrhaphy, 13 with partial splenectomy,and 32 treated with autoplasty of spleen. Results All the cases were cured with satisfactory followed-up results.Conclusion The operation of preserving spleen for splenic injury is safe and feasible.