Objective To compare the impact of nimodipine combined with mannitol and mannitol only on the neurologic impairment score,cerebral hemodynamic parameters and clinical efficacy of hypertensive cerebral hemorrhage in acute phase.Methods 68 patients with hypertensive cerebral hemorrhage in acute phase were selected,and they were randomly divided into control group (34 cases) and study group(34 cases) by digital table method.The control group was treated with mannitol only,while the study group was treated with nimodipine combined with marmitol.The clinical efficacy,hematoma volume,area of cerebral edema,cerebral hemodynamic parameters,neurologic impairment score,Barthel score of the two grou.ps were compared,and the adverse drug reaction of the study group was observed.Results The total effective rate (82.4％ vs.94.1％) and efficiency rate (44.1％ vs.61.8％) of the two groups had statistically significant differences (x2 =5.688,4.956,all P ＜ 0.05).The neurologic impairment score [post-treatment of the control group (10.2 ± 9.3) points vs.pre-treatment (14.9 ± 11.6) points,t =4.607,P ＜ 0.05;post-treatment of the study group (6.0 ± 4.7) points vs.pre-treatment (14.4 ± 10.8) points,t =8.379,P ＜0.05],area of cerebral edema[post-treatment of the control group (3.7 ± 0.6) cm2 vs.pre-treatment (4.8 ±0.9) cm2,t =5.262,P ＜ 0.05;post-treatment of the study group (2.2 ± 0.8) points vs.pre-treatment (5.1 ±1.2) points,t =9.193,P ＜ 0.05],hematoma volume [post-treatment of the control group (12.5 ± 7.4) mL vs.pre treatment (18.9 ± 7.1) mL,t =6.033,P ＜ 0.05;post-treatment of the study group (8.6 ± 8.2) points vs.pre treatment (18.4 ± 7.3) points,t =10.437,P ＜ 0.05] and Barthel score [post-treatment of the control group (73.6 ±40.4) points vs.pre-treatment (32.8 ± 27.1) mL,t =7.827,P ＜ 0.05;post-treatment of the study group (85.6 ±46.8) points vs.pre-treatment (36.7 ± 28.6) points,t =10.966,P ＜ 0.05] of the two groups had statistically significant differences.The neurologic impairment score of the study group after treatment was much lower than that of the control group [(6.0 ± 4.7) points vs.(10.2 ± 9.3) points,t =3.955,P ＜ 0.05].There were statistically significant differences between after and before treatment of the control group in critical pressure [(9.3 ± 2.2)kPa vs.(9.6 ± 2.1) kPa,t =5.046,P ＜ 0.05],peripheral resistance [(1 788.2 ± 209.4) kPa · s-1 · mL-1 vs.(1 659.2 ±219.3)kPa·s-1 · mL-1,t =6.146,P＜0.05]and mean blood flow velocity[(6.4 ±1.1) mL/s vs.(7.9±1.2) mL/s,t =6.266,P ＜ 0.05].The cerebral hemodynamic parameters of the study group after treatment had statistical differences compared with before treatment in critical pressure [(8.9 ± 2.3) kPa vs.(8.2 ± 1.1) kPa,t =5.292,P ＜ 0.05],peripheral resistance [(1 794.3 ± 188.6) kPa · s-1 · mL-1 vs.(1 469.5 ± 161.8) kPa · s-1mL-1,t =4.693,P ＜ 0.05],mean blood flow velocity [(6.4 ± 1.3) mL/s vs.(8.6 ± 1.5) mL/s,t =4.069,P ＜0.05],mean blood flow volume [(13.3 ± 3.0) cm/s vs.(14.5 ± 3.3) cm/s,t =5.633,P ＜ 0.05].There were statistically significant differences between the two groups in critical pressure,peripheral resistance,mean blood flow velocity,mean blood flow volume (t =4.664,4.563,5.532,5.327,all P ＜ 0.05).There were 4 cases of facial flushing,2 cases of pulsatile headache,3 cases of blood pressure drop,and the symptoms were gradually relieved after slowing down.Conclusion In the acute phase of hypertensive cerebral hemorrhage,nimodipine can reduce the scope of hematoma in a timely manner,significantly improve the efficacy and the quality of life of patients,it is worthy of clinical pronotion.

BACKGROUND: There have been some prospective, randomized, controlled studies regarding the feasibility and safety of laparoscopic gastrectomy for gastric cancer, but controversy exists.OBJECTIVE: To systemically assess the feasibility and safety of laparoscopic gastrectomy for gastric cancer.METHODS: A computer-based online research of prospective, randomized, controlled studies addressing laparoscopic gastrectomy versus open gastrectomy published between January 1994 and December 2009 was performed in PubMed, Ovid Medline, Web of Knowledge, EMbase, Chinese Journal Full-text Database and Wanfang Database. Meta analysis of acquired data was performed through the use of RevMan 5.0 software. The inverse variance method was used to test the significance of continous data, while the Mantel-Haenszel method was used for dichotomous data. The chi-square test was used for evaluation of data heterogeneity. Homogenous data was calculated using the fixed effect model, and heterogeneous data was calculated using freedom model. Statistical data was expressed as 95% confidence interval. Funnel plot was used for sensitivity analysis to show potential publication bias.RESULTS AND CONCLUSION: Five papers that corresponded to inclusion criteria were included in this study. Among 326 cases included, 164 underwent laparoscopic gastrectomy and 162 received open gastrectomy. Meta analysis revealed that laparoscopic gastrectomy took longer operating time and removed fewer lymph nodes than open gastrectomy (both P ＜ 0.01), but for early-stage gastric cancer, laparoscopic gastrectomy was superior to open gastrectomy in terms of blood loss and hospital stay (P ＜ 0.01). But there was no significant difference in terms of time to resumption of oral intake, postoperative complications,postoperative morbidity rate, and tumor recurrence. Sensitive analysis demonstrated that publication bias existed in all indices to different extents with the exception of lymph node. The five papers adopted two different modes to remove lymph nodes, so subgroup analysis was also used. Results showed that for D1 lymph node dissection, laparoscopic gastrectomy took significantly reduced blood loss than open gastrectomy. All these findings indicate that laparoscopic gastrectomy for early stage gastric cancer is feasible and safe.

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 study the clinical characteristics in young women with breast cancer.Methods Clinical data on 71 young breast cancer cases (under 35 years) out of a total 810 female cases during a period of 20 years were retrospectively analyzed. Result Delayed medical consultation was more often seen in young patients(56?4)?d vs (35?3)?d; u=2.33; P

n clinic.

Objective To investigate the effects of thyroid stimulating antibody (TSAb) on the thyroid peroxidase (TPO) activity and its signal transduction pathways in cultured thyrocytes. Methods The TPO activity in primary cultured human thyrocytes was determined by amended guaiacol oxidation assay. At the same time, inhibitors of signal transduction were applied and the roles of cAMP/protein kinase A (PKA), phosphatidylinositol (PIP 2)/Ca 2+and tyrosine protein kinase (TPK) pathway on the TPO activity in cultured thyrocytes were observed. Results TSAb significantly enhanced the TPO activity in cultured thyrocytes, and the peak of TPO activity (360% of controls) reached with 4 mg/ml TSAb for 48 h. Addition of PKA inhibitor for blocking cAMP/PKA pathway decreased TPO activity by 79.2% (P

Objective To study the value and clinical significance of diffusion tensor imaging(DTI)in differentiating high-grade astrocytomas and solitary metastatic tumors of brain.Methods 16 patients with intracranial solitary metastasis and 25 patients with high-grade astrocytoma confirmed pathologically were examined with MR DTI.Mean diffusivity(MD)and fractional anisotropy(FA)were measured in the regions of interest(ROI)of peritumor and cerebral parenchyma of the normal side on DTL Fiber tractography was reconstructed and the encountered patterns of tumor-related alteration to cerebral white matter were observed.Results The peritumor were all depicted as hyperintense or isointense signals on DTI.The FA values were 0.227±0.05 and 0.169±0.07 in the peritumor of high-grade astrocytoma and metastasis respectively,which was of significant difference(P＜0.05).Furthermore,fiber tractography could display the course of white matter tracts in three-dimensional space.Conclusion DTI may be help to differential diagnosis of solitary metastasis and high-grade astrocytoma in clinical practice.

Objective To study the HLA-DRB1 genotupe and their relation with OBI infection.Methods HLA-DRB1 genotyping was conducted in 102 patients OBI infection and 201 health controls,by using polymerase chain reaction sequence-based typing (PCR-SBT)method.The association between HLA-DRB1 genotype and OBI was also studied.Results Compared to 201 health controls,the allele frequency of HLA-DRB1 * 0405 (1.980 4％) (x2 =12.477 0,P =0.000 0,OR =16.367 3) * 0803 (4.257 3％) (x2 =30.689 8,P =0.000 0,OR =36.454 5)、* 1101 (5.545 9％) (x2 =4.471 2,P =0.034 5,OR =1.903 8)、* 1201 (1.481 6％) (x2 =8.591 9,P =0.003 4,OR =12.151 5) were markedly higher.The allele frequency of HLA-DRB1 * 0701(2.230 8％) (x2 =5.585 5,P=0.018 1,OR=0.417 7)、* 1301 (0.245 4％) (x2 =4.513 7,P=0.033 6,OR=0.147 4) 、* 1302(0.491 4％) (x2=11.369 1,P=0.000 7,OR=0.000 0) 、* 1312(0.245 4％) (x2 =5.0198,P=0.025 1,OR=0.136 5) 、* 1501(4.257 3％) (x2=10.763 1,P=0.001 0,OR=0.000 0)was obviously lower than than in HBV patients.Conclusion HLA-DRB1 * 0701、* 1301、* 1302、* 1312、* 1501 are closely related with susceptibility to OBI,and HLA-DRB1 * 0405、* 0803、* 1101、* 1201 is closely related with resistance to OBI.

Objective To study the relation between thyroid nodule and urine iodine and to provide a scientific basis for etiological research of thyroid nodule.Methods 178 cases of thyroid nodule were detected urine iodine concentration (μg/L) by As ( Ⅱ ) 2Ce4 + catalytic spectrophotometry.160 normal people were set as control group.Data of the 2 groups and the correlative clinical information were analyzed.Results The median urine iodine concentration was 116.2 μg/L for the 178 cases of thyroid nodule,217.2 μg/L for the control group.Among the 178 cases,the median urine iodine concentration was 125.6 μg/L for the 92 cases with nodule size ＞ 10 mm and 136.4 μg/L for the 86 cases with nodule size ＜ 10 mm.The difference of urine iodine had no statistical significance between the thyroid nodule group and the control group.There was no correlation between urine iodine and the size of thyroid nodule as well as sex.Conclusions No correlation is found between urine iodine and thyroid nodule.Patients with thyroid nodule,no matter male or female,don't have to restrict iodine intake excessively.

Objective To investigate the anti-apoptosis effects of heme oxygenase-1 (HO-1) in a mouse model of liver ischemia-reperfusion ( IR ) injury and to analyze the possible mechanisms . Methods A cell model of hypoxia/reoxygenation injury was established after transfecting mouse liver AML12 cells with HO-1 small interfering RNA ( siRNA) . Real-time PCR and Western blot assay were performed to detect the changes of HO-1, B-cell lymphoma 2 (Bcl2) and caspase-3 at the cellular level. The mouse models of liver ischemia-reperfusion injury were established with/without pretreatments with cobalt proporphyrin (CoPP), CoPP+znic proporphyrin ( ZnPP) and/or ZnPP. The levels of aspartate transaminase ( AST) and alanine transaminase ( ALT) in serum samples were measured. Immunohistochemistry was used to analyze the chan-ges of caspase-3. Western blot assay was used to detect the expression of HO-1 and Bcl2 at protein level. The pathological changes of liver tissues were observed under light microscope. The apoptosis of hepatocytes was observed by using Tunel assay. Results Decreased expression of HO-1 and Bcl2 and increased expres-sion of caspase-3 were observed in the model of hypoxia/reoxygenation injury by pre-transfecting the AML12 cells with HO-1 siRNA. Compared with the IR injury group, the CoPP pretreatment group showed lower lev-els of AST and ALT (P<0. 05) and alleviated pathological damages in liver tissues. Moreover, the expres-sion of caspase-3 was inhibited, but the expression of HO-1 and Bcl2 were enhanced. Less apoptotic cells was detected by the Tunel assay (P<0. 05). However, these protective effects could be suppressed by adding ZnPP. Conclusion HO-1 has anti-apoptotic effects in the in vitro model of hypoxia/reoxygenation. CoPP can upregulate the expression of HO-1 and play the role of anti-apoptosis in a mouse model of liver is-chemia-reperfusion injury.