observation group than in the control group at T1 and T2 (P < 0.01). These findings indicate that dexmedetomidine for sedation after hip replacement can lessen inflammatory response and contribute to the recovery of hip function.

Objective To study the clinicopathological characteristics and ultrastructural features of secretory meningioma.Methods A total of 19 cases of secretory meningioma were studied by clinicopathology,immunohistochemical and ultrastructural observation.Results Eosinophilic hyaline inclusions with different sizes were found in cytoplasm of tumor cell,which were positive to PAS and alcian blue stains.These inclusions were secreted by microvesicles in cytoplasm of tumor cell under electron microscopy.Conclusion Immunohistochemistry and ultrastructural observation play important roles in the diagnosis and differential diagnosis of this tumor.

Objective: To explore the expression and gene amplification status of human epidermal growth factor receptor-2 (HER2) in the different stages of invasive urothelial bladder carcinoma. Methods:Tumor tissues from 49 patients with different stages of invasive urothelial bladder carcinoma were tested by immunohistochemical staining for HER2 and HER2 gene fluorescence in situ hybridization. Results:The number of male patients was higher than that of females. The positive rate of HER2 protein expression was higher in the patients with the higher stage of invasive urothelial bladder carcinoma. However, no gene amplification was observed in all patients. Twelve patients had ployploid chromosome 17. More ployploids were observed in the patients with the higher stage of inva-sive urothelial bladder carcinoma. Conclusion:The increase in the protein expression of HER2 in the invasive urothelial bladder carci-noma patients was not caused by gene amplification. Other transcriptional and post-transcriptional mechanisms were probably involved in the regulation of the HER2 protein.

Objective To analyze the incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage(t-SAH), time windows of CVS as well as the risk factors. Method A total of 98 patients,with t -SAH admitted from June 2007 to December 2008, were enrolled for this prospective study. The hemodynamics of middle cerebral artery (MCA) in these patients was monitored with trancranial Doppler (TCD) daily for 7 days after admission and on the 14th day of hospital stay. The incidence of cerebral vasospasm (CVS) in patients with traumatic subarachnoid hemorrhage (t-SAH) ,time windows of CVS as well as the risk factors were analyzed. Results Of them, 41 patients (41.8%) had CVS. The flow velocity of MCA in patients with GCS≤ 8 was significantly higher than that in patients with GCS≥9. Classified by t-SAH cumulative blood Hijdra method, 2(4.44%) of 45 patients(45.9%)with scores 6 or less,9 (29.0%)of 31 patients (37.8%) with scores 6～ 13,and 8 (36.4%) of 22 patients (20.0%)with scores 13 or more had CVS. Severe CVS occurred in 13 (35. 1% )of 37 surgical patients (37.8%), and local cerebral infarction occurred in four surgical patients after symptomatic treatment. The flow velocity of the MCA was significantly higher in surgical patients than that in non-surgical patients 3 days after admission. Conclusions The severity of original trauma, bleeding, location of t-SAH and operation are the major risk factors to lead to CVS in patients with t-SAH. Attention should he paid to those risk factors during the treatment of patients with t-SAH.

BACKGROUND: Facial nerve injury causes facial nerve paralysis (or facial palsy) and even results in psychosocial disturbances of the patients. Repair the injured facial nerve and reconstruction of the nerve function as early as possible have been the primary concern in clinical studies.OBJECTIVE: To investigate the timing and surgical approaches for repairing facial paralysis in order to provides evidences for its therapeutic and prognostic evaluation.DESIGN: Case analysis based on patients.SETTING: Hospital of Plastic Surgery of Chinese Academy of Medical Sciences.PARTICIPANTS: Nine patients with traumatic facial paralysis hospitalized in the Hospital of Plastic Surgery of Chinese Academy of Medical Sciences from December 1993 to November 2001.METHODS: Facial nerve anastomosis was performed microsurgically along with the implantation of the sural nerve graft into orbicular muscle of the eye 3 or 4 months after nerve injury in the 9 patients. The clinical data of the patients were retrospectively reviewed.MAIN OUTCOME MEASURES: The facial nerve function was evaluated with House-Brackmann scale and photographs of the patients' faces before and after surgical treatment were taken.RESULTS: In the follow-up of these patients lasting 6 months to 2 years,all the patients attained satisfactory outcome.CONCLUSION: Early operation is crucial for the treatment of traumatic facial paralysis,with facial nerve anastomosis as the primary choice. The implantation of the nerve graft into muscle is also indicated for repairing traumatic facial paralysis in some cases. The importance of individualized treatment choice is reiterated on the basis of cicatrectomy and the extent and specific features of the injury.

Objective To investigate severe complications of inferior vena cava filter (IVCF) applying for preventing pulmonary embo-lism after spinal cord injury. Methods From December 2014 to July 2015, 95 patients with acute spinal cord injury (SCI) in our hospital were retrospected. Results Deep venous thrombosis (DVT) appeared in 23 cases, in which 15 cases placed IVCF. All patients accepted anti-coagulant therapy, except 10 cases with contraindication. 3 cases had severe complication, in which 2 cases had comprehensive DVT distal to IVCF, with both lower limbs severe swelling, acute renal inadequacy and hypertension;1 case had continuous hyperpyrexia. Conclusion Although the IVCF placement was widely used in acute SCI for preventing pulmonary embolism in patients with DVT, however, the selec-tion of IVCF and complication prevention should be taken into account.

Objective To analyze the risk factors of BKV infection and compare the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells. Methods The peripheral blood samples of 129 renal recipients were collected. According to the result of PCR, 129 patients were divided into 2 groups:①BKV-DNA(+);②BKV-DNA(-). The sex, age, cold ischemia time, hemotodialysis duration, immunosuppressive agent and other clinical parameters were compared between the 2 groups and a Logistic regression was performed to analyze the risk factors of BKV infection. Results There were 20(15. 5%) patients in BKV-DNA(+), 109(84. 5%)patients in BKV-DNA(-)group. Logistic regression found that the cold ischemia time, hematodialysis duration, living donor were significantly related to the BKV-DNA. The results of the real-time PCR procedure and urinary sediment smears of patients checked for decoy cells were related. Conclusion Real-time fluorescent quantitative PCR and urine decoy cell are good way for detection of BKV infection after renal transplantation. The cold ischemia time and hematodialysis duration and brain death donor were the risk factors of BKV infection post renal transplantation.

OBJECTIVEOn the basis of the concept of adhesive deformity from upper eyelid fold formation, the clinical results after using various methods to correct the adhesive deformities are summarized.

METHODSA total of 33 cases of adhesive deformity from upper eyelid fold formation have been treated using various corrective methods including taking off the sutures, shifting of the septal fat or the pre-septal orbicularis muscle, transferring of pretarsal orbicularis muscle, grafting of autogenous fat tissue, and repairing or/and shortening of the palpebral levator. Postoperative follow-up ranged from 3 months to 2 years.

RESULTSThe effective results have been got with the used methods except shifting of the pre-septal orbicularis muscle or transferring of pretarsal orbicularis muscle.

CONCLUSIONSThe suitable methods to correct the adhesive deformity from upper eyelid fold formation must be chosen according to the causes and the local situations.

Objective To understand the changes in the level of osteocalcin (OC) in patients with type 2 di-abetes mellitus (T2DM) and discuss the correlation between the changes and glycated hemoglobin (HbA1c), fasting blood glucose (FBG),thyroid globulin (TG),total cholesterol (TC),high-density lipoprotein (HDL C),low density lipoprotein (LDL C),fasting insulin (FINS),and fasting C peptide (FCP) and so on.Methods 108 cases of T2DM patients were collected from group T2DM and 92 healthy subjects as healthy control group.Fasting venous blood was taken from the subjects and serum levels of OC were detected by chemilumi-nescence.HbA1c,FBG,TG,TC,HDL-C,LDL-C,FINS and FCP levels were detected,and Pearson correlation and logistic regression were used to analyze the relationship between OC and other indicators.Results The level of OC in the T2DM group was significantly lower than that in the control group,and the difference was statistically significant [(14.98 ± 10.16)ng/mL vs.(18.20 ± 6.67)ng/mL,P<0.05].There was a signifi-cant negative correlation between OC and HbA 1c and FBG in T2DM patients (P< 0.01),and a significant positive correlation with HDL C(P< 0.01);Logistic regression analysis showed that HbA 1c was an inde-pendent influence factor of serum OC(P<0.01).Conclusion The level of OC in peripheral blood of T2DM patients was significantly decreased.OC level was closely related to blood glucose and blood lipids,and it had a certain effect on the prevention and evaluation of T2DM.

Objective Investigate the therapeutic strategies of hypertrophic obstructive cardiomyopathy ( HOCM ) com-bined with mitral regurgitation(MR).Methods From January 2014 to January 2017, 34 patients with HOCM complicated with moderate to severe MR were enrolled.All patients underwent modified Morrow surgery.Compare the clinical data of pa-tients before and after surgery and the results of one year after surgery .Results There is no patient died during hospitaliza-tion, and all were discharged smoothly without serious complications ( ventricular septal perforation, complete atrioventricular block, etc.) .Results of echocardiography 1 week after surgery suggested: Left ventricular outflow tract pressure difference [(93.36 ±7.93) mmHg vs.(16.73 ±2.02) mmHg,1 mmHg=0.133 kPa, P<0.01], left ventricular outflow tract velocity[(472.40 ±22.12)cm/s vs.(188.40 ±14.16)cm/s, P<0.01], interventricular septal thickness [(19.43 ±0.77) mm vs.(16.45 ±0.76) mm, P<0.01], mitral valve structure and function were good, and MR area [(8.41 ±0.69)cm2 vs. (3.04 ±0.73)cm2, P<0.01], all of which were significantly lower than that before surgery, and the differences were statis-tically significant.Although the results of echocardiography 1 week after surgery indicated that the left ventricular ejection frac-tion(LVEF) was significantly lower than that before surgery(0.67 ±0.07 vs.0.65 ±0.07, P=0.01), the symptoms of the patients were significantly improved, and the cardiac function(NYHA classification) was grade I～II.The results of echocar-diography after 1 year of follow-up suggested that: Left ventricular outflow tract pressure difference [(93.36 ±7.93) mmHg vs.(16.98 ±2.33) mmHg, P<0.01], left ventricular outflow tract velocity [(472.40 ±22.12)cm/s vs.(189.33 ±14.23) cm/s, P<0.01], ventricular septal thickness [(19.43 ±0.77) mm vs.(16.55 ±0.83) mm, P <0.01], mitral valve structure and function well, MR area [(8.41 ±0.69) cm2 vs.(2.95 ±0.66) cm2, P<0.01], and the MR area was signifi-cantly decreased compared with that before operation .The difference was statistically significant .Results of echocardiography 1 week and 1 year after surgery suggest:Left ventricular outflow tract pressure difference [(16.73 ±2.02) mmHg vs.(16.98 ± 2.33) mmHg, P>0.05], left ventricular outflow tract velocity [(188.40 ±14.16)cm/s vs.(189.33 ±14.23)cm/s, P>0.05], ventricular septal thickness [(16.45 ±0.76) mm vs.(16.55 ±0.83) mm, P>0.05], MR area [(3.04 ±0.73) cm2 vs.(2.95 ±0.66) cm2, P>0.05], no statistical significance.One year after the operation, the symptoms and quality of life were significantly improved .Conclusion Hypertrophic obstructive cardiomyopathy often combined with mitral regurgita-tion, modified Morrow operation can fully clear the left ventricular outflow tract, which can eliminate MR and SAM signs, and the results are satisfactory.