Objective To provide a description of clinical manifestations, special imaging features and treatment of diffuse axonal injury(DAI).Methods Retrospective analysis of 32 cases of diffuse axonal injury.Result 87.5% patients were involved in traffic accident. All patients came into persistent comatose state immediately. 75% patients had abnormal CT scan findings. MRI showed more sensitive. It could reveal injury appearance of corpus callosum and brain stem clearly. Hypothermic therapy and calcium ion antagonist were used. Conclusions combination of clinical manifestations and special imaging features helped to diagnosis of DAI in early stage. Intensive care and preventing secondary brain injury were the important treatment points.

Objective To speculate the contents changes and clinical significance of heme oxygenase-1(HO-1) and unconjugated bilirubin (UCB) in the patients with acute cerebral infarction.Methods HO-1 and UCB in blood serum were measured in these patients with acute cerebral infarction(ACI) and control group at one day, third day,and sixth day after the onset by ELISA and oxidation of vanadate. Results The content of HO-1 and UCB in serum decreased step by step at the first day, third day, and sixth day after the onset. The level of HO-1 displayed a positive correlation with the UCB in serum in the first day after the onset (r=0.645, P

Objective In order to select appropriate size of embolizing granules and to achieve complete embolization and good therapeutic effect, the diameters of thyroid arteries in Graves disease was measured. Methods Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of resected thyroid glands were made. After being embeded and stained, diameters of arteries in various parts of thyroid glands were measured with microscope calipers (Olympus). Results Average diameter capillary network of the thyroid body gland adjacent to superior, infreior artery was 0. 12-0. 25 mm, and the smallest one was 0. 04-0. 11 mm. The diameter of isthmus was 0. 130. 15 mm. The average diameter of superior and inferior artery was 2- 5. 5 mm and 3. 0- 3. 75 mm measured by using interventional angiography Conclusion According to the diameters of arteries which were measured, complete embolization and good therapeutic effect can be achieved.

Objective To study the pathological morphology of thyroid specimen after thyroid arteries embolization. In order to select appropriate size of embolizing granules, the diameters of thyroid arteries in Graves' disease were measured. Methods Multiple slides of embolized thyroid tissues from superior pole, body and inferior pole of the resected thyroid glands were made. After being embedded and stained, pathological morphology was observed and diameters of arteries in various parts of thyroid glands were measured under microscopy. Results Pathological examination of thyroid glands showed that superior and inferior thyroid arteries and most of their branches were embolized with ischemic necrosis and fibrosis in the embolized thyroid tissue. Follicular epithelium appeared as flat or cubic shapes with colloid reduction. Average diameter of main branches of superior artery was 440～550?m and that of inferior artery was 300～375?m. The diameters of capillary network in the thyroid body was 120～250?m, and the non embolized ones was 40～110?m. The diameter of isthmus was 130～150?m. Conclusions Pathological morphology of Graves' disease after thyroid arteries embolization showed that the excretion of thyroid glands would be decreased and equivalents to subtotal thyroidectomy.

Objecitve To investigate the changes of chronotropic response before and after percutaneous coronary intervention ( PCI)in patients with coronary disease .Methods A total of 339 patients with coronary disease was included in this study .All sub-jects underwent treadmill exercise test and coronary angiogram , and some patients underwent PCI if necessary .The parameters of chro-notropic response were recorded and analyzed , including ratio of the highest to predicted heart rates ( rHR) ,chronotropic response in-dex ( CRI) , and heart rate reserve ( HRR) .After coronary angiogram , the score of gensin was recorded and analyzed .Results There was significant difference in the parameter of CRI between unstable angina pectoris and silent myocardial ischemia groups ( P <0.05 ) , CRI were 0.80 ±0.11 and 0.89 ±0.07 , respectively .After coronary angiogram and PCI , there were significant differences in the parameters of rHR, CRI, and HRR between pre-therapy and post-treatment ( t =2.440, 1.977, 2.529, all P <0.05).A nega-tive correlation was found between the parameters of rHR , CRI, and HRR and the score of Gensin ( r =-0.686 , -0.673 , and-0.672, all P <0.05).The significant difference in rHR, CRI, and HRR existed between the groups of <20 and >40 ( t =2.567, 2.223, 2.062, all P <0.05).Conclusions Parameters (rHR, CRI, and HRR) had important clinical values in evaluating the changes of chronotropic response before and after PCI in patients with coronary disease with a negative correlation with the score of Gensin.

Objective To investigate the effects of hyperbaric oxygen (HBO) on the expression of caveolin2 and matrix-metalloproteinase-9 (MMP-9) in brain tissues and the blood brain barrier (BBB) after cerebral ischemia and reperfusion (I/R) in rats. Methods Three hundred and seventy male Wistar rats were randomly assigned into sham,ischemia-reperfusion,HBO,and I/R + HBO groups. After creating cerebral I/R models,oxygen at 0.25 MPa was administered 5 times,and 2％ Evans blue (EB) was injected into the tail veins 1 h before the rats were sacrificed.The permeability of the BBB,the expression of caveolin-2 and MMP-9,and EB content were determined by Western blotting,immunohistochemistry,and spectrophotometery,respectively. Results In the I/R group,the EB content increased steadily to a peak at 4 hours.EB content in the IR + HBO group was significantly lower than in the I/R group.Caveolin-2 and MMP-9 were significantly augmented by I/R injury at the 24th,48th and 72nd hours.Compared to the I/R group,HBO intervention decreased their expression levels. Conclusion HBO intervention can reverse the increase of caveolin-2 and MMP-9 caused by I/R injury,which suggests a mechanism for protective effects of HBO on the permeability of the BBB in I/R injury.

Objective To compare the treatment outcome of underwent surgery plus radiotherapy and radiotherapy/chemoradiotherapy plus salvage surgery for stage Ⅲ/Ⅳ laryngeal carcinoma,to investigate an optimized treatment for the patients of stage Ⅲ/Ⅳ laryngeal carcinoma.Methods Clinical data from 103 patients with stage Ⅲ (39 cases) or stage Ⅳ (64 cases) laryngeal carcinoma were retrospectively analyzed.The patients were divided into surgery plus radiotherapy group (S±R,46 cases) and radiotherapy/chemoradiotherapy plus salvage surgery group (R±S,57 cases).Overall survival,relapse free survival,and laryngeal preservation rate were used to compare the treatment outcome between two groups.Multivariate regression models were used to analyze the independent factors for survival and laryngeal preservation rate.Results Survival rate was higher in S±R group than in R±S group [2 year overall survival/relapse free survival 74.7 ％ (34/46) / 72.4 ％ (33/46) vs 46.4 ％ (26/57) / 40.9 ％ (23/57),P ＜ 0.05].Laryngeal preservation rate was higher in R±S group than in S±R group [93.0 ％ (15/46) vs 32.6 ％ (53/57),P ＜ 0.05].Multivariate analysis demonstrated that treatment modality and T stage were independent factors for long-term survival,while treatment modality was the only an independent factor for laryngeal preservation rate.Conclusions Surgery plus radiotherapy result in better survival and lower laryngeal preservation rate than radiotherapy/chemoradiotherapy plus salvage surgery in treatment of stage Ⅲ/Ⅳ laryngeal carcinoma.Surgery plus radiotherapy should be the first choice for treatment of locally advanced laryngeal carcinoma.Improvement of the quality of life could be achieved by laryngeal preservation surgery and phonation reconstruction procedures.

Objective To evaluate a surgical approach and anastomosis for the treatment of carcinoma of the gastric cardia. Methods Transabdominal intramediastinal esophagogastric anastomosis covered by sero-muscular flap of gastricwall for cardial carcinoma in 187 cases. Results The method reached the satisfactory surgical result in terms of tumor free cut edge on esophagus end of the resected samples. And the morbidity rate was 5.8%. Conclusion The technique enables lymphadenectomy within the lower mediastinum and a sufficiently long enough resection of esophagus. Transabdominal incision of the crus dextrum of the diaphragm makes a clear operative field for the purpose of radical operation for carcinoma of the gastric cardia. The anastomosis effectively prevents anastomotic leakage. This procedure is indicated for cardial carcinoma cases in which the esophaged involvement is within 2cm.

Objective To investigate the effects of hyperbaric oxygen(HBO)on the expression of MMP-9 and MMP-2 mRNA in the brain tissues after cerebral ischemia and reperfusion,and the permeability of blood brain barrier(BBB).Methods Using cerebral ischemia-reperfusion models with conscious mice,0.25 MPa(atmosphaera absolutus,ATA)HBO was applied 5 times during the reperfusion period,and 2%Evan's blue(EB)was injected into the tail vein 1 hour before the animals were sacrificed.The expression of MMP-9 and MMP-2 mRNA and EB content were determined by RT-PCR and spectrophotometry.Results The expression of MMP-9 and MMP-2 mRNA aswell as EB content significantly increased in the ischemia-reperfusion group as compared with a sham surgery group.The expression of MMP-9 and MMP-2 mRNA,and EB levels in the HBO group were similar to those in the sham surgery group.The expression of MMP-9 and MMP-2 mRNA and EB levels in the group given HBO plus reperfusion group were significantly decreased as compared with those in the group receiving reperfusion alone. Conclusion HBO can significandy reduce the expression of MMP-9 and MMP-2 mRNA and the permeability of the BBB.

Objective To compare the clinical efficacies between warm needling and Ibuprofen sustained release capsules (a nonsteroidal anti-inflammatory drug, NSAID) in treating patients with dysmenorrhea in adenomyosis. MethodSixty-five patients with dysmenorrhea induced by adenomyosis were randomized into a treatment group of 33 cases and a control group of 32 cases. The control group was intervened by oral administration of Ibuprofen sustained release capsules, while the treatment group was intervened by warm needling.The intervention lasted 3 menstrual cycles and a 3-month follow-up was studied. The Visual Analogue Scale (VAS), dysmenorrhea symptoms scores and clinical efficacy were compared between the two groups.ResultThe VAS scores after the intervention and inthe first and second months of the follow-up study were significantly different from the pre-treatment score in the two groups (P<0.01); the VAS score of the 3-month follow-up was significantly different from the score before the intervention in the treatment group (P<0.01). There were significant differences in comparing the VAS score after the intervention and in the follow-up study between the two groups (P<0.01), and the treatment group was superior to the control group. The dysmenorrhea symptoms scoresdeclined significantly after the intervention and in the first and second months of the follow-up study in both groups (P<0.01); the dysmenorrhea symptoms score of the 3-month follow-up study decreased in the treatment group and was significantly different from the pre-treatment score (P<0.01). There were significant differences in comparing the dysmenorrhea symptoms scores in the second and third months of the follow-up study between the two groups (P<0.01). The total effective rate was 93.9% in the treatment group, significantly better than 62.5% in the control group (P<0.01).ConclusionWarm needling is effective in easing pain and improving the symptoms of dysmenorrhea in adenomyosis, and can produce a consistent efficacy after the termination of thetreatment; it's superior to NSAIDs in comparing both short-term and long-term treatment efficacies.