Objective To discuss the surgical complications secondary to decompressive craniectomy as well as the clinical factors related to these complications. Methods We reviewed a series of 83patients undergone surgical decompression and analyzed the incidence of surgical complications as well as the relationship of the complications with GCS score and operation opportunity selection. Results There were 51 patients (61%) with surgical complications after decompression, among whom 30 patients ( 36% ) had more than two kinds of complications. The trauma severity would increase with the incidence of surgical complication, with statistical difference between groups. The late operative group ( ≥ 12hours) showed higher incidence of complication than the early operative group ( < 12 hours), with no statistical difference. Conclusion The procedure of decompressive craniectomy develops kinds of complications which should be prevented, detected and treated early for an optimal prognosis.

Objective To investigate the phenotype,number and distribution of inflammatory cells in early and late stages of spontaneous regression of halo nevi,and to elucidate the immunological mechanisms for spontaneous regression of these nevi.Methods Halo nevi,their surrounding non-lesional skin,and normal control skin were examined by immunohistochemical staining with monoclonal antibodies to CD3,CD4,CD8,CD20,CD1a,CD56 and CD68.Staining results were observed and analyzed by the computer image analysis system,image-pro plus 6.0.Results The number of CD4+,CD8+,CD20+,CD1a+cells,along with the diameter of CD1a+and CD68+ cells was significantly increased in the lesions of early and late stage of spontaneous regression of halo nevi than in non-lesional skin and normal control skin(both P＜0.01).The ratio of CD8+/CD4+ cells in the lesions of late stage of spontaneous regression was also higher than that in the lesions of early stage (2.05∶1 VS 1.82∶1).A massive infiltrate of CD8+ cells was observed in the nests of nevus cells.ConclusionsCD4,CD8,CD20,CD1a,CD56 and CD68 positive cells are all involved in the spontaneous regression of halo nevi,and CD8+ cells may play a predominant role in this process.

Objective To study curative efficacy of radix notoginseng saponin dispersible tablets combined with rivaroxaban in treatment of tibial fracture after operation and its effects on joint function and the leves of inflammatory factors .Methods 90 patients of tibial fracture who received therapy from March 2014 to March 2016 in our hospital were selected.According to random number table,all elective surgery,those patients were divided into the observation group (n=45) and the control group (n=45),the control group was treated with radix notoginseng saponin dispersible tablets,while the observation group was treated combined with rivaroxaban.After two weeks of treatment, the hemorheology, inflammatory factors, joint function were compared between two groups.Results The patient swelling time and bed time in the observation group were shorter than the control group (P<0.05);after treatment,the levels of red cell volume, whole blood viscosity,fibrinogen in the observation group were lower than the control group (P<0.05);the levels of tumor necrosis factor TNF-α, IL-1,IL-6 in the observation group were lower than the control group (P<0.05);after treatment three months and six months,the Baird-Jackson scores in the observation group were higher than the control group (P <0.05).Conclusion Radix notoginseng saponin dispersible tablets combined with rivaroxaban is well for tibial fracture after operation,which can improve hemorheology,reduce the level of inflammatory factors,promote joint functional recovery.

Objective To study the in vitro culture condition for melanoblasts from human foreskin tissue. Methods The skin tissue taken from foreskin of children was treated with 0.5% dispase Ⅱ to separate epidermis from dermis, then with trypsin to obtain single cell suspension, which was cultured in modified medium for melanoblasts, i.e., MCDB254 medium supplied with several cell growth factors. Finally, melanoblasts were obtained based on the difference of adhesion speed. The morphology and proliferation of cultured melanoblasts were observed under a light microscope. DOPA staining, immunostaining with anti- S-100 and -tyrosinase related protein 2 (TRP2) antibodies, and transmission electron microscopy were per- formed to identify the cultured melanoblasts. Results The cultured human melanocytes displayed a match-like shape, scattered arrangement, syrmnetric double poles, slim cell body, highly refractive nuclei; meanwhile, the melanoblasts exhibited plentiful cytoplasm, large volume, bipolar or irregular shape and clonal growth. Additionally, the melanocytes were positive for TRP2, S-100 and Dopa staining, while the melanoblasts were positive only for TRP2. Electron microscopy revealed the presence of mature melanin granules (stage Ⅲ-Ⅳ ) in melanocytes but immature melanin granules (stage Ⅰ ) in melanoblasts. Conclu- sion Stable pure culture of melanoblasts has been realized with the reformed medium, which may lay a foundation for the investigation into the mechanism of epidermal pigmentation.

Objective To explore the bacterial spectrum and drug resistance that separated from respiratory tract of schizophrene.Methods 311 samples taken from the respiratory tract of schizophrenes were investigated and analyzed.Results From 311 samples 58 pathogenic bacteria were separated,the gram negative was 55.93% and the gram positives was 44.07%;5 most pathogenic commoly bacteria were klesbsiella pneumoniae and S.aureus and escherichia coli and streptococcus and enterococcus;Except that all the staphylococcus were sensitive to vancomycin,enterobacteriaceae were sensitive to imipenem,all the other separated strains showed total resistance to the agents tested in different levels,also the multidrug resistance emerged in lower respiratory tract infections with mulitidrug resistance in high levels.Conclusion The most common pathogenic bacteria separated from these schizophrene are klesbaiella pneumoniae and S.aureus.In clinical therapy,sensitive antibiotics should be selected according to the drug sensitive tests,combine with other agents when necessary to accelerate the clearance of bacteria from infectious respiratory tract in schizophrene.

8 hours and without and binding nursing in these 3 groups respectively. Observed the condition of respiratory tract infection in 3 groups. Results The incidence rate of respiratory tract infection in binding nursing groups was 50%, which was significant higher than that of in no binding nursing group (P8 hours group was 66.67%, and this rate had an tendency of rising with the time of binding nursing lasting (P

BACKGROUND:It is so difficult to have aortic valve replacement with smal aortic annulus. Improper treatment may lead to patients with valvular mismatch phenomenon, and thus make left ventricular outflow tract obstruction, increase transvalvular pressures, cause cardiac hypertrophy secondary to increased left ventricular afterload and even congestive heart failure.
OBJECTIVE:To summarize the treatment strategy for preventing valvular mismatch phenomenon caused by smal aortic annulus after aortic valve replacement.
METHODS:Eighty-five patients with smal aortic annulus underwent aortic valve replacement surgery. 19 mm SJM Regent valve was applied to the patients with orifice diameter>17 ≤ 19 mm;to the adult patients with orifice diameter ≤ 17 mm, we performed bovine pericardial patch enlargement of the smal aortic annulus and valve replacement using 19 mm SJM Regent valve. For those with orifice diameter>19 ≤ 21 mm, we selected 21 mm Hancock II ultra biological valve for valve replacement. Effective orifice area index, left ventricular mass index, inter-ventricular septal thickness, left ventricular wal thickness, trans-valvular peak velocity, the pressure difference across the valve and trans-valvular mean pressure were measured through echocardiography. After discharge, patients were fol owed up in out-patient clinic and evaluated regularly by echocardiography.
RESULTS AND CONCLUSION:There were no early deaths after operation and al cases were cured and discharged. Fol ow-up time was between 6 months and 3 years. The main complications included low cardiac output syndrome in two cases, reoperation due to bleeding in one case, and ventilator dependence in two cases. No cases occurred in cerebral complications such as cerebral hemorrhage or cerebral thrombosis, and no valvular dysfunction or card flap appeared. There was no bovine pericardium tearing, thrombosis, calcification, tumor-like bulge, infection or immune reactions. A total of 81 cases were fol owed up and the fol ow-up rate was 95%(81/85). There were NYHA class grade I in 65 cases, and grade II in 16 cases. Peak velocity across the aortic valve and the mean pressure were significantly decreased, effective orifice area index increased significantly, left ventricular mass index, left ventricular wal thickness and the thickness of the inter-ventricular septum were significantly reduced compared with pre-operation, and no valvular mismatch phenomenon occurred. Compared 21 mm Hancock II ultra biological valve with 21 mm SJM Regent group, the former got a better peak velocity and mean trans-valvular pressure, and better left ventricular remodeling index. Body weight and body surface area were significantly increased in 19 mm Regent valve group after operation. The results suggest that individualized treatment strategies should be taken to prevent the occurrence of postoperative valvular mismatch phenomenon for patients with smal aortic annulus.

Objective To investigate the relationship of fascin-1 protein expression with the metastasis of basal cell carcinoma and squamous cell carcinoma. Methods Skin specimens were obtained from 10 normal human controls, 13 patients with basal cell carcinoma (8 nodular variant and 5 superficial variant) and 24 patients with SCC (11 SCC in situ and 13 invasive SCC). Immunohistochemical staining was performed to analyze the expression of fascin-1 protein. The staining results were quantitatively assessed with computer image analysis system (Image-pro Plus 6.0). Results The optical density of fascin-1 averaged 0.1152±0.04574 in SCC in situ, 0.1257±0.03096 in invasive SCC, and 0.0293±0.00981 in normal controls; the expression of fascin-1 was significantly higher in SCC tissue than in normal control skin (both P<0.05). Increased optical density was also observed for fascin-1 in nodular variant of SCC (0.0808 ±0.05642) and superficial variant of SCC (0.0806±0.04346) compared with the normal controls, whereas no statistical difference was observed between nodular and superficial variant of SCC. Conclusion In BCC and SCC, there is an over expression of fascin-1, which may be linked to the local invasion of carcinoma,

OBJECTIVE To study the clinical and pathological characteristics of antrochoanal polyps. METHODS From Oct. 1998 to Sept. 2004, 1023 cases(1895 sides)of chronic sinusitis and/or nasal polyps were treated with endoscopic sinus surgery. Forty-six patients were diagnosed with antrochoanal polyps; all had a unilateral lesion. The average age of these patients was 15a. The polyps from these patients were fixed in formalin and embedded in paraffin. The sections were cut,stained with HE and observed under light microscope. RESULTS All 46 patients were cured after following up for more than 1 year. The antrochoanal polyps were usually unilateral and appeared in younger patients. The main symptom was nasal obstruction. Macroscopically,they had a cystic intramaxillary portion and a solid intranasal portion. Microscopically,the polyps were covered by pseudostratified ciliated columnar epithelium. The inflammatory cell infiltration in submucous tissue was mainly that of neutrophil cells with few eosinophil cells. Edema and cyst were also found in the submucous tissue. CONCLUSION The pathological findings and clinical features of the antrochoanal polyps indicate that antrochoanal polyps has a different pathogenesis compared with the usual nasal polyps. It should be named antrochoanal cysts rather than antrochoanal polyps.

This study was aimed to explore the correlation between the phlegm-stasis syndrome of coronary heart disease ( CHD ) and multiple objective indexes in order to provide the basis for clinical study of phlegm-stasis syndrome of CHD . A total of 120 patients were divided into the phlegm-stasis syndrome group ( 76 cases ) and the non-phlegm-stasis syndrome group ( 44 cases ) . And 20 cases of healthy volunteers were selected as the normal control group . Comparison and statistical analysis were made from aspects of blood lipids , glucose metabolism , inflammation factor and etc . The results showed that the levels of total cholesterol ( TC ) , triglyceride ( TG ) , low density lipoprotein cholesterol ( LDL-C ) , fasting insulin ( FINS ) , hypersensitive C-reactive protein ( hs-CRP ) , matrix metalloproteinase-9 ( MMP-9 ) in the phlegm-stasis syndrome group were significantly higher than those in the normal control group and the non-phlegm-stasis syndrome group ( P <0.05, or P < 0.01). It was concluded that the levels of TC, TG, LDL-C, FINS, hs-CRP and MMP-9 can provide objective basis for the phlegm-stasis syndrome of CHD .