Objective To evaluate the surgical indications and treatment of spontaneous cerebellar hemor-rhage.Methods The clinical data and surgical methods of 46 patients with spontaneous cerebellar hemorrhage were retrospectively analyzed.Results Follow up 6 months,4 cases were dead.Outcomes were assessed by the ADL:17 cases wereⅠ,10 cases were Ⅱ,9 cases were Ⅲ,4 cases were Ⅳ,2 cases were Ⅴ.Conclusion The surgical way should be selected according to degree of patients,conditions severity and CT imaging of hemorrhage in the patients with spontaneous cerebellar hemorrhage.The curative of timely proper surgery on the patients with spontaneous cerebellar hemorrhages is good.

Objective To observe effects of Glycyrrhiza flavonoids on DNA and RNA in tumor cell of S_(180) and H_(22) tumor-bearing mice.Methods S_(180) and H_(22) mice were randomly divided into Glycyrrhiza flavonoids(25,11.25,and 5.58 mg/kg) groups,positive control(cytoxan 25 mg/kg) group,and negative control(NS) group,whom were given drugs by sc.DNA and RNA in tumor cells were examined,respectively by Laser Scanning Confocal Microscope and fluorescent probe of acridine orange(AO) technology.Results All different dosage of Glycyrrhiza flavonoids,cytoxan reduced the brightness of fluorescence of DNA and RNA;low and high dosage of Glycyrrhiza flavonoids had no significant effect on the fluorescence pixels of RNA/DNA;Both middle dosage of Glycyrrhiza flavonoids and cytoxan had significant effect on the fluorescence pixels of RNA/DNA(P

To investigate the effect of propofol on the release of glutamate and gamma-aminobutyric acid (GABA) from rat hippocampal synatosomes, synaptosomes was made from hippocampus and incubated with artificial cerebrospinal fluid (aCSF). With the experiment of Ca(2+)-dependent release of glutamate and GABA, dihydrokainic acid (DHK) and nipectic acid were added into aCSF. For the observation of Ca(2+)-independent release of glutamate and GABA, no DHK, nipectic acid and Ca2+ were added from aCSF. The release of glutamate and GABA were evoked by 20 micromol/L veratridine or 30 mmol/L KCI. The concentration of glutamate and GABA in aCSF was measured by using high-performance liquid chromatography (HPLC). 30, 100 and 300 micromol/L propofol significantly inhibited veratridine-evoked Ca(2+)-dependent release of glutamate and GABA (P < 0.01 or P < 0. 05). However, propofol showed no effect on elevated KCl-evoked Ca(2+)-dependent release of glutamate and GABA (P > 0.05). Veratridine or elevated KCI evoked Ca(2+)-independent release of glutamate and GABA was not affected significantly by propofol (P > 0.05). Propofol could inhibit Ca(2+)-dependent release of glutamate and GABA. However, it has no effect on the Ca(2+)-independent release of glutamate and GABA.
Anesthetics, Intravenous/pharmacology ; Calcium/metabolism ; Glutamic Acid/*biosynthesis ; Hippocampus/*metabolism ; Propofol/*pharmacology ; Rats, Sprague-Dawley ; Synaptosomes/*metabolism ; gamma-Aminobutyric Acid/*biosynthesis

Objective To observe the effect of comprehensive rehabilitation treatment before and after fabrication of lower limb prostheses for the earthquake wounded.Methods The patients were treated with comprehensive rehabilitation treatment before and after fabrication of lower limb prostheses,including stump treatment(massage,pat and stump mold),physiotherapy(range of motion,strength,balance,standing and walking training,and use of physical agents),psychological therapy.Results The percentage of stump ulcer,stump swelling,limitation of joint motion and stump pain of all 42 cases was 74%,72%,41%and 5%,respectively.Stump ulcer healed and stump swelling decreased after comprehensive rehabilitative treatment.The stump shape,motion of joint and muscle strength improved significantly.All stumps can be fit with prosthetic limb.Excellent,good and fair walk functions of prosthetic limb were 51%,44%,and 2%,respectively.Conclusion The rate of poor stump limb was high after earthquake.Application of comprehensive rehabilitation treatment before and after fabrication of lower limb prostheses is very important for the earthquake wounded.

Objective To explore the reasons for rebleeding and its coping strategies.Methods To study the 19 hypertensive intracerebral hemorrhage patients'medical records who suffered postoperative rebleeding in our department from June 2011 to May 2015.Results Rebleeding time:within 6 hours:11 cases,6 ~24 hours:5 cases, 2 ~3 weeks:3 cases.Among 19 cases,hematoma puncture drainage in 2 cases,small bone window craniotomy surgery in 9 cases,craniotomy with big bone flap decompression in 8 cases,6 cases with severely disabled and 7 cases died. Conclusion Intraoperative bleeding operation is not standardized,early postoperative blood pressure control failure in patients,preoperative instability function are the main causes of postoperative bleeding.Choosing a better operating time,the specification intraoperative hemostasis and controlling blood pressure to stable after surgery can reduce the membership of hypertensive intracerebral hemorrhage incidence of postoperative bleeding.

To investigate the effect of propofol on the release of glutamate and γ-aminobutyric acid (GABA) from rat hippocampal synatosomes, synaptosomes was made from hippocampus and incubated with artificial cerebrospinal fluid (aCSF). With the experiment of Ca2+-dependent release of glutamate and GABA, dihydrokainic acid (DHK) and nipectic acid were added into aCSF. For the observation of Ca2+-independent release of glutamate and GABA, no DHK, nipectic acid and Ca2+were added from aCSF. The release of glutamate and GABA were evoked by 20μmol/L veratridine or 30 mmol/L KCl. The concentration of glutamate and GABA in aCSF was measured by using high-performance liquid chromatography (HPLC). 30, 100 and 300 μmol/L propofol significantly inhibited veratridine-evoked Ca2+-dependent release of glutamate and GABA (P＜0.01 or P＜0.05). However, propofol showed no effect on elevated KCl-evoked Ca2+-dependent release of glutamate and GABA (P＞0.05). Veratridine or elevated KCl evoked Ca2+ -independent release of glutamate and GABA was not affected significantly by propofol (P＞0.05). Propofol could inhibit Ca2+-dependent release of glutamate and GABA. However, it has no effect on the Ca2+-independent release ofglutamate and GABA.

Objective To explore the relationship between serum silent information regulator 2 related en-zyme(SIRT)3,SIRT6,and sepsis complicated with acute respiratory distress syndrome(ARDS)and progno-sis.Methods Sixty-eight patients with sepsis complicated with ARDS admitted to the Baoding First Central Hospital from March 2020 to February 2022 were selected as the study objects,and were divided into mild group,moderate group and severe group according to the criteria of mild,moderate and severe ARDS.Accord-ing to the prognosis within 28 days,the patients were divided into survival group and death group.The levels of serum SIRT3 and SIRT6 were detected by enzyme-linked immunosorbent assay.The sequential organ fail-ure assessment(SOFA)scores,acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)scores,the levels of serum SIRT3 and SIRT6 in each group were compared.The clinical data of patients were collected,the influencing factors of mortality in patients with sepsis complicated with ARDS was analyzed by univariate and multivariate Logistic regression.The predictive value of serum SIRT3 and SIRT6 of mortality in patients with sepsis complicated with ARDS was analyzed by receiver operating characteristic(ROC)curve.Results The levels of serum SIRT3 and SIRT6 in moderate group and severe group were lower than those in mild group,the scores of SOFA and APACHE Ⅱ were higher than those in mild group,the levels of serum SIRT3 and SIRT6 in severe group were lower than those in moderate group,and the scores of SOFA and APACHE Ⅱwere higher than those in moderate group,with statistical significance(P＜0.05).There were statistically significant differences in age,mechanical ventilation time,lactate,arterial oxygenation index[arterial partial pressure of oxygen(PaO2)/inhaled oxygen concentration(FiO2)],C reactive protein(CRP),interleukin(IL)-6,SIRT3,SIRT6,SOFA score and APACHE Ⅱ score between the two groups(P＜0.05).Longer mechanical ventilation time,higher lactic acid,higher CRP,higher IL-6,higher SOFA score and higher APACHE Ⅱ score were all risk factors for death in sepsis complicated with ARDS within 28 days,while larger PaO2/FiO2,high-er SIRT3 and higher SIRT6 were protective factors(P＜0.05).ROC curve results showed that the area under the curve and 95％CI of serum SIRT3,SIRT6 levels,SOFA score and APACHE Ⅱ score were 0.706(0.493-0.922),0.722(0.497-0.954),0.753(0.570-0.922),0.710(0.442-0.952)and 0.872(0.761-0.976),respectively when applied alone and in combination.Conclusion Serum SIRT3 and SIRT6 levels are decreased in patients with sepsis complicated with ARDS,and the lower the serum SIRT3 and SIRT6 levels are as the disease worsens,the two can help predict the prognosis of patients with sepsis complicated with ARDS.

ObjectiveTo systematically evaluate the efficacy and safety of Jiedu Tongluo therapy in the treatment of diabetic kidney disease （DKD）. MethodDatabases including CNKI， Wanfang Data， PubMed， and Web of Science were systematically searched from January 2003 to December 2022 for clinical randomized controlled trials （RCTs） on the application of Jiedu Tongluo therapy for DKD treatment over the past 20 years. In these trials， the control group received conventional treatment （including diabetes and kidney health education， glycemic and blood pressure control， and lifestyle interventions）， along with western medicine or Chinese patent medicine treatment. The experimental group received primarily Jiedu Tongluo therapy via oral administration of Chinese medicine or in combination with western medicine. The Cochrane risk of bias assessment tool was used for the quality evaluation of the trials， and R 4.1.0 statistical software was used for analysis. ResultForty-one RCTs with 3 478 participants were included. The Meta-analysis results demonstrated that the experimental group， compared with the control group， showed significant improvement in overall clinical efficacy ［odds ratio （OR）=2.46， 95% confidence interval （CI） （2.08， 2.92）， I²=0%］， effective reduction of serum creatinine （Scr） levels ［mean difference （MD）=-15.83， 95% CI （-21.5， -10.37）， P< 0.01］， 24-hour urinary protein excretion rate （24 h-Up） ［MD=-350.88， 95% CI （-419.49， -282.28）， P< 0.01］， TCM syndrome score ［MD=-6.08， 95% CI （-7.81， -4.36）， P<0.01］， and effective regulation of fasting blood glucose （FBG） ［MD=-0.57， 95% CI （-0.75， -0.38）， P<0.01］. The treatment also demonstrated certain safety ［OR=0.99， 95% CI （0.35， 2.76）］. ConclusionJiedu Tongluo therapy in DKD treatment exhibits favorable clinical efficacy and safety. However， due to limitations in the quality and quantity of the included literature， these conclusions should be further validated through larger-scale， high-quality RCTs.

Aged ; Coronary Artery Disease ; diagnosis ; Coronary Vessel Anomalies ; diagnosis ; Coronary Vessels ; pathology ; Humans ; Male

OBJECTIVE: To determine the incidence of surgical site infection (SSI) after abdominal surgery and to further evaluate the related risk factors of SSI in China. METHODS: The multicenter cross-sectional study collected clinical data of all adult patients who underwent abdominal surgery from May 1, 2018 to May 31, 2018 in 30 domestic hospitals, including basic information, perioperative parameters, and incisional microbial culture results. The primary outcome was the incidence of SSI within postoperative 30 days. SSI was classified into superficial incision infection, deep incision infection, and organ/gap infection according to the US Centers for Disease Control and Prevention (CDC) criteria. The secondary outcome variables were ICU stay, postoperative hospital stay, total hospital stay, 30-day mortality and treatment costs. Multivariate logistic regression was used to analyze the risk factors of SSI. RESULTS: A total of 1666 patients were enrolled in the study, including 263 cases of East War Zone Hospital of PLA, 140 cases of Affiliated Hospital of Qingdao University, 108 cases of The First Affiliated Hospital of Nanchang University, 87 cases of Central War Zone Hospital of PLA, 77 cases of West China Hospital, 74 cases of Guangdong General Hospital, 71 cases of Chenzhou First People's Hospital, 71 cases of Zigong First People's Hospital, 64 cases of Zhangjiagang First People's Hospital, 56 cases of Nanyang City Central Hospital, 56 cases of Lanzhou General Hospital of Lanzhou Military Command, 56 cases of Shandong Provincial Hospital, 52 cases of Shangqiu First People's Hospital, 52 cases of People's Hospital of Xinjiang Uygur Autonomous Region, 48 cases of The Second Xiangya Hospital of Central South University, 48 cases of Chinese PLA General Hospital, 44 cases of Affiliated Hospital of Xuzhou Medical University, 38 cases of Hunan Province People's Hospital, 36 cases of Dongguan Kanghua Hospital, 30 cases of Shaoxing Central Hospital, 30 cases of Northern Jiangsu People's Hospital, 29 vases of The First Affiliated Hospital of Zhengzhou University, 27 cases of General Hospital of Tianjin Medical University, 22 cases of Zigong Fourth People's Hospital, 21 cases of The Second Hospital of University of South China, 18 cases of Tongji Hospital, 15 cases of Nanchong Central Hospital, 12 cases of The 901th Hospital of PLA, 11 cases of Hunan Cancer Hospital, 10 cases of Lanzhou University Second Hospital. There were 1019 males and 647 females with mean age of (56.5±15.3) years old. SSI occurred in 80 patients (4.8%) after operation, including 39 cases of superficial incision infection, 16 cases of deep incision infection, and 25 cases of organ/interstitial infection. Escherichia coli was the main pathogen of SSI, and the positive rate was 32.5% (26/80). Compared with patients without SSI, those with SSI had significantly higher ICU occupancy rate [38.8%(31/80) vs. 13.9%(220/1586), P<0.001], postoperative hospital stay (median 17 days vs. 7 days, P<0.001) and total hospital stay (median 22 days vs. 13 days, P<0.001), and significantly higher cost of treatment (median 75 000 yuan vs. 44 000 yuan, P<0.001). Multivariate analysis showed that male rise(OR=2.110, 95%CI:1.175-3.791, P=0.012), preoperative blood glucose level rise(OR=1.100, 95%CI: 1.012-1.197, P=0.026), operative time (OR=1.006, 95%CI:1.003-1.009, P<0.001) and surgical incision grade (clean-contaminated incision:OR=10.207, 95%CI:1.369-76.120, P=0.023; contaminated incision: OR=10.617, 95%CI:1.298-86.865, P=0.028; infection incision: OR=20.173, 95%CI:1.768-230.121, P=0.016) were risk factors for SSI; and laparoscopic surgery (OR=0.348, 95%CI:0.192-0.631, P=0.001) and mechanical bowel preparation(OR=0.441,95%CI:0.221-0.879, P=0.020) were protective factors for SSI. CONCLUSIONS The incidence of postoperative SSI in patients with abdominal surgery in China is 4.8%. SSI can significantly increase the medical burden of patients. Preoperative control of blood glucose and mechanical bowel preparation are important measures to prevent SSI.
Abdomen ; surgery ; Adult ; Aged ; China ; Cross-Sectional Studies ; Female ; General Surgery ; statistics & numerical data ; Humans ; Male ; Middle Aged ; Operative Time ; Postoperative Complications ; prevention & control ; Preoperative Period ; Retrospective Studies ; Risk Factors ; Surgical Wound Infection ; prevention & control