Objective To investigate the feasibility and effectiveness of inducing cerebral vasuspasm by injecting autologous blood into cisterna magna (CM) twice after puncture of CM with a fine needle in dogs.Methods Six healthy aduh mongrel dogs of both sexes weighing 14-18 kg were involved in this study. The animals were anesthetized with intraperituneal 3% pentobarbital sodium 30-40 mg/kg. Spontaneous breathing was kept. Nonheparinized autologous arterial blood 0.5 ml/kg was injected into CM twice at the rate of 0.5 ml/s at 48 h interval after puncture of CM with a fine needle. Neurological function was assessed and scored ( 1 = normal, 5 =dead) and CT angiography was performed to determine the diameter of cerebral basilar artery before the first CM injection (T1 , baseline) and at days 7, 14 and 21 after the second CM injection (T2.4 ). Results The injection of autologous blood into CM twice significantly increased the success rate of the puncture and intraoporative survival rote of the animal*. The neurological function scores were significantly increased and diameter of cerebral basilar artery shortened at T2 and T3 compared with the baseline value. Conclusion The model of cerebral vasospasm after subarachnoid hemorrhage can be successfully established by injecting autologous blood into CM twice following puncture of CM with a fine needle in dogs, with higher postoperative survival rate and less injury to the animals.

Objective To investigate complications of polyacrylamide hydrogel injection for augmentation mammaplasty and treatment of the complications so as to reduce the suffering of the patients to the lowest degree. Methods The clinical signs of 8 cases who had complications after polyacrylamide hydrogel injection for augmentation mammaplasty were studied. Results The complications of 8 cases included bleeding, hard nodule, aseptic inflammation and difficulty to clean the filling material completely from the normal tissue of human body. Conclusions The complications mainly result from improper procedure during the operation. Cautious attitude should be taken in the clinical application of this material and it should not be abused. Furthermore, the standard and appropriate method and technique for the operation should be employed.

Objective To reduce unreasonable use of antibiotics in acute suppurative tonsillitis cases. Methods Retrospective analyses of 1107 acute suppurative tonsillitis cases from the pediatric outpatient department were conducted.According to course of antibiotic treatment, these cases were divided into the group of full course of treatment and the group of insufficient course of treatment.According to the types of antibiotic, the subjects were di-vided into azithromycin group and non-azithromycin group.Three months after the onset of illness, the occurrence of complications and illness relapse between full course of treatment group and insufficient course group, azithromycin group and non-azithromycin group were analyzed.Meanwhile, the cases were divided into Chinese mainland group, Macao and Taiwan group, and foreign group according to their native places and nationalities.We compared the num-ber of cases used insufficient course in these three groups and analyzed their reasons.Results The relapse rate was significantly lower in the full course treatment group compared with insufficient course treatment group ( P<0.05 ) , and significantly higher in non-azithromycin group compared with azithromycin group ( P<0.05 ) .The occurrence rate of insufficient course treatment in the Chinese mainland group was obviously higher than the Macao group, Tai-wan group and foreign group (P<0.05).The main reasons for insufficient course of treatment were the insufficient patients′obedience and some doctors′poor understanding of the disease course.Conclusion A full course treatment with antibiotics on acute suppurative tonsillitis are strongly suggested.It may be of great significant to strengthen the awareness of reasonable use of antibiotics among the inland citizens.

Objective To develop the questionnaire of medication adherence in patients with schizophrenia.Methods Delphi method was used in this study.The questionnaire of medication adherence in patients with schizophrenia was developed based on two rounds of consultation among 14 experts.Results The questionnaire of medication adherence in patients with schizophrenia consisted of 3 dimensions,7 items of each dimension.Conclusions The questionnaire can be used as the tool of evaluation of medication adherence in patients with schizophrenia.Further theoretical and empirical study is needed to verify the questionnaire.

Objective To investigate the clinical value and relating problems in treating complex fractures of proximal humerus by using replacement of humeral head prosthesis. Methods There were 23 cases (10 males and 13 females, age range 43-76 years, mean 58.6 years) with complex fractures of proximal humerus. According to Neer classification, 4 cases had three-part fracture, 17 four-part fracture, 2 cleavage fracture of humeral head, 18 fresh fracture (within 2 weeks after injury) and 5 old fracture, which were all treated with replacement of humeral head prosthesis. Results Follow-up study for a mean period of 15.6 months was conducted in all the cases. No flexible prosthesis, prosthesis dislocation, infection, nerve damage or periprosthesis fractures occurred. According to scoring system modification for hemiarthroplasty (SSMH) of UCLA (Los.Angeles, California, USA), the average score was 26.3. Score was above 27 (excellent) in 3 cases and 24-27 (good) in 18 with an excellence rate of 91.3%, score was 18-24 (moderate) in 2 but no one had score less than 18. Average score was 9.5 in pain, 8.6 in function and 8.2 in muscle power and motion in 23 cases. Conclusions Replacement of humeral head prosthesis is a preferable method for treating the complex fractures of proximal humerus, with significant effect in relieving the pain in the shoulder joint posterior to trauma. It is key to a satisfactory curative effect to correctly select the indication, clearly master the local anatomy, grasp the operation technique and give early and reasonable postoperative rehabilitation treatment.

Objective To investigate the effect of music electroacupuncture on perifocal ferric ions and neuronal apoptosis and the brain water content in rats with acute cerebral hemorrhage and explore the mechanism of its action on acute cerebral hemorrhage.Methods One hundred and twenty-eight healthy adult male Wister rats were randomized to normal, model, electroacupuncture and music electroacupuncture groups. In each group, four time points of 6 hrs, 24 hrs, 3 days and 7 days were set up, eight rats each time point. A rat model of acute cerebral hemorrhage was made using collagenase. In the electroacupuncture and music electroacupuncture groups, point Baihui was connected to the anode and point Taiyang to the cathode, 2 voltage was used as a selection parameter and electroacupuncture lasted 30 min. Intracerebral perifocal ferric ions and neuronal apoptosis and the brain water content were measured at four time points of 6 hrs, 24 hrs, 3 days and 7 days after model making.Results Intracerebral ferric ion content was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrsafter model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 24 hrs, 3 and 7 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 3 and 7 days after model making (P<0.05). Intracerebral neuronal apoptosis was higher in the model, electroacupuncture and music electroacupuncture groups of rats than in the normal group at 6 hrs after model making (P<0.05) and lower in the music electroacupuncture group than in the electro- acupuncture group at 7 days after model making (P<0.05). The brain water content was higher in the model, electro- cupuncture and music electroacupuncture groups of rats than in the normal group at 6 and 24 hrs after model making (P<0.05), lower in the electroacupuncture and music electroacupuncture groups than in the model group at 3 days after model making (P<0.05) and lower in the music electroacupuncture group than in the electroacupuncture group at 7 days after model making (P<0.05).Conclusions Music electroacupuncture has a benign regulating effect on intracerebral perifocal ferric ions, inhibits neuronal apoptosis around hematoma in the early stage and reduces cerebral edema in rats with acute cerebral hemorrhage. Its therapeutic effect is superior to that of electroacupuncture.

Objective To investigate the relationship between different expression of gastrocolic omentum visfatin (VF) mRNA and gestational diabetes mellitus (GDM) in late trimester pregnancy. Methods One hundred cases of pregnant women in late trimester were divided into two groups, including 45 GDM women( GDM group) and 55 normal glucose tolerance women( NGT group). Semi-quantitative RT-PCR was applied to determine the expression of VF mRNA in gastrocolie omentum. Fast-blood glucose, insulin,cholesterol(TC) and triglyceride (TG) levels were measured. The progestational body mass index(BMI) and the homeostasis model assessment(HOMA) insulin resistance(IR) were calculated in these cases. Results The expression of gastrocolic omentum VF mRNA in GDM group and NGT group were 0.8 ±0.4,0.5±0.3. Fast-blood glucose levels were(4.12±0.14),(3.65±0.13) mmol/L. Insulin levels were (72±5) ,(61±5) pmo]/L TG levels were (5.6±0.3), (3.8±0.3) mmol/L TC levels were(5.6±0.9 ), (3.9±0.3) mmol/L HOMA-IR were 12.5±5.9,9.5±0.8. The progestatianal BMIs were(22.6±0.8), (20.9±0.4) kg/m2. All the indices in the GDM group were significantly higher than NGT group (P<0.05). Furthermore, the expression of gastrocolic omentum VF mRNA had a positive correlation with BMI (r=0.32, P<0.01), but had no association with insulin resistance or metabolic parameters. Conclusion The experiment demonstrates that different expression of VF mRNA has a strong correlation with GDM and obesity.

Objective To investigate the effect of endovascular cooling on perioperative brain injury in patients undergoing intracranial aneurysm resection.Methods Sixteen Hunt-Hess Ⅱ -Ⅳ patients of both sexes aged 18-64 yr undergoing intracranial aneurysm resection were randomly divided into 2 groups(n = 8 each): mild hypothermia group(group MHT)and nonnothermia group(group NT).A CL-2295AE catheter was placed in the femoral vein after anesthesia induction to perform endovascular cooling.Bladder temperature was reduced to 34 ℃ and maintained for 24 h.The hemodynamic parameters were recorded during and after operation.Coagulantion function and electrolyte levels were determined at 24 h before operation and at 12 and 24 h after operation.The serum neuron-specific enolase(NSE)and S100B concentrations were determined at 1 d before operation and at 1,3and 7 d after operation by ELISA.Neurological function was assessed with GOS grade at 1 and 3 months after operation.Results There was no significant difference in hemodynamic parameters,electrolyte levels(Na+ ,K+ ,Ca2+)and coagulantion function(PT,APTT,Plt)between the two groups(P ＞ 0.05).The GOS grade was significantly higher,while serum NSE and S100B concentrations were significantly lower after operation in group MHT than in group NT(P ＜ 0.05).Conclusion Endovascular cooling(34℃,24 h)can reduce the brain injury safely and effectively during the perioperative period in patients undergoing intracranial aneurysm resection and improve the prognosis.

Objectives In order to evaluate the clinical effect of manipulation combined with traditional Chinese medicine for the lateral epicondylitis.Methods A total of 150 patients with lateral epicondylitis were randomly divided into two groups, 75 patients in each group. The treatment group received manipulation combined with the TCM herbal bathing decoction, and the control group received the shock wave therapy and TCM herbal bathing decoction. Two groups were treated for 3 months. The SF-McGill scale, VAS, PPI, PRI were measured, and the clinical curative effect rate was assessed after treatment.Results The total effective rate of the treatment group was 92.0% (69/75), and the control group was 80.0% (60/75). There was statistical significant difference between two groups (χ2=8.339,P=0.039). The SF-McGill pain questionnaire scores, after treatment (26.3 ± 9.9vs. 29.4 ± 8.8, t=-4.183), one month after treatment (20.5 ± 7.7vs. 25.6 ± 6.9, t=-3.954), and 3 months after treatment (14.4 ± 8.0vs. 18.3 ± 6.7,t=-4.031) in the treatment group were significantly lower than those in the control group (P<0.05). The VAS scores after treatment (4.9 ± 1.4vs. 5.8 ± 1.3,t=-4.631), one month after treatment (3.0 ± 1.0vs. 4.1±1.2,t=-3.752), and three months after treatment (2.3 ± 1.0vs. 3.0 ± 1.3,t=-4.350) in the treatment group were significantly lower than those in the control group  (P<0.05). The PPI score after treatment (2.4 ± 0.6vs. 3.1 ± 0.5,t=-7.528), one month after treatment (1.8 ± 0.6 vs. 2.5 ± 0.7,t=-6.630), and 3 months after treatment (1.1 ± 0.4vs. 1.9 ± 0.7,t=-3.425) in the treatment group were significantly lower than those in the control group (P<0.05). The PRI score after treatment (19.5 ± 8.0vs. 22.3 ± 5.7,t=-3.574), one month after treatment (13.7 ± 4.7vs. 17.3 ± 5.3,t=-3.985), and three months after treatment (9.3 ± 6.6vs. 12.5 ± 4.8,t=-1.270) in the treatment group were significantly lower than those in the control group (P<0.05).Conclusions The Manipulation combined with traditional Chinese medicine bathing therapy can relief the symptoms of lateral epicondylitis, and improve the clinical curative effect.

Objective To observe the neural protective subsidiary effect of Wenyang Yiqi method on patients with severe traumatic brain injury under mild hypothermia therapy.Methods A prospective study was conducted in which 53 patients with severe traumatic brain injury treated by mild hypothermia were randomly divided into control group (26 cases) and observation group (27 cases). All the patients in the two groups received conventional western treatment combined with mild hypothermia therapy. In the observation group, additionally was given the representative drug of Wenyang Yiqi method, Shenfu injection 100 mL mixed into 5% glucose 500 mL intravenous drip once a day. At the end of mild hypothermia, the Shenfu injection was stopped. After treatment, the changes of intracranial pressure (ICP) on 1 (the day the treatment began), 2, 3, 4, 5, 6 and 7 days and the indexes levels, including S-100B, lactate dehydrogenase (LDH) and creatinkinase (CK) in the cranial spinal fluid (CSF) before treatment and 2, 4, 6 days after treament (CSF) were observed. The Glasgow coma score (GCS) before treament and 3, 5, 7, 14, 28 days after treament, and Glasgow outcome scale (GOS) on 28 days and 3 months after treatment were recorded, and the incidences of complications were calculated at the end of therapy.Results After treatment with the prolongation of therapeutic time, the levels of ICP were gradually increased in two groups and reached the peak values on the 4th day, then beganto fall, and on the 5th day it was significantly lower in observation group than that in control group [ICP (mmHg, 1 mmHg = 0.133 kPa): 16.11±1.23 vs. 18.73±1.42], persisting the same situation to the 7th day (14.17±0.80 vs. 16.94±1.00,P < 0.05). The levels of S-100 B in the two groups were progressively decreased after the treatment, on the 2nd day it was significantly lower in observation group than that in control group (μg/L: 1.21±0.43 vs. 1.86±0.57, P < 0.05), also persisting to the 6th day (0.40±0.09 vs. 0.94±0.15,P < 0.05); the levels of LDH and CK reached the peak values on the 2nd day, then began to fall, they were significantly lower in the observation group than those in the control group on the 4th day [LDH (U/L): 63.43±12.21 vs. 80.11±14.34, CK (U/L): 52.41±14.14 vs. 88.37±12.21, bothP < 0.05], and on the 6th day still there were statistically significant differences between the two groups. The GCS before treatment showed no statistically significant difference between the two groups (P > 0.05); after treatment, the GCS score of the two groups was progressively improved, and on the 14th day the score in the observation group began significantly higher than that in the control group (11.74±1.24 vs. 9.41±2.11,P < 0.05), persisting the same situation to the 28th day (12.68±2.51 vs. 10.67±1.99,P < 0.05). On the 28th day after treatment, the GOS showed no statistically significant difference between the two groups (2.35±0.16 vs. 2.43±0.22,P > 0.05), but the score in the observation group was significantly higher than that in the control group after treatment for 3 months (4.11±0.38 vs. 3.72±0.41, P < 0.05). The incidences of complications in the observation group were significantly lower than those in the control group [respiratory failure: 25.9% (7/27) vs. 50.0% (13/26), shock: 18.5% (5/27) vs. 53.8% (14/26), acute pulmonary edema: 14.8% (4/27) vs. 30.8% (8/26), stress ulcer: 22.2% (6/27) vs. 57.7% (15/26), hypoproteinemia: 40.7% (11/27) vs. 73.1% (19/26), allP < 0.05].Conclusion Wenyang Yiqi method has the subsidiary neural protective effect on patients with severe traumatic brain injury treated by mild hypothermia, and can improve their outcome.