ObjectiveToinvestigatetheclinicalfeatures,riskfactorsforbleedingandtreatment outcomes in moyamoya disease patients w ith intracranial aneurysms. Methods The clinical symptoms, location and size of aneurysm, treatment and the long-term folow-up results of the moyamoya disease patients w ith intracranial aneurysms w ere analyzed retrospectively. Results A total of 34 moyamoya disease patients w ith intracranial aneurysms (35 aneurysms) w ere enrol ed, including 22 (64.7%) in the intracranial hemorrhage group and 12 ( 35.3%) in the non-intracranial hemorrhage group. Of the 35 intracranial aneurysms, 23 (main artery type 11, peripheral artery type 12) w ere in the intracranial hemorrhage group and 12 (main artery type 11, peripheral artery type 1) w ere in the non-intracranial hemorrhage group. There w ere 29 smal aneurysms and 6 medium aneurysms (al w ere patients w ith hemorrhagic moyamoya disease). The aneurysms w ere mainly peripheral arterial type in the intracranial hemorrhage group, and the aneurysms w ere mainly artery type in the non-intracranial hemorrhage group. There w as significant difference in aneurysm typing betw een the tw o groups ( P= 0.013 ). Tw o patients did not perform encephalo-duro-arterio-synangiosis (EDAS) in the intracranial hemorrhage group, other patients and those of the non-intracranial hemorrhage group performed EDAS. Angiographical reexamination revealed that 3 patients w ith peripheral aneurysm disappeared, and 1 aneurysm recurred after aneurysm embolization, and the remaining aneurysms did not have any change. Long-term fol ow-up show ed that 1 patient died of sudden cerebral hemorrhage at 1 year after procedure in the intracranial hemorrhage group, and the others did not have ischemic or hemorrhagic stroke. The modified Rankin scale scores w ere improved in 21 patients. Conclusions There are differences in moyamoya disease patients w ith intracranial aneurysm typing w ith different clinical manifestations. Moyamoya disease patients w ith intracranial aneurysms are mostly smal aneurysms and they can not temporarily be treated directly and can perform EDAS directly. Intracranial aneurysms after procedure may remain long-term stability, and some peripheral aneurysms may disappear.

Femurs of 206 Chinese adults (122 males and 84 females) were used for the present study. Their lengths, and torsional and inclinational angles were measured after Martin's method. The results are as follows:1. The Lengths of FemurThe average length of the femur in males is 43.68?2.02 cm. (43.77?2.02 cm. on the left side, and 43.61?2.04 cm. on the right), while that in females is 40.96?2.84 cm. (41.05?2.84 cm. on the left side and 40.93?2.84 cm. on the right). No significant difference has been found between the femoral lengths of both sides; however, there is a significant difference between both sexes.2. The inclinational angles of femoral neckTheir average value in the male is 128.46??6.58?(128.87??6.76?on the left side, and 127.46??6.60? on the right), but that in the female is 130.52??6.44?(130.88??6.10? on the left side, and 130.17??6.80? on the right). No significant difference exists between both sides; however, there is a significant difference between both sexes.3. The Torsional Angles of FemurTheir average value in the male is 11.95??8.89? (14.51??8.08? on the left side, and 9.20??7.75? on the right), whereas that in the female is 12.80??9.07? (15.95??9.63? on the left side, and 9.63??7.31? on the right). There is a significant difference between two sides, but no significant difference between both sexes.4. The relationship between the inclinational and torsional angles on one hand and the changes in the femoral lengths on the other has been studied by dividing the femurs into groups according to their lengths. It has been shown that the changes in the femoral length exert no effect upon the inclinational and torsional angles of the femoral necks, neither in the male nor in the female.Besides, a comparison has also been made between the femurs of both sides and both sexes, between the femoral lengths and the inclinational and torsional angles, and between the variant ranges of the torsional angles of femurs. A discussion on these problems has been made with reference to the racial differences.

Objective To investigate the clinical features and prognosis of patients with moyamoya disease and renal artery stenosis. Methods The clinical data such as the first symptom,intracranial vascular lesions,renal artery lesions,treatment and follow-up results of the 15 patients with moyamoya disease and complicated with renal artery stenosis (RAS group)and the baseline-matched 30 moyamoya diseased patients without renal artery stenosis (MMD group)treated at the Department of Neurosurgery,the 307 th Hospital of People′s Liberation Army from March 2009 to June 2012 were analyzed retrospectively. Results (1)The moyamoya diseased patients with renal artery stenosis accounted for 1. 6%(15 / 927)of the total number of patients with moyamoya disease admitted in the same period. In the RAS group,the left renal artery stenosis accounted for 5 cases,the right renal artery stenosis accounted for 4 cases,and the bilateral renal artery stenosis accounted for 6 cases. Mild stenosis accounted for 71. 4%(15 / 21 sides), proximal stenosis accounted for 85. 7% (18 / 21 sides). The incidence of hypertension (80. 0%,n = 12) of the RAS group was significantly higher than that of the MMD group (30. 0%,n =9). There was significant difference (χ2 = 10. 045,P < 0. 05). There was significant difference in the distribution of Suzuki stage between the patients of the two groups (Z = -6. 184,P <0. 01). (2)Four patients underwent interventional therapy,their blood pressure decreased to normal level after procedure. Three patients were followed up for 9 months to 108 months with angiography after interventional treatment. No restenosis occurred in renal artery.
Conclusion The incidence of hypertension in patients with RAS is significantly higher than that without RAS,and there is difference between the degree of intracranial vascular lesions and the patients without RAS. Renal artery stenosis is mainly the proximal mild stenosis. Interventional therapy is an effective method for the treatment of moyamoya disease with severe renal artery stenosis;however,the long-term prognosis needs to be further followed up.

Purpose To describe clinicopathological features, diagnosis and differential diagnosis of Castleman′s disease. Methods Retrospective analyses of the clinical data, clinicopathology and immunohistochemistry were conducted in ten cases of Castleman dis-ease and reviewed of literature. Results There were 8 cases of unicenrtic Castleman′s disease and 2 cases of multicentric Castleman′s disease. Pathologically, there were 6 cases of hayline vascular types, one case of plasmatcyic type and 3 cases of mixed type in all Castleman′s disease. Immunohistochemically, all cases were negative for BCL-6 and CD10, and Ki-67 expression was less than or e-qual to 30%. There were 4 cases with complete follow-up data, including one case of intermediate type, 3 cases of hyaline vascular type which were healed by surgical resection without recurrence. Conclusions Castleman′s disease is a rare and lymphoproliferative disorders with unknown cause, it is not easy to diagnose before the operation. Whether immunohistochemical features reflect abnormal immune function or play unknown role in the pathogenesis of Castleman′s disease is also demanded further study.

Objective To observe the influences of Bcl-2 expression and pancreatic cancer cell proliferation after downregulating Beclin1 expression and discuss the mechanism.Methods Target interfering plasmid siBeclin1 was constructed and transfected to PANC-1 cell,and cells were divided into non transfected group(Beclin1 group),blank control group(control siNegative group) and transfection group(siBeclin1 group).Western blot and qRT-PCR were used to detect the transfection efficiency and Bcl-2 expression after transfection.Proliferation was detected by MTT.Results Western blot and qRT-PCR results showed that expression of Beclin1 in siBeclin1 group was lower than Beclin1 and siNegative control groups (27.823± 1.432,8.635±1.481,26.904±1.098;F=8.176,P＜0.01),qRT-PCR showed that the Beclin1 mRNA level of PANC-1 cells in siBeclin1 group was lower than Belcin1 and siNegative groups (0.421 ±0.157,0.194±0.104,0.399 ±0.123;F=5.239,P＜0.01),and the silencing rate was about 60％-70％.Bcl-2 protein expression and levels of mRNA in siBeclin1 group were significantly higher than that of Beclin1 group(26.912±1.927,8.004±1.534,t =7.329,P＜0.01;0.582±0.297,0.217±0.186,t =6.835,P＜0.01);MTT results showed that the proliferation of PANC-1 cells were strengthened,(61.54±6.81)％ and (46.78±7.28)％ at 72 h,(76.39±7.26)％ and (54.27±8.17)％ at 96 h,and the difference was significant(t=3.674,P＜0.05;t =10.185,P ＜0.01).Conclusion Proliferation of pancreatic cancer cells are strengthened after Beclin1 expression downregulating,so Beclin1 may inhibit the proliferation of pancreatic cancer cells by Bcl-2 downregulating.Beclin1 can be a target candidate gene of pancreatic cancer therapy.

Objective To investigate the epidemiological characteristics of patients with craniocerebral injury in primary level hospital of Pearl River Delta and provide evidences for developing reasonable prevention and management policy of this disease. Methods The gender,age,injury time,occupation,injury mechanism, injury information,the relation between the craniocerebral injury and the alcohol drink in the 1 898 patients with craniocerebral injury admitted to Changping People's Hospital of Dongguan in Guangdong Province were analyzed with descriptive epidemiological method. Results There were more male cases with craniocerebral injury than in female ones(1 402 cases vs. 496 cases). The major group of craniocerebral injury consisted of patients aged between 20 to 39 years old〔1088 cases(57.32%)〕. The incidence of the injury in productive workers was higher than that of employees in other kinds of work〔57.48%(1 091 cases)vs. 42.52%(807 cases)〕. The incidences of such cases were the highest between March to May〔28.71%(545 cases)〕and in October〔9.69%(184 cases)〕,December〔11.22%(213 cases)〕than those in other months. The peak days of the incidence in a week were Saturday〔392 cases(20.65%)〕and Sunday〔375 cases(19.77%)〕,but the rate of Thursday was the lowest〔201 cases(10.59%)〕. The peak time in a day was between 18 to 24 o'clock〔961 cases(50.63%)〕. Traffic accident was the leading cause of the injury accounting for 52.95%. The incidence of mild to moderate craniocerebral injury(79.98%)was much higher than that of severe and especially severe injury(20.02%). The alcohol drink was bound up with craniocerebral injury. Conclusion The occurrence of craniocerebral injury has certain regularities concerning the respects of patients' gender, age, occupation,injury time,injury mechanism,types of injury,etc and based on the epidemiological characteristics,a proper management policy should be taken to effectively reduce the morbidity of craniocerebral injury.

Objective To analyze and discussed the incidence and clinical feature of the hypocalcemia after parathyroidectomy in patient with primary hyperparathyroidism.Methods Thirty seven patients with primary hyperparathyroidism who were hospitalized at the Department of General Surgery,Second Affiliated Hospital of China Medical University from Jan 2012 to Sep.2016,their clinical data were analyzed retrospectively.Divided in 4 groups by symton,count the incidence of hypocalcemia of each group and hospital stay after operation,analyze and compare the difference of each group,summarize its regularity.SPSS20.0 statistical software was adopted.The results of metering data were indicated by mean and standard deviation,and Kruskal-Wallis group was used to compare the rank.When the sample size was less than 40,the Fisher exact probability method was used for the test,and when the sample size was large,chi-square test was adopted.Results Postoperative hypocalcemia occured in 26 patients in total,the incidence was 70.2％,the average length of hospital stay after parathyroidectomy was 7.2 days;postoperative hypocalcemia occured in 7 patients in bone type group patients,the incidence was 87.5％,the average length of hospital stay after parathyroidectomy was 11.6 days;postoperative hypocalcemia occured in 6 patients in renal type group patients,the incidence was 46.1％,the average length of hospital stay after parathyroidectomy was 5.5 days;postoperative hypocalcemia occured in 10 patients in asymptomatic type group patients,the incidence was 76.9％,the average length of hospital stay after parathyroidectomy was 4.8 days.Mixed type group,digestive system type group and neuropsychiatric type group has 1 patients respectively,and postoperative hypocalcemia occured in all of them.There was statistically significant difference in the incidence of hypocalcemia among bone type group,renal type group and asymptomatic type group (P =0.147),and there was significant difference in the postoperative hospitalization days among groups (x2 =11.202,P =0.004).Conclusions Hypocalcemia is a commom complication after parathyroidectomy in patients with primary hyperparathyroidism.The incidence of hypocalcemia was highest in bone type group,and it has the longest length of hospital stay,so surgeons should be alert to the occurrence of hypocalcemia in bone type patients most.The severity of hypocalcemia on renal and asymptomatic type patients is lower,they can be discharged from the hospital at discretion as early as possible.