Objective To summarize the experience of prevention and treatment of cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH). Methods Fifty-eight cases with aneurysmal SAH were taken as study objects and their clinical data were retrospectively analyzed. All the patients with intracranial aneurysm undergoing Guglielmi detachable coils (GDC) or mechanical detachable coils (MDC)embolization were treated comprehensively by papaverine solution lavage in surgical field during intracranial aneurysm surgery,lumbar continued drainage of cerebrospinal fluid, nimodipine infusion continuously and blood pressure increasing,blood volume improving,blood diluting (3H) therapy after operation. Results Among the total 58 cases of SAH, 8 patients occurred cerebral vasoapasm ( 13.8%),mainly included 4 cases of transient paralysis,2 cases of unconsciousness dcepened,2 cases of transient aphasia,after active treatment,the motor function, disturbance of consciousness and language functions all restored with none in plant state or died. Conclusion Detachable coil embolization underwent in earlier period and then drained cerebrospinal fluid, infusioned nimodipine, taken 3H therapy and so on are the effective measures for preventing and treating cerebral vasospasm after SAH.

Objective To explorer effect of integrated traditional chinese and western medicine on hyperthyroidism and on blood glucose metabolism disorder. Methods 70 cases of patients with hyperthyroidism during March 2014 to March 2016 were randomly divided into two groups with 35 cases respectively ,and control group were treated with propylthiouracil,while observation group were treated with traditional chinese medicine on the basis of the control group.Before and after treatment,serum thyroid stimulating hormone(TSH), triiodothyronine(FT3), thyroxine(FT4 ) and fasting plasma glucose (FPG) , 2 hours postprandial blood glucose(2hPG)were detected respectively,the curative effect and adverse reactions were observed. Results After treatment,the levels of TSH,FT3 and FT4 of the both two groups were significantly ameliorative (P<0.05),and FT3 ,FT4 of the observation group were significantly more ameliorative than the control group (P<0.05).The levels of FPG,2hPG of two groups were significantly depressed (P<0.05),and those of the observation group were significantly lower than those of the control group (P<0.05).The clinical effective rate of the observation group was significantly higher than those of the control group (P<0.05).Adverse reactions of two groups were not significantly different. Conclusion The treatment of hyperthyroidism with traditional chinese and western medicine can significantly improve the clinical curative effect and regulate the blood glucose metabolism, and the safety is high.

Objective To explore the risk factors of hyponatremia in postoperative patients with aneurysm and analyze the clinical characterstics in order to provide reference for clinic.Methods Participants included 120 patients who treated by aneurysm occlusion.Detailed recorded the patient's history and basic information.The patients with hyponatremia were in case group,and other patients were in control group.The risk factors of hyponatremia were analyzed.Results Forty-five patients (37.5％) occurred hyponatremia after operation.The level of natrium was (125.2 ± 10.1) mmol/L,the average time of appear hyponatremia was (8.2 ± 0.8) d,15 patients were in the first peak(postoperative 1-3 d),25 patients were in the second peak (postoperative 8-9 d),5 patients occurred hyponatremia at other time.Thirty-nine patients were internal carotid artery aneurysms,6 patients were vertebrobasilar artery aneurysms.Single factor analysis showed that the age,preoperative GCS scores,history of hypertension and diabetes,emergency operation,the size of arterial aneurysms,medium-sized aneurysm of artery between two groups had significant difference [(48.7 ± 8.4) years vs.(54.7 ± 8.4) years,(14.4 ± 3.1) scores vs.(10.3 ± 3.4)scores,26.7％ (20/75) vs.60.0％ (27/45),33.3％ (25/75) vs.62.2％ (28/45),32.0％ (24/75) vs.62.2％(28/45),(0.9 ±0.3) cm vs.(1.4 ±0.4) cm,24.0％(18/75) vs.42.2％(19/45),P ＜ 0.01 or ＜ 0.05].Multifactors regression analysis showed that preoperative GCS scores,emergency operation were the independent risk factors of hyponatremia (P＜ 0.05).Conclusions Postoperative 1-3 d and 8-9 d are the peak stage of hyponatremia.Different treatment should be adopted according the peak stage.Lower scores of preoperative GCS and emergency operation are the independent risk factors of hyponatremia.Clinical work need to pay more attention to the risk factors,appropriate treatment and prevention.

ObjectiveTo investigate the role of electroencephalogram (EEG) examination in the prognosis evaluation of patients with severe craniocerebral injury.MethodsFifty-seven patients with severe craniocerebral injury were selected as study subjects and their clinical data were analyzed retrospectively.All the patients got EEG examination,and the relationships between EEG grading and Glasgow coma scale (GCS) score,the prognosis of outcome were analyzed.ResultsThe EEG of 57 patients within 24 h after hospitalization were all abnormal.There was significantly negative correlation between EEG grading and GCS score (r =-0.742,P ＜0.05).EEG grading was significantly positively correlated with the prognosis of outcome (r =0.730,P＜ 0.05).ConclusionsEEG examination and EEG grading can evaluate the prognosis of patients with severe craniocerebral injury.It provides reference for clinical treatments.

Objective To investigate the clinical efficacy of S-1 combined with cisplatin in the treatment of old patients with advanced gastric cancer.Methods 85 patients were randomly divided into two groups.Experimental group was treated by S-1 combined with cisplatin,while control group was treated by 5-FU and cisplatin.Short-term efficacy and adverse reactions were evaluated after four cycles.Results All patients had succcssfully accomplished chemotherapy.Compared with the control group ( RR =52.4％,DCR =81.0％ ),RR and DCR in experimental group ( RR =67.4％,DCR =93.0％ ) had statistically significant difference ( P ＜ 0.05 ).The top three of adverse reactions and complications in patients of the two groups were:nausea and vomiting,low WBC,low hemoglobin concentration.Compared with the control group,the toxicity in experimental group had no statistically significant difference ( P ＞0.05).All patients were followed up with a meau of( 15.5 - 2.7 ) months.The 1 year survival rate was 60.5％(26/43) in the experimental group; the 1 year survival rate was 52.4％ (21/42) in the control group.There was no statistically significant difference( P ＞ 0.05 ).Conclusion The S-1 combined with cisplatin had shown better efficacy in the treatment of old patients with advanced gastric carcinoma,and the toxicity was relatively mild and tolerable.

Objective To explore the efficacy of fast-track surgery (FTS) combined with standard rehabilitation program (HSS) in elderly patients undergoing total hip arthroplasty (THA).Methods Ninety elderly patients with femoral neck fracture were randomly assigned to receive either FZS plus HSS Tehabilitation program (experimental group,n =45) or HSS rehabilitation program (control group,n =45) after THA from December 2013 to December 2014 in our hospital.The experimental group had 23 men and 22 women,with an average age of 68.2 ± 3.7 years.The control group had 22 men and 23 women,with an average age of 70.6 ± 4.1 years.Harris score and visual analogue scale (VAS) were used to assess the hip joint function before operation,4,8 and 14 weeks after operation.The complications were compared between the 2 groups at 14 weeks after operation.Results All the patients completed a 14-week follow-up.There were no significant differences in Harris and VAS scores at pre-operation between the 2 groups (P ＞ 0.05).At 4,8 and 14 weeks after operation,the Harris scores in the experimental group (67.2 ±3.5,88.3 ±2.5and 92.5±3.3) were significantly higher than those in the control group (52.5±7.8,65.8±4.9 and 72.2±4.9) and the VAS scores in the experimental group (3.4±0.8,2.2±0.8 and 1.3±0.5) were significantly lower than those in the control group (5.6 ±0.9,4.2 ±0.8 and 2.9 ±0.8) (P ＞ 0.05).There were no complications in the experiment group while there were 14 complications (31.1％) in the control group,showing a significant difference (P ＜ 0.05).Conclusion FTS combined with HSS standardized rehabilitation can effectively reduce the incidence of complications and accelerate the functional recovery of hip joint in elderly patients after THA.

Objective To evaluate the impact of preoperative renal artery embolization in renal cell carcinoma patients with venous tumor thrombus.Methods A total of 249 RCC patients with venous tumor thrombus underwent radical nephrectomy and thrombectormy in our hospital.Seventy-four patients received preoperative renal artery embolization while other 175 patients did not.The related items were analyzed.The tumor thrombus level was divided into 5 groups with American Mayo clinic classification system.Considering the significant difference in tumor situation and treatment strategies, we took the hepatic vein as a cut-off line, dividing patients into two subgroups, the early and advanced tumor thrombus groups.There were 208 patients in the early tumor thrombus group and 41 patients in the advanced group.The related items were analyzed respectively.Results Patients in the embolization group tended to have larger tumors and higher percentage of advanced tumor thrombus.For all patients, the embolization group had longer operation time [(4.8 ±2.1) h vs.(4.1 ±2.2) h ,P <0.05] and greater median blood loss (900ml vs 500 ml,P <0.05), compared to the non-embolization patients, and RAE did not show benefits on perioperative outcomes seemingly.However, subgroup analysis of patients with advanced tumor thrombus ( above hepatic vein) , in spite of the larger size of tumor, preoperative RAE showed significant benefits on reducing operation time [(7.0 ±1.7)h vs.(8.2 ±1.8)h, P<0.05)] and intraoperative blood loss (2 000 ml vs.3 000 ml, P<0.05) and decreasing blood transfusion (1 525 ml vs.2 050 ml ,P>0.05).Conclusion Preoperative RAE may be more appropriate for patients with advanced tumor thrombus because of its benefits in reducing operation time, intraoperative blood loss and elevating the operative security.

AIM: To observe the changes in expression and activity of the transcription factor myocyte enhancer factor 2A (MEF2A) during hepatic stellate cells (HSC) activation, and to study the roles of MEF2A in the process of HSC activation. METHODS: Cultured HSC was isolated from male sprague-dawley rat liver on plastic dishes and were used as model of activation. The freshly isolated (0 day) and cultured HSC at time points of 1st, 2nd, 3rd, 4th, 5th, 6th, 7th and 8th day were collected. Expression of MEF2A mRNA was detected by real-time quantitative PCR. MEF2A and α-smooth muscle actin (α-SMA, a marker for activated HSC) were tested by Western blotting. Meanwhile, the MEF2A DNA binding activity was determined by electrophoretic mobility shift assays (EMSA). RESULTS: The expression of MEF2A mRNA was small amounts in the freshly isolated HSC and increased gradually after culture on plastic dishes. Western blotting revealed that the freshly isolated HSC expressed very low levels of MEF2A and α-SMA. The proteins of MEF2A and α-SMA were increased gradually in the process of HSC activation. Increased MEF2A protein was correlated with α-SMA. EMSA revealed that MEF2A DNA binding activity was increased gradually during HSC activation. CONCLUSION: In the process of HSC activation, expression and activity of MEF2A are increased gradually, indicating a role in HSC activation.

Objective To investigate the dynamical changes of Rho kinase in the cerebrospinal fluid (CSF) and its relationship with cerebral vascular spasm CVS. Methods CSF were collected on the ist, 3rd, 7th, 10th and 14th day after subarachnoid hemorrhage. The expression of Rho-kinase mRNA in CSF was determined by RT-PCR. The expression of endothelin-1 in CSF was determined by radioimmuno-assay. TCD was used to measure the velocity of the cerebral artery. Results The levels of ET-1 and Rho-kinase mRNA in CSF were re-markably increased on the 3rd day, and reached at the peak on the 7th day after subarachnoid hemorrhage, which were significantly higher than those without CVS. Conclusion There is a positive correlation between the level of Rho-kinase mRNA and ET-1 in CSF. Rho-kinase may participate in the development of CVS.

Objective To investigate the protective effect of total flavonoids of Salvia divinorum extract against acetaminophen(APAP)-induced acute liver injury(ALI)and its molecular mechanism.Methods The main chemical constituents of total flavonoids of Salvia divinorum were obtained through literature search,and their pharmacological mechanisms were predicted using bioinformatics analysis.In a mouse model of APAP-induced ALI,the protective effects of 100,200 and 400 mg/kg total flavonoids of Salvia miltiorrhiza and 150 mg/kg bifidus were evaluated by observing changes in blood biochemistry and liver histopathology and detecting expressions of the key proteins in the Nrf2/HO-1 signaling pathway.Results Network pharmacology analysis suggested that the main active components in total flavonoids of Salvia divinorum for regulating APAP-induced liver injury included quercetin,lignocerol,caruric acid,and kaempferol,for which GO function enrichment analysis yielded 632 GO entries,including 472 involving biological processes,42 involving cellular composition,and 118 involving molecular function.KEGG enrichment analysis showed that the total flavonoids of Salvia divinorum regulated APAP-induced liver injury mainly through ferroptosis-related signaling pathway.In mice with APAP-induced ALI,treatment with the total flavonoids significantly lowered ALT and AST levels,improved liver histopathology and inflammatory cell infiltration,reduced iron deposition in liver tissues,improved lipid peroxidation-related indexes,promoted the expressions of Nrf2,HO-1,SLC7A11,and GPX-4 proteins,and inhibited the expression of keap1 protein.Conclusion The total flavonoids of Salvia divinorum alleviate APAP-induced ALI in mice possibly by suppressing hepatocyte ferroptosis via activating the Nrf2/SLC7A11/GPX-4 signaling pathway.