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 compare the operative and conservative treatments for senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ using Meta-analysis.Methods A literature search was conducted in PubMed,Embase,Web of Science,Cochrane Library,Wanfang Data and CNKI for studies on senile dens fractures of Anderson-D Alonzo type Ⅱ or Ⅲ from the earliest records through June 2016.The relative studies identified were screened by 2 independent authors.The quality of these articles was evaluated using modified Newcastle-Ottawa scale,and the meta-analysis was conducted using Review Manager 5.3.Results A total of 22 articles were brought into this Meta-analysis.The union rate was significantly higher in the operative group than in the conservative group[OR =0.30,95％ CI(0.20,0.44),P ＜ 0.001];the mortality in the operative group was significantly lower than in the conservative group[OR =0.61,95％ CI (0.39,0.96),P=0.03];the complication rate was similar in both groups[OR=1.09,95％ CI(0.76,1.57),P ＜ 0.46].The heterogeneity of all the 3 indexes was low.In the subgroup analysis,the union rate was significantly higher in posterior operations than in anterior operations or conservative treatments (P ＜ 0.05).Conclusion For the elderly patients with dens fracture of type Ⅱ or Ⅲ who can tolerate surgery,operative treatment may be more suitable because it can lead to much better prognosis.

Objective To evaluate the effects of rehabilitation training according to Brtmnstrom stage on ability of daily life (ADL) and motor function of stroke patients. Methods 120 bemiplegia patients who suf-fered from stroke were randomly divided into the observation group and the control group with 60 cases in each group. Both groups received routine cerebrovascular medicine treatment and routine nursing, the observation group received rehabilitation training according to Brannstrom stage(including body position,simple kinesithera-py,daily life exercise), psychological nursing and health guidance. The motor function and ADL were as-sessed respectively by Brurmstrom assessment and Barthel index before and 4 weeks after training using rank test. Results Brurmstrom stage and ADL of the observation group were better than those of the control group after rehabilitation training. Conclusions Early rehabilitation training according to Bnmnstrom stage can obviously improve the recovery of motor function and ADL as well as life quality of stroke patients.

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.

ObjectiveTo study the clinical effect of YL-1 type hematoma puncture needle in the treatment of basal ganglion region cerebral hemorrhage.MethodsSixty-two patients with hypertensive basal ganglion region cerebral hemorrhage were treated by YL-1 type hematoma puncture needle from January 2007 to May 2011 (minimally invasive punctural evacuation group),of which,60 patients were treated by conservative treatment(conservative treatment group) as control,compared two groups of neural function defect score,hematoma clearance rate on admission,after 3 weeks treatment,and quality of life after 6 months.ResultsNeural function defect score on admission of minimally invasive punctural evacuation group was (23.6 ± 18.4) scores,while (23.4 ± 17.8) scores in conservative treatment group,the difference was not statistically significant(P ＞ 0.05).After 3 weeks' treatment,neural function defect score and hematoma clearance rate of minimally invasive punctural evacuation group was superior to conservative treatment group [ (14.6 ± 12.4) scores vs.(20.1 ± 18.4) scores,(92.3 ± 5.4)％ vs.(79.5 ± 13.8)％ ] (P ＜0.05 ).After 6 months' treatment,the good rate of quality of life in minimally invasive punctural evacuation group was 81.7％(49/60),which was significantly increased compared with that of conservative treatment group [67.2％ (39/58)] (P ＜ 0.05).ConclusionsThe minimally invasive punctural evacuation in the treatment of basal ganglion region cerebral hemorrhage has small invasion,better prognosis,effective and fast decompression of intracranial hematoma,reducing disability rates,improvement of the quality of life,which could be a beneficial complement for traditional therapies.

ObjectiveTo explore the regulation of claudin-4 expression in endometrial adenocarcinoma cell lines by progesterone.Methods Ishikawa cells were treated with various concentrations of megestrol acetate (MA:2,5,10,15,20 mg/L).After cultured for 24,48 and 72 hours,cells growth were measured by methyl thiazolyl tetrazolium (MTT).The group of Ishikawa cells incubated with MA at the 50％ inhibitory concentration ( IC50 ) was selected for cell apoptosis assay by using transmission electron microscopy and flow cytometry method.Real-time PCR and western blot were used for detecting the mRNA and protein expression levels of claudin-4.The localization of claudin-4 was examined by immunofluorescent staining.Results The inhibitory effects of megestrol acetate on the growth of Ishikawa cells were dosedependent and time-dependent.IC50 of MA on Ishikawa cells was 15 mg/L after incubated for 72 hours.After MA treatment,Ishikawa cells showed shrinkage,nuclear chromatin condensation,fractures of nuclear membrane and endoplasmic reticulum expansion,even round apoptotic bodies were found.The apoptosis rate of cells before MA treatment was (0.076 ±0.024)％,and the rate was (3.934 ±0.816)％ by MA treated for 72 hours,in which there were signicant difference( P ＜ 0.05 ).The relative quantification of claudin-4 mRNA and protein of the cells before MA treatment were 0.64 ± 0.20 and 0.94 ± 0.18,while they were 0.47 -0.15 and 0.62 ±0.15 after MA treated.The expression of claudin-4 was significantly decreased after MA treatment ( P ＜ 0.05 ).The localization of claudin-4 transferred from cytomembrane to cytoplasm and nucleus after MA treatment.Conclusions MA could inhibite the growth of Ishikawa cells,in which the mechanism may be decrease the expression of claudin-4 and the apoptosis of cells.The distribution change of claudin-4 may be related to the anti-cancer effect of progesterone.

BACKGROUND: Adriamycin is anthracycline-based drugs of anti-cancer and inhibits many malignant tumors. But due to the large toxicity, it will induce dose-dependent cardiac toxicity, resulting in heart failure in severe case. Compound huangjing oral lipid is against the injury of free radial and is expected to be applied as an assistant therapy for heart failure.OBJECTIVE: To probe into the therapeutic effect of compound huangjing oral lipid and its mechanism on heart failure.DESIGN: Randomized controlled observation was designed.SETTING: Department of Traditional Chinese Medicine , First Affiliated Hospital of Fujian University of Medical Science, Fujian College of Traditional Chinese Medicine.MATERIALS: The experiment was performed in Fujian Research Institute of Hypertension from August 2000 to May 2001, in which, 66 rats were employed and randomized into 6 groups, 11 rats in each one.METHODS: In normal group, physiological saline of equal volume was injected abdominally. In adriamycin group, adriamycin 1mg/kg was injected abdominally on the 2nd and 4th days after experiment, 2 mg/kg was injected on the 6th and 8th days, 3 mg/kg was on the 10th and 12th days and 4 mg/kg was on the 14th and 16th days. The dose was accumulated up to 20 mg/kg in 16 days. In adriamycin+compound huangjing oral liquid 2 mL (small-dose group), adriamycin +compound huangjing oral liquid 4 mL (moderate-dose group) and adriamycin+compound huangjing oral liquid 6ml (large-dose group), the oral lipid of various doses was applied for gastric perfusion everyday successively from the beginning of experiment, in which, the dose of adriamycin was same as adriamycin group. In adriamycin+tebonin group (tebonin group), tebonin 450 mg/kg was administrated once every two days, totally for 8 days, in which, the dose of adriamycin was same as adriamycin group.MAIN OUTCOME MEASURES: To observe the changes of Left ventricular weight and body weight (LVW/BW), α-MHC (myosin heavy-chain)and β-MHC.RESULTS: In the whole experiment, of 66 experimental animals, 5 rats in adriamycin group, 4 rats in small-dose group, 2 rats in moderate-dose group, 3 rats in large-dose group were died from obvious congestive heart failure, finally, 47 rats entered result analysis. Compared with normal group, in adriamycin group, α-MHC was reduced by 20.88% (P ＜ 0.01), β-MHC was increased by 50.93% (P ＜ 0.01) and LVW/BW was increased by 33.83% (P ＜ 0.01). After medication, myocardial β-MHC was transformed to α-MHC; compared with adriamycin group, α-MHC in every medical group was increased (P ＜ 0.01), β-MHC was decreased (P ＜ 0.01) and LVW/BW was decreased of different degrees (P ＜ 0.01 or P ＜ 0.05); among the above-changes, the results in moderate group were the best.CONCLUSION: Compound huangjing oral liquid alleviates toxicity of heart failure induced by adriamycin, probably due to the dose-dependence improvement of the oral liquid in myocardial α-MHC transformation.

Objective To study the clinical characteristics and treatment of esophageal injury caused by button battery foreign bodies in children, then improve the diagnosis and management level of this hazardous problem of children. Methods 15 patients with esophageal injury caused by button battery foreign bodies were retrospectively analyzed the clinical characteristics, treatment and prognosis. Results 12 button battery foreign bodies were removed successfully with rigid esophagoscope, 3 with electronic gastroscope. 12 cases occurred serious esophageal lesions, 10 patients were fully recovered after nasal feeding, anti-inflammatory and supporting therapy. Serious complication such as esophageal perforation occurred in 2 cases, one of them occurred tracheo-esophageal fistula. Conclusion Button battery embedded in the esophagus is easy to cause serious esophagus injury, early detection is the key of the management, and its prompt removal is mandatory. Button battery have a distinctive appearance on radiography, chest radiographs can be used as the first choice of diagnosis. The reasonable treatment can obtain better curative results and avoid serious complications according to the course of the disease and esophageal damage degree. Physicians must recognize the hazardous potential and serious implications such as esophageal perforation and tracheo-esophageal fistula.

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 expression profile of macrophage inhibitory factor (MIF) in heart and renal tissues of sepsis mice. Method The sepsis model was established by Cecal ligation and puncture (CLP) in mice. Thirty male BALB/c mice were randomly divided into five groups: sham operation group, the twelfth hour, twenty-forth hour, thirty-sixth and forty-eighth hour group after CLP. MIF mRNA were semiquantitat-ed by the reverse transcription polyraerase chain reaction(RT-PCR), Western Blotting was used for MIF protein. The measured data were analyzed with one-way ANOVA. Results MIF mRNA and protein expressions in heart tissue signifiantly increased at the twelfth hour, peaking at the thirty-sixth hour, and a high level was maintained till the forty-eighth hour after CLP. But in the kidney tissue of models, the content of MIF reached peak at the twenty-forth hour and started to decrease at the forty-eighth hour after CLP. Conclusions The content of MIF in heart and kidney tissues of sepsis models was higher than that in the sham group, especially from the twelfth hour to forty-eighth hour after CLP. It indicates that MIF as a kind of late cytokine might participate in dysfunction of organs in mice with sepsis.