Objective To detect the expression of the tryptase in the plasma,and study the meaning in brain traumatic patients.Methods There were two groups:the brain traumatic group(40 patients)and the control group (20 health people).The content of plasma tryptase was determined by fluorescence enzyme immunoassay..Results The level of plasma tryptase had no statistical significance in control group(2.97 ±1.05)μg/L compared with the brain traumatic group(3.03 ±1.39)μg/L,however there had statistical significance comparing with sever brain traumatic patients(3.84 ±0.52μg/L)(t =3.32,P <0.05).4 cases of death in patients with severe head injury group content of tryptase (5.85 ±1.05)μg/L,which was significantly higher than the group of 16 cases of injury in severe head injury after 2 months still alive with the content of serum tryptase (2.49 ±0.52)μg/L,the difference was statistically significant (t =8.13,P <0.01).Conclusion The plasma tryptase level in sever brain traumatic patients increased significantly,and might be of importance for treatment strategies and prognosis.

Objective To compare the advantages and disadvantages of non-irrigation and irrigation in the surgical approach of chronic subdural hematoma (CSDH),thus to provide reference for clinical treatment of CSDH.Methods Clinical data of 102 patients with CSDH were retrospectively analyzed.According to the different operation methods,the patients were divided into the non-irrigation group(52 cases) and the irrigation group(50 cases).The blood loss during the procedure,operative time,length of stay and postoperative complication rate between the two groups were compared,and the causes of postoperative complications were analyzed.Results The blood loss during the procedure,operative time and length of stay in the non-irrigation group were (6.73 ± 1.17) mL,(15.06 ± 2.64) min and (10.74 ± 2.20) d,respectively,which in the irrigation group were (19.52 ± 3.18) mL,(38.54 ± 6.95) min and (10.44 ± 2.07)d,respectively,there were statistically significant differences between the two groups in the blood loss during the procedure and the operative time (t =-27.11,-22.72,all P ＜ 0.05),there was no statistically significant difference between the two groups in the length of stay (t =0.70,P ＞ 0.05).The incidence rates of postoperative complication in the non-irrigation group and irrigation group were 8.00％ and 7.69％,respectively,there was no significant difference between the two groups (x2 =0.003,P ＞ 0.05).Conclusion Each of the two methods has its own advantages and disadvantages in the treatment of CSDH.Compared with burr hole irrigation,burr hole non irrigation has the advantages of less blood loss and shorter operative time.However,burr hole non-irrigation is more likely to suffer serious complication.We should select suitable surgical approach by the specific circumstances of the patients.The causes of postoperative complications of CSDH are varied.In particular,there is an important relationship between the non-standard operation and postoperative complications.

Objective To explore the association between infant breastfeeding and cognition and behavior development in school age children.Methods Five hundred and eighty-one children aged 7-11 years old from two schools in Ningyang of Tai′an.Their cognition and beha-vior development during school age were assessed by Ravin's standard progressive matrices and child behavior check list(CBCL).Their feeding conditions during infant period,family environment,education level of parents,et al,were investigated with self-made inventory questionnaire.Association between infant breastfeeding types,duration of breastfeeding and cognition,behavior development were analyzed.Results The single factor analysis showed the scores of perceptual distinction,similarity,and Abstract thought in children who were only breast fed before 4 months were higher than those of controls for male children(Pa

Objective To investigate the median effective plasma target concentration of propo-fol (Cp50 )needed for lumbar surgery during inhalation-intravenous balanced anesthesia when BIS is 50.Methods Patients aged 40-56 years,scheduled for vertebral pulp ectomy were included.Anesthe-sia were maintained by TCI of propofol,sevoflurane 0.5 MAC,remifentanyl 0.2 μg·kg-1 ·min-1 , and vecuronium 0.08 mg·kg-1 ·h-1 .The target plasma concentration of propofol was initially set at 1.8 μg/ml,and adjusted by the sequential up-and-down methods,based on BIS index.The Cp50 of propofol and its 95% confidence interval (CI)were calculated.Results Twenty-six patients were en-rolled in this study.The median effective plasma target concentration of propofol was 1.61 μg/ml (95%CI 1.52-1.70)μg/ml.Conclusion The Cp50 of propofol needed for maintaining the BIS index of 50 is 1.61 μg/ml during the anesthesia with 0.5 MAC of sevoflurane combined with remifentanyl in lumbar surgery.

Objective:To investigate the changes and significances of serum cystatin C and transforming growth factor-β1 levels for the neonatal asphyxia.Methods:Forty-six asphyxia newborns were chosen as the asphyxia group,and thirty healthy newborns were selected as the control group.The TGF-β1,CysC,BUN,Scr,and GFR levels of both groups were detected on the 1st,3rd,7th day after hospitalization.According to the renal injury,the 46 newborns were divided into normal group and asphyxia group,and the serum indexes were detected and analyzed.Results:On the 1st,3rd,7th day after hospitalization,the TGF-β1,GFR of asphyxia group was obviously increased and was lower than those of the control group (P＜0.05);the level of CysC,BUN,Scr in both groups were decreased,and the change degree in asphyxia group were higher than that of the control group (P＜0.05);the CysC,BUN,Scr in renal injured group were higher than those of normal group,and TGF-β1,GFR were much lower (P＜0.05).Additionally,TGF-β1 level of renal injured group was negatively correlated to the BUN and Scr,and positively correlated with the GFR (P＜0.05).The level of serum CysC in renal injured group was positively correlated to BUN and Scr and negatively correlated to GFR (P＜0.05).Conclusion:The serum TGF-β1,CysC in asphyxia newborns had significant changes compared with the healthy newborns and was correlated to the renal injured indexes,which had clinical directive significance on the early diagnosis,condition judgment,and prognosis of neonatal asphyxia with renal injury.

Objective To discuss the diagnosis and treatment of inflammatory granuloma in central nervous system(CNS)to provide reference for clinic.Methods Retrospective data included 8 patients with CNS inflammatory granuloma in Department of Neurosurgery,Shanxi People's Hospital,2012 -2015.We analyzed the imaging features, postoperative symptoms,blood and cerebrospinal fluid changes and prognosis.Results 8 cases all received surgical treatment.All the symptoms were improved,and the CT showed that the lesions were disappeared.All the patients had recovered to normal life and work.Conclusion The diagnosis of CNS inflammatory granuloma is difficult.Clinical manifestations are lack of specificity.The blood and cerebrospinal fluid laboratory examination have no abnormal changes.CT and MRI are the main diagnostic methods.Postoperative pathology is the gold standard for diagnosis.The large lesion,frequent episodes of epilepsy,severe neurological deficits and possibility of brain tumor all should be treated by surgery.

Chemical and Drug Induced Liver Injury ; Humans ; Liver Diseases ; diagnosis ; therapy

Brown-Sequard Syndrome ; etiology ; Cervical Vertebrae ; Humans ; Intervertebral Disc Displacement ; complications ; surgery ; Male ; Middle Aged

Objective To investigate the operation process,extent of resection,protection function,the tumor recurrence and clicical value of neuronavigation with intraoperative ultrasound for treating functional glioma;signifi-cance of intraoperative ultrasound for correcting brain shift.Methods We analyzed the cliclical materical of 24 case of functional gliomas which were resected by neuronavigation with intraoperative ultrasound.Results The accuracy of localization of functional glioma was 100%.The distance of brain shift was 2 to 10mm,with an average 4.7mm.After 24 hours MRI confirmed that total removal of function glioma was achieved in 21 cases,subtotal in 3 cases.After oper-ation function improve was 20 cases,invalid of 2 cases,hemiplegia happened in 2 cases and no death in all the patients.Conclusion Neuronavigation with intraoperative ultrasound can correct brain shift and improve the accuracy of localization of functional glioma,to improve extent of function glioma and decrease dysfunction.Neuronavigation with intraoperative ultrasound is important to functional glioma.

Objective To investigate the clinical outcomes in the treatment of complex acetabular fractures through a single supra-ilioinguinal approach after the application of preoperative 3D printing and rapid prototyping simulating the operative procedure.Methods From January 2013 to January 2016,24 cases of complex pelvic and acetabular fractures in our hospital were retrospectively analyzed.Among them 18 cases were male and 6 were female.The average age was 39.2+±13.8 years (range,24-68 years).According to Letoumel-Judet's classification,there were 6 cases of transverse,4 cases of T shaped,4 cases of combined anterior column and posterior hemi-transverse (ACPHT) and 10 cases of 2-column fractures.The time from injured to operation averaged 9 days (range,4-18 days).Before operation,pelvic AP view,three-dimensional CT as well as CTA of iliac blood vessels was taken routinely in all cases.The CT and CTA scan data were then imported into Mimics software for 3D reconstruction.Surgical simulation and optimal placement of internal fixations were performed on computer.After that,the individual simulated model of the pelvis was printed by the use of 3D printing and rapid prototyping technique.The order of reduction,selection and optimal position of the implants were determined.The plates were bent before operation and the length and direction of the screws were recorded.A uniform supra-ilioinguinal approach was used in all cases.Results The length of incision averaged 9 cm (range,8-13 cm).The operative time average 130 min (range,90-220 min).The blood loss averaged 600 ml (range,300-1 500 ml).Once a satisfactory reduction was obtained,single placement of the plates was achieved.In accordance with the preoperative plan,the plates were perfectly fitted to the bone surface.The 24 patients were followed for an average time of 18.3 months (range,15-30 months).The fractures healed in all cases.The average healing time was 4.2 months (range,3-6 months).According to Matta criteria,there were 16 cases of excellent,6 cases of good,2 cases of poor and the excellent rate was 91.7％ (22/24).The average modified Merle d'Aubigne score was 16.5 (range,13-18).The functional outcome was excellent in 13 cases,good in 6 cases and poor in 5 cases.The excellent rate of hip functions was 79.2％ (19/24).There were 2 cases of femoral lateral cutaneous nerve injury (recovered one month later) and another 1 case of fat liquefaction of the incision happened three days postoperatively (the wound healed completely after several dressing changes).No inguinal hernia or abdominal wall hemias was found.No other postoperative complications was found.Conclusion The application of 3D printing and rapid prototyping technique allows preoperatively simulating reduction in vitro,determining the optimal position of the implants,bending the plates and measuring the length of the screws in advance,which could largely reduce the operative time,intraoperative blood loss and occurrence of postoperative complications.Adopting supra-ilioinguinal approach for the treatment of complex acetabular fractures with a small incision and less trauma,a full exposure could be obtained,so the reduction and fixation of the anterior,posterior and middle column (also named pubo-ischiatic column) could be completed in a direct visualization,resulting in a satisfactory clinical outcomes.