Objective To explore clinical effects of micro-nurosurgical treatment with small craniotomy lateral fissure approach to treat moderate or severe intraceral hemorrhage from putamen.Methods All of 51 patients with moderate or severe intracerebral hemorrhage were subjected to surgical treatment.Scalp incision was approximate the projection of lateral fissure on head,the diameter of the window of bone was about 3cm.The lateral fissure was opened by anatomizing sylvian cistern.After incising the cortex of insular,hemotoma was removed.Results 11 cases were dead,the mortality was 21 57%.The ADL was accepted as a standard means of describing outcome in these patients .2 cases,were subjected to Grade Ⅰ,6 cases for GradeⅡ,15 cases for GradeⅢ,8 cases for Grade Ⅳ,2 cases for Grade Ⅴ.Conclusions There is no significant difference of outcome between small craniotomy and craniotomy.(Lateral fissure approach) Transsylvian route is very directly for deep hemotomas,and brain injury caused by approach also is very light.

OBJECTIVE:To establish the method for the rapid determination of stilbene glycoside in Shouwu pills. METH-ODS:HPLC method was used to determine the content of stilbene glycoside in Shouwu pills(as measured value). The determina-tion was performed on ODS-C18 column with mobile phase consisted of acetonitrile-water(25:75,V/V)at the flow rate of 0.8 mL/min. The detection wavelength was set at 320 nm,and the column temperature was 30 ℃. The sample size was 10 μL. The partial least square method-near infrared diffuse reflectance spectrophotometry was used to establish quantitative calibration model for pre-dicting the content of stilbene glycoside in Shouwu pills. According to measured value,76 calibration set samples and 24 validation set samples were collected. Standard normalization method and first-order derivative method combined with Savitzky-Goly filter method were used for spectrum pretreatment. The optimal band ranged 9000-4150 cm-1,and main component factor was 12. RE-SULTS:The content determination method of stilbene glycoside in Shouwu pills was in line with the requirements. The correlation coefficients,the root-mean-square error of calibration,the root-mean-square error of predication and the root-mean-square error of cross-validation(RMSECV)of the quantitative calibration model were 0.99190,0.0201,0.0236 and 0.07629. There was no sta-tistical significance between predicted value and measured value(P>0.05). CONCLUSIONS:The method is accurate,stable and simple,and can be used for rapid determination of stilbene glycoside in Shouwu pills.

Objective To study influences of magnetic field on behavior of depressive rats under chronic unpredictable mild stress,and possible mechanisms under such phenomena.Methods Thirty-six Wistar rats were divided into model group,magnetic field group and control group (n =12 in each group) according to random number table.The model group and the magnetic field group received CUMS stimulation daily for 5 weeks,while the control group received no any treatment.At the end of the fifth week,rats in the magnetic field group were placed in the center of a magnetic machine (400 mT),and the model group was raised freely for4 weeks.The severity of depressive behaviors,cortisol levels and contents of C-reactive protein in blood and urine sample were tested pre-treatment,at the end of 5 weeks and 9 weeks.Results After 5 weeks,consumption of glucose solution of the control group was higher than the other two groups (P ＜ 0.05).After 5 and 9 weeks,body weights of the magnetic group and the model group were lower than the control group (P ＜ 0.05).At the end of 9 weeks,performance of the magnetic group as indicated by frequency of grid crossing,grooming time and suspending tail test were improved to a significantly greater extent than the other two groups (P ＜ 0.05).In addition,the urine content of cortisol in 24 hours in magnetic field and model groups was higher than the control group at the end of 5 weeks,and the serum level of cortisol in the magnetic field group were significantly higher than the model group at the end of 9 weeks (P ＜ 0.05).Conclusion The 400mT magnetic field can reduce the severity of behavior changes of rats with CUMS-induced depression,which might be attributable to its influence on the cortisol levels in blood and urine.

Objective To detect the osteopontin(OPN)expression in renal tissue of rats with fluorosis and low calcium diet,and study the role of OPN in renal injury of fluorosis.Methods Forty-eight aged 1 month Wistar rats,80-120 g,were randomly divided into 4 groups by 2×2 factorial design(the number of female and male in each group was equal):the control group,high-flluoride group,low-calcium group and low-calcium with high-fluoride group.All rats of the fluorosis groups were fed with feed containing corn exposed to coal-burning from endemic fluorosis areas with high fluoride(100 mg/kg,corn),the other two groups were fed with feed containing coru from nonendemic fluorosis areas(fluoride 5 mg/kg,corn).After 16 weeks,the rats were killed.The change of teeth was examined,and the incidence rate of dental fluorosis was calculated.The expressions of both protein and mRNA of OPN in rat renal tissue were determined by RT-PCR and immunohistochemistry after four-month experimentation.Results The growth of teeth was very well in the control group and the low-calcium group.The two high-fluoride groups showed evident dental fluorosis(100%).The results of immunohistochemistry showed that the OPN protein was localized in renal tubule cytoplasm.The OPN-positive cells from renal tissue were lightly and scatteredly stained in control and low-calcium groups.The OPN-positive cells had deeper color in high-fluoride group and low-calcium with high-fluoride group,widely distributed in the renal tubular epithelial cells.The protein expression of OPN in the two groups exposed to fluoride(168.64±13.21,169.26±8.92)was significantly higher than those of the corresponding control group(145.78±10.26,all P<0.01)and low-calcium group(149.60±16.84,all P<0.01).The mRNA expression of OPN in the two groups exposed to fluoride(1.89±0.37,1.94±0.22)was significantly higher than those of the corresponding control group(1.32±0.26,all P<0.05)and low-calcium group(1.30±0.186,P<0.05),respectively.High fluoride influenced the expression of protein and mRNA of OPN(F=13.821,4.24,all P<0.05).Low calcium did not affect the expression of protein and mRNA of OPN(F=2.164,0.58,all P>0.05).However,high fluoride and low calcium had a cross interaction on the expression of protein and mRNA of OPN(F=6.257,432,all P<0.05).Conclusions Over-dose fluoride enhances the expression of OPN.The higher expression observed in the cases exposed to high fluoride concentration is associated with serious renal injury.OPN may he a potential marker for renal injury in fluorosis.Moreover,over-dose fluoride and low calcium make the renal injury worse,indicating low calcium plays an important part in renal injury by fluoride.

OBJECTIVETo compare the efficacy difference in treatment of myofasical pain syndrome between sparrow-pecking moxibustion and acupuncture at trigger points so as to provide the reference of the effective therapeutic method for myofascial pain syndrome.

METHODSNinety patients were randomized into a sparrow-pecking moxibustion group and an acupuncture group, 45 cases in each one. The trigger points were selected in pain areas in the two groups. In the sparrow-pecking moxibustion group, the sparrow-pecking moxibustion was applied, 30 min in each time. In the acupuncture group, the filiform needles were inserted obliquely at 45 degrees and retained for 40 min in each treatment. The treatment was given once a day and 10 treatments made one session in the two groups. The short-form McGill pain questionnaire was used as the observation index, and the changes in pain rating index (PRI), present pain intensity (PPI) and visual analogue scale (VAS) before and after treatment were used for efficacy assessment.

RESULTSThe results of PRI, PPI and VAS after treatment were reduced apparently as compared with those before treatment in the sparrow-pecking moxibustion group and the acupuncture group (all P<0.001). The differences in PRI, PPI and VAS after treatment were not significant in comparison of the two groups (both P>0.05). The curative and remarkably effective rate was 80.0% (36/45) in the sparrow-pecking moxibustion group, which was better than 40.0% (18/45, P<0.001) in the acupuncture group.

CONCLUSIONSparrow-pecking moxibustion at trigger points achieves the superior efficacy on myofascial pain syndrome as compared with acupuncture at trigger points. This therapy is simpler in operation additionally.

Acupuncture Points ; Adolescent ; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; Myofascial Pain Syndromes ; physiopathology ; therapy ; Treatment Outcome ; Trigger Points ; physiopathology ; Young Adult

Objective To explore the effects of application of laparoscopic simulators in teaching of plastic surgery. Methods 10 plastic surgeons and 20 standardized training surgical residents with 2 to 4 years' experience were tested about their proficiency in moving beans, pinching, suturing and tying by timing and counting. After they were trained with laparoscopic simulators 3, 6, 9 times with each time for 90 min, tests were taken. SPSS 19.0 was used to make single factor variance analysis of the related data or conduct q test. Result There was significant difference before and after the residents' training of moving beans, pinching, suturing and tying (P<0.05). Less time to finish the operation was needed after training, but after training for 6 times or 9 times, there was no significant difference in operation time (P >0.05). Conclusion Application of laparoscopic simulator training can significantly improve the operation skills of the novices with some clinical experience in the short term, which is conducive to the endoscope assisted breast augmentation surgery, and is worthy of promotion.

OBJECTIVE:To study the effects and mechanism of propranolol on the myocardial abnormal electrophysiology sta-tion in diabetic model rats. METHODS:SD rats were randomly divided into normal control(normal saline)group,diabetic(nor-mal saline)group,PD98059(ERK inhibitor,10 mg/kg)group and propranolol low-dose,medium-dose and high-dose(1,20,50 mg/kg)groups,with 8 rats in each group. Except for normal control group,rats were given alloxan(20 mg/kg)intravenously via tail vein to induce diabetic model. They were given relevant medicine intragastrically,once a day,for consecutive 42 days. The car-diac index,electrocardiogram and action potential durations (APD) of rats were analyzed;the expression of TNF-α,IL-2,IL-6 and IL-10 protein in serum were detected,and the expression of Ras,Raf,ERK kinase(MEK)and ERK1/2 in myocardial tissue were detected. RESULTS:Compared with normal control group,cardiac index increased in diabetes group;heart rate decreased;QT interval and APD were prolonged;the relative expression of TNF-α,IL-2,IL-6,IL-10,Ras,Raf,MEK and ERK1/2 protein increased (P<0.01). Compared with diabetes group,cardiac index decreased in propranolol medium-dose and high-dose groups and PD98059 group,heart rate increased,QT interval and APD were shortened;the relative expression of TNF-α,IL-2,IL-6, IL-10,Ras,Raf,MEK and ERK1/2 protein decreased(P<0.05 or P<0.01). CONCLUSIONS:Propranolol can improve myocar-dial abnormal electrophysiology station of diabetic model rats by down-regulating inflammatory reactions in serum and inhibiting the activation of MEK/ERK signaling pathway.

OBJECTIVE:To observe the efficacy and safety of eprosartan in the treatment of hypertensive patients with coro-nary heart disease. METHODS:160 hypertensive patients with coronary heart disease randomly divided into observation group and control group. All patients were given aspirin,nitroglycerin,low molecular weight heparin,statins and other conventional treat-ment;control group was additioanlly given 50 mg Losartan potassium tablet,orally,once a day. Observation group was additional-ly given 600 mg Eprosartan tablet,orally,once a day. The treatment course for both groups was 6 months. Clinical efficacy,sit-ting systolic blood pressure and diastolic blood pressure,alanine aminotransferase(ALT),aspartate aminotransferase(AST),urea (UREA),creatinine(Cr),uric acid(UA),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol (LDL-C),the Mini-Mental status (MMSE) scale and activities of daily living (ADL) scale scores before and after treatment and incidence of adverse reactions in 2 groups were observed. RESULTS:There was no signifi-cant difference in the total effective rate between 2 groups(P>0.05). After treatment,the sitting systolic blood pressure and diastol-ic blood pressure,MMSE and ADL scale scores in 2 groups were significantly lower than before,and sitting systolic blood pres-sure in observation group was lower than control group,the differences were statistically significant(P<0.05),and there were no significant differences in sitting diastolic blood pressure,MMSE and ADL scale scores between 2 groups(P>0.05),and no signifi-cant differences in ALT,AST,UREA,Cr,UA,TC,TG,HDL-C and LDL-C between 2 groups before and after treatment(P>0.05). There were no obvious adverse reactions during treatment. CONCLUSIONS:Eprosartan can effectively reduce sitting systol-ic blood pressure in hypertensive patients with coronary heart disease,and improve cognitive function,with good safety.

Objective To evaluate effects of two different preoperative biliary drainages on patients of malignant obstructive jaundice complicated with acute cholangitis.Methods Retrospective analysis was made on effects of two preoperative biliary drainages of ultrasound-guided percutaneous transhepatic cholangial drainage (PTCD) and endoscopic nasobiliary drainage (ENBD) in cases of malignant obstructive jaundice complicated with acute cholangitis.Results Days of preoperative drainage(t =3.217,P ＜ 0.05) and declines of bilirubin level after drainage (t =3.178,P ＜ 0.05) were significantly better in ENBD group (26 cases) than PTCD group (22 cases).There were no significant differences between two groups in operation time length and intraoperative blood loss after drainage.However,postoperative hospital stay (t =2.542,P ＜ 0.05) and overall stay (t =3.172,P ＜ 0.05) were significantly shorter in ENBD group compared with PTCD group.Conclusions When preoperative biliary drainage is indicated in the cases of malignant jaundice before radical surgery,ENBD should be the first choice over DTCD.

Objective To evaluate the diagnosis and treatment of residual gallbladder.Methods The diagnosis of residual gallbladder depends on a history of previous cholecystectomy and postoperative existent symptoms suggesting cholecystitis.In this series the diagnosis was finally established by ultrasonography and laparotomy in 52 cases.Results Ten cases received laparoscopic residual cholecystectomy,32 cases underwent residual cholecystectomy,7 cases did residual cholecystectomy plus common bile duct exploration,1 case was treated with residual cholecystectomy,common bile duct exploration and left lateral lobe hepatectomy,1 case with residual cholecystectomy,common bile duct exploration,cholangioenterostomy,1 case by radical resection of residual gallbladder cancer.Conclusions Residual gallbladder is a secondary disease,diagnosis is not difficult,surgery has certain difficulty,the application of intraoperative ultrasound and choledochoscope has great value.