Objective To investigate the effect of psychological intervention combined with electroacupuncture and hyperbaric oxygen therapy on patients with depression after traumatic brain injury (TBI). Methods Forty-five patients with depression after TBI were randomly divided into a treatment group and a control group. The two groups were both treated with routine medication and anti-depression drugs ( Fluoxetine ) for 8 weeks as a routine course of treatment, but psychological intervention combined with electroacupuncture and hyperbaric oxygen therapy was added to the treatment group's regimen. Hamilton Depression Scale ( HAMD), Modified Edingberg Scandinavian Stroke Scale (MESSS) and Quality of Life-index (QL-INDEX) scores were evaluated at the end of 8 weeks.Results There was no significant difference in the average HAMD, MESSS or QL-INDEX scores of the two groups before therapy. After treatment, the average HAMD and MESSS scores of the treatment group were significantly lower than those of the control group, and the average QL-INDEX score was significantly higher. Conclusions Psychological intervention combined with electroacupuncture and hyperbaric oxygen therapy plays an important role in the treatment of patients with depression after TBI to improve their mental status, treatment effectiveness and quality of life.

Objective To study the techniques for treating the intracranial tumor.Methods Through a keyhole approach with endoscope-assisted micro-neurosurgery,30 patients with intracranial tumor were treated.With microneurosurgery,larger part of tumor was resected,then under neuroendo-scope remains of tumors were found out and removed.Results Tumors were totally removed in 22 patients,subtotally removed in 5.In three patients cerebral aneurysm was clipped successfully.Two patients with pituitary adenoma had temporay diuresis and one patient non-bacteria meningitis,and after two weeks treatment all recovered.There was no-mortality in 41 patients,no cerebral hemorrhage,optic nerve injury,internal carotid injury,and other complications occurred.Conclusion Endoscope-assisted microneurosurgery through a keyhole approach can increase the total-resection rate for tumors,reduce the trauma of operation and postoperative reaction.

Objective To summarize experience of the combined treatment of ependymoma in fourth ventricle of the brain of child and to study improvement of effect of the operation plus radiotherapy.Methods 35 cases with ependymoma in fourth cerebral ventricle were treated with microneuro-surgical resection.Among the 35 cases,25 were treated with total brain and spinal cord plus local focus radiotherapy within 2 to 3 weeks after operation;8 only with local focus radiotherapy,2 cases were not done with radiotherapy.Results Total removal of tumors was done in 20 cases,subtotal removal in 15 cases,and no patient died from operation.After operation,20 patients had a good recovery,10 had a light disability,and 5 needed assistance.The 5-year survival rate were 90.0%(18/20),6.6%(1/15),88.0(22/25),62.5%(5/8) and 0%,in different group respectively.Conclusion Surgical treatment is obviously effective to ependymoma in fourth ventricle of the brain and total removal of tumors combined with radiotherapy is aid to extend the patient's survival time.

Objective To discuss the diagnosis and treatment of microneuro-surgery for meningiomas of the lateral ventricle.Methods A retrospe CT analysis was performed on 20 patients with meningomas of the lateral ventricle during a 7-year period.Results 20 cases had total tumor removal.among them 6 cases were completed removal,14 cases were cent piece removal.There were no postoperative deaths.The follow-up period ranged from 0.5 to 7 years.All followed patients went well.Conclusion Lateral ventricular meningiomas can be diagnosed by CT or MRI and fedding vascular of tom or revealed by cerebral vascular angiography.By using the ideal approach,the tumors could be totally removed under microscope.

BACKGROUND: The use of bone graft materials can promote bone fusion and enhance the stability of the spine during the spinal fusion. OBJECTIVE: To investigate the effect of autologous bone marrow mesenchymal stem cel s with hydroxyapatite/ tricalcium phosphate in the spinal fusion. METHODS: A retrospective analysis of clinical data of 64 patients with spinal fusion was carried out, and these patients were divided into two groups (n=32 per group): control group undergoing autogenous iliac bone grafting and observation group undergoing autologous bone marrow mesenchymal stem cel s combined with hydroxyapatite/tricalcium phosphate. Al patients were fol owed up for 12 months, and their recovery conditions about low back pain, spinal fusion and vertebral reset were assessed. RESULTS AND CONCLUSION: The low-back outcome scale scores and excel ent rate, Lenke grading and Cobb angle had insignificant differences between the two groups after treatment (P > 0.05). No infection, inflammation and skin irritation occurred in the two groups. The coagulation function, renal function and inflammatory factor levels were at normal levels in al the patients, and there was no difference between the two groups (P > 0.05). These findings indicate that autologous bone marrow mesenchymal stem cel s combined with hydroxyapatite/tricalcium phosphate can achieve clinical outcomes equivalent to the autologous iliac bone grafting.

Objective To find out the correlation of C -reactive protein (CRP)and acute cerebral infarc-tion,and to provide research data for acute cerebral infarction.Methods 43 cases with acute cerebral infarction were set as the observation group,and 40 healthy people were set as the control group.The CRP level of the observation group and the control group,and CRP level of different infarction volume and neurological function defect degree were compared.The influence factors of CRP level were analyzed with single factor analysis and Logistic regression.Results The CRP level of the observation group was (14.19 ±2.60)mg/L,which was significantly higher than that of the control group (t =7.453,P <0.05).With the increase of infarction volume,CRP levels increased (t =3.451,8.534, 5.930,all P <0.05).With the increase of nerve function defect degree,CRP level elevated (t =3.845,9.077, 6.730,all P <0.05).CRP level and systolic blood pressure,fasting glucose,total cholesterol,fibrinogen were positively correlated (r =0.479,0.603,0.508,0.603,all P <0.05 ).Cerebral infarction,systolic blood pressure,fasting glucose,total cholesterol and fibrinogen were the influence factors of CRP level.Conclusion There is correlation between C -reactive protein and acute cerebral infarction;detecting CRP level can assist in diagnosis of cerebral infarction.It was favorable to prevent and control the occurrence and progress of acute cerebral infarction.

Objective To investigate the effect of xenon intervention on delayed neuropsychologic sequelae (DNS)in acute carbon monoxide(CO)poisoning.Method Adult Wistar rats were randomly divided into sustained group,early intervention group,and control group.CO(150 ml/kg)was infused by intraperitoneal injection to produce DNS model.In sustained intervention group(S-group),xenon(150 ml/kg/d)was infilsed by intraperitoneal injection for 2 weeks;in control group(C-group),xenon was replaced by equal volume air;and in early intervention group(E-tvoup),xenon(150 ml/kg/d)was,employed in the first 3 days and air(150 ml/kg/d)was substituted for xenon in the following days until 2 weeks after CO poisoning.Morris maze test was used to evaluate the intelligence of rats.The long-term potentiation(LTP)of hippocampus Was detected by neuroelectricity recording.The apoptosis rates in brain was detected by TUNEL staining.The data were expressed as(x±s)and analyzed with student's test and analysis of variance.A P value less than 0.05 indicated statisfical significance.Results After exposure to CO,poisoned rats showed intelligence decline,demyeliation ofwater matler and cell apoptosis increased,which were consistent with DNS.In S-group and E-group,the rates of DNS and apoptosis were significantly lower than those in C-group,whereas the rote of LTP in S-group and E-group Was significantly higher than those in C-group.Conclusions Early xenon intervention can effectively decrease the rates of DNS occurred after acute CO poisoning.

Objective To compare the effect of traditional open surgery and laparoscopic repair of gastric perforation on postoperative pulmonary function.Methods Fifty patients were divided into two groups according to therapeutic method.Group A underwent traditional open gastric perforation repair(n=25).Group B underwent laparoscopic repair of gastric perforation(n=25).The pulmonary functions were examined at 1 day,3 days and 7 days postoperatively.Results All patients had different degrees of postoperative pulmonary function decline.After operation,the forced vital capacity(FVC)and forced expiratory volume in 1 second(FEV1)and vital capacity(VC)in group A were significantly lower than those in preoperation(P<0.05).The patients in laparoscopic operation group decreased significantly only on the first day postoperative.The postoperative pulmonary function of patients undergoing open surgery was significantly lower than that of patients undergoing laparoscopic surgery(P<0.05).Conclusion Laparoscopic repair of gastric perforation has less damage to the lung function than traditional open gastric perforation repair.Laparoscopic surgery plays an important role in the recovery of postoperative pulmonary function.

OBJECTIVE:To observe clinical efficacy and safety of tiotropium bromide combined with budesonide formoterol in the treatment of severe bronchial asthma in adults. METHODS:A total of 110 adult patients with severe bronchial asthma were selected from our hospital during Mar. 2013-Mar. 2016 were divided into control group and observation group according to random number table,with 55 cases in each group. Control group was given Budesonide formoterol powder for inhalation,2 inhalations each time,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18 μg,qd,on the basis of con-trol group. Both groups were treated for 6 months. Clinical efficacies as well as ACT scores,respiration function indexes and the times of acute attack of asthma before and after treatment,the occurrence of ADR were compared between 2 groups. RESULTS:The efficiency rate and total response rate of observation group were 54.55% and 96.36%,which were significantly higher than 32.73%,78.18% in control group,with statistical significance(P<0.05). Before treatment,there was no statistical significance in ACT scores,respiration function indexes or the times of acute attack of asthma between 2 groups(P>0.05). After treatment,ACT scores of 2 groups were significantly higher than before treatment;FEV1,FEV1/FVC and PEF were significantly greater than be-fore treatment,PEFR was significantly lower than before treatment;and the indexes in observation group was significantly better than control group,with statistical significance(P<0.05). 1,3,6 months after treatment,the times of acute attack of asthma in 2 groups were significantly less than before treatment,and that in observation group was significantly less than control group,with statistical significance(P<0.05). The incidence of ADR in observation group was 20.00%,and there was no statistical signifi-cance compared to 14.55% of control group(P>0.05). CONCLUSIONS:Tiotropium bromide combined with budesonide formoter-ol in the treatment of severe bronchial asthma in adults can effectively relieve the severity of disease,improve respiration function, reduce the times of acute attack of asthma,and have good therapeutic efficacy and safety.

OBJECTIVE To investigate the ?-lactamases in Klebsiella pneumoniae strains isolated from the elderly patients.METHODS We had an observation on 20 strains of Klebsiella pneumoniae about 15 kinds of ?-lactamase gene test(blaTEM,blaSHV,blaLEN,laOKP,blaCTX-M-1 group,blaCTX-M-2 group,blaCTX-M-9 group,blaOXA-1 group,blaOXA-2 group,blaOXA-10 group,blaGES,blaPER,blaVEB,blaDHA,and blaACT-1).RESULTS Six kinds of ?-lactamase genes had been found out from these 20 strains of K.pneumoniae,namely,blaTEM,blaSHV,blaCTX-M-1 group,blaCTX-M-9 group,blaOXA-1 group,and blaDHA.Their positives were 95%,30%,50%,5%,5% and 15%.Among these 20 strains of K.pneumoniae,there were 19 ones of K.pneumoniae which at least contained 1 kind of ?-lactamase genes.Fifteen strains of K.pneumoniae were found containing more than 2 kinds of ?-lactamase genes,at the same time.Some were even tested out having 4 kinds of ?-lactamase genes.CONCLUSIONS The resistance of ?-lactamase antibiotics of these 20 strains of K.pneumoniae has a close relative to the number of ?-lactamase.