Objective To observe the effects of cinepazide maleate and nimodipine in improving the neurological function in patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.Methods Seventy-eight patients with hypertensive cerebral hemorrhage were randomly divided into 2 groups,cinepazide maleate group (39 patients)and nimodipine group(39 patients).After 3 days operated with the microtraumatic craniopuncture,cinepazide maleate group used the amount 160mg cinepazide maleate mixed with sodium chloride injection(500ml,concentration 0.9%),and the nimodipine group uesd nimodipine(4mg)mixed with the same injection.Both the patients of the 2 groups were given intravenous drip once a day,then after continuous 14 days,the general information and the improvement of nerve were observeed.Results The total improvement rate and the improvement rate of nervous symptom was 87.2%and 61.5%respectively,in comparison,the nimodipine group was 64.1%and 39.9%.Conclusion Cinepazide maleate was better than nimodipine in improving chnical symptoms and the neurological deficit of the patients with hypertensive cerebral hemorrhage after microtraumatic craniopuncture.

OBJECTIVETo investigate the rationality and feasibility of primary closure of the common bile duct after choledochotomy for common bile duct calculi.

METHODSFrom January 1990 to June 2001, 386 patients with the evidence of stones in the common bile duct underwent choledochotomy. Among them, 215 received primary closure of the common bile duct (group A) and 171 T-tube drainage (group B). The patients with emergency operations were excluded. Intraoperative choledochoscopy or cholangiography was routinely performed to rule out the possibility of retained stones. The duct was meticulously stitched using 0/3 to 0/5 absorbent sutures for primary closure. A T-tube was placed in the subhepatic space in the patients of both groups.

RESULTSPostoperative bile leakage was seen in 9 patients of group A and in 5 of group B, respectively (P > 0.05), and no reoperations were necessary. After surgery, the average time and volume of transfusion was 4.9 days and 9.1 liters in group A, versus 7.3 days and 12.8 liters in group B (P < 0.01). The patients in group B had a longer postoperative hospital stay than the those in group A (average 17.6:10.0 days, P < 0.01). T-tube removal resulted in bile peritonitis in 5 patients at day 16, 17, 19, 21 and 22 after surgery in group B, and 3 patients required repeated surgery.

CONCLUSIONSPrimary closure of the common bile duct after choledochotomy is safe, effective, and inexpensive in selected patients with common bile duct calculi, and should be regarded as an alternative procedure.

Adult ; Aged ; Biliary Tract Surgical Procedures ; methods ; Choledocholithiasis ; surgery ; Common Bile Duct ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

Objective To further update the evidence-based medicine evidence of clinical efficacy and safety of butylphthalide soft capsules in the treatment of Parkinson disease(PD). Methods Randomized controlled trials(RCT) on Butylphthalide soft capsules for PD was collected from PubMed,Embase,Cochrane Library,CNKI,Wanfang and CBM,the retrieval time was from inception to August 2021.The literature selection,data collection were conducted. Meta-analysis was performed by RevMan 5.3 software. Results A total of 28 studies were included and 2463 patients were included. Compared with control group,butylphthalide soft capsules could reduce UPDRS score (MD=-9.52,95%CI -11.23~-7.82,P<0.05),increase MMSE score (MD=3.40,95%CI 2.74~4.06,P<0.05) and MoCA score (MD=3.31,95%CI 3.04~3.57,P<0.05). It also could reduce CRP levels (MD=-2.37,95%CI -2.49~-2.24,P<0.05) and PARK-7 level (MD=-9.39,95%Cl -10.56~-8.22,P<0.05),increase NT-3 levels (MD=8.04,95%CI 7.01~9.07,P<0.05). However,there was no statistical difference in the number of adverse events between the treatment and control groups (RR=1.21,95%CI 0.75~1.94,P=0.43). Conclusion Butylphthalide soft capsules can improve cognitive dysfunction and other complications in Parkinson's patients,by reducing PARK-7,CRP levels and increase NT-3 levels,No serious adverse events have been observed.

【Objective】 To explore the characteristics of esophageal motility and reflux of endoscopic-negative heartburn patients based on the Lyon Consensus Diagnostic Criteria and discuss the differential diagnosis value of the mean nocturnal baseline impedance （MNBI） and the postreflux swallow-induced peristaltic wave （PSPW） index for reflux hypersensitivity （RH） and functional heartburn （FH） patients. 【Methods】 We enrolled 132 patients with heartburn as the main symptom who visited the Gastroenterology Department of our hospital from January 2017 to June 2021， including 24 in the non-erosive reflux disease （NERD） group， 24 in the RH group， and 84 in the FH group. All the patients completed gastroscopy， esophageal high-resolution manometry and 24h-pH impedance monitoring. We analyzed and compared the related indexes of esophageal motility and reflux. The receiver operating characteristic （ROC） curve was used to analyze the esophageal proximal MNBI， distal MNBI， and PSPW indexes for the differential diagnosis of RH and FH. 【Results】 The lower esophageal sphincter （LES） average resting pressure， LES residual pressure and intact relaxation pressure （IRP） in NERD were lower than those in RH and FH （P<0.05）. The number of acid reflux， the upright acid exposure time （AET）， the supine position AET， the total AET， and the DeMeester score were higher in NERD than in RH and FH （P<0.05）. The non-acid reflux， distal MNBI and PSPW indexes were lower in NERD than in RH and FH （P<0.05）. The distal MNBI and PSPW indexes were lower in RH than in FH （P<0.05）. However， there was no significant difference in proximal MNBI among the three groups （P>0.05）. When the proximal MNBI， distal MNBI， and PSPW indexes were used alone respectively to diagnose RH， the area under the ROC curve was 0.480， 0.810， 0.682， respectively， with the sensitivities being 87.5%， 100% and 91.7%， and the specificities being 26.2%， 66.7% and 51.2%， respectively. 【Conclusion】 NERD patients have obvious abnormal esophageal dynamics， mainly manifested as LES relaxation， which further aggravates the pathological acid reflux， while patients with RH and FH are mainly exposed to physiological acid or non-acid reflux. In patients with endoscopic negative heartburn， distal MNBI value can improve the clinical diagnosis rate of RH and help distinguish RH from FH.