Objective To investigate the clinical effect of standard large bone flap decompression for severe craniocerebral injury.Methods This study was performed in 58 patients with severe traumatic brain injury,according to different surgical methods,the patients were divided into control group and study group,29 cases in each group.The control group was treated with conventional bone flap craniotomy,and the study group was treated with large bone flap decompression surgery.The clinical effect and complications were compared between the two groups.Results After operation,the patients were followed up for 5 months.The mortality of the study group (10.34%)was significantly lower than that of the control group (27.59%),and the difference was statistically significant (χ2 =3.98,P <0.05).In addition,the good rate of the study group (55.17%)was significantly higher than that of the control group (27.59%),and the difference was significant (χ2 =4.55,P <0.05).The preoperative intracranial pressure had no significant difference between the two groups.While at postoperative 1d,3d and 5d,the intracranial pressure of the study group was significantly lower than that of the control group,and the difference was statistically significant (t =3.55,4.02,6.12,all P <0.05).The scores of GOS and BAI in the study group were significantly higher than those in the control group (t =5.02,4.21,P <0.05 ).The incidence rates of complications such as cerebrospinal fluid leakage,trauma of cerebral infarction,trauma of epilepsy,hydrocephalus,wound infection of the study group were sig-nificantly lower than those of the control group,and the differences were statistically significant (χ2 =4.00,5.02, 456,4.22,3.99,all P <0.05).Conclusion Compared with conventional craniotomy,open standard big bone flap decompression can significantly reduce the mortality rate,decrease intracranial pressure,and improve the quality of life of patients,it has better curative effect and prognosis for patients with severe craniocerebral injury,and is worthy of clinical application.

OBJECTIVE:To establish a method for simultaneous contents determination of schizandrin,schizandrin B and cin-namaldehyde in Xiaoqinglong granule. METHODS:HPLC was performed on the column of Wondasil-C18 with the mobile phase of acetonitrile-0.1% phosphoric acid solution(gradient elution)at the flow rate of 1.0 ml/min,the detection wavelength was 245 nm, temperature was 25 ℃ and volume was 20 μl. RESULTS:The linear range was 1.008-20.16 μg/ml(r=0.999 8) for schizandrin, 0.496-9.92μg/ml(r=0.999 7)for schizandrin B,and 1.012-20.24μg/ml(r=0.999 6)for cinnamaldehyde;RSDs of precision,sta-bility and reproducibility tests were no more than 1.33%;the average recoveries were respectively 98.9%(RSD=1.71%,n=6), 99.9%(RSD=1.50%,n=6) and 98.7%(RSD=2.10%,n=6). CONCLUSIONS:The method is simple,accurate and reproduc-ible,and can be used for the quality control of Xiaoqinglong granule.

Intracoronary effects of calcitonin gene related peptide (CGRP) on coro-nary hemodynamics were observed in the normal and following different extent of coro-nary stenosis using graded coropary- stenosis modl in dogs. The results showed that CGRPincreased the coronary artery blood flow (CBF) and distant coronary blood prepsure (DCP),but decreased mean artery pressure (MAP), coronary vessels total resistance (R_T),large co-ronary vessels, resistance (R_L) and small coronary vessels resistance (R_s). Thirty minutesafter. coronary middle. stenosis, CGRP was given intracoronary, MAP had no significantchange, but CBF insreased and R_T R_L, R_s decreased, and which maintained for 30 min. 30min after coronary severe stenosis, CGRP increased CBF and MAP, but decreased DCP,R_T, R_L, R_S continuously. These results suggested that CGRP could ameliorate myocardialischemia through enlargement of coronary vessels and by increasing CBF.

Monoclonal gammopathy of undetermined significances (MGUS) is a premalignant clonal disorder occurring in 4.2 ％ of adults ＞50 years old,and is associated with a 1％ risk every year of progression to multiple myeloma (MM),light-chain amyloidosis and related conditions.Differential diagnosis of asymptomatic and symptomatic monoclonal gammopathies is the determinant for starting therapy.Most patients with MGUS need frequent assessment and follow-up.A few patients with MGUS might progress into smoldering MM and symptomatic MM,or develop into light chain diseases such as AL amyloidosis and light chain deposition disease caused by M-protein,who should be followed with effective therapy.The above were in detail reviewed in the 54th American Society of Hematology (ASH) annual meetina.

Objective: To study the efficacy and safety of microscope assisted nasal transsphenoidal pituitary tumor resection. Methods: pituitary tumor patients in our hospital from March 2011 to May 2013 were enrolled and divided into observation group given microscope assisted nasal transsphenoidal pituitary tumor resection and control group given oral-nasal septum-sphenoid sinus pituitary tumor resection according to different operation mode. Then stress level, curative effect related index and complications were observed and compared with existing research. Results: (1) Adrenaline, noradrenaline, rennin, angiotensin Ⅱlevel and operation time, intraoperative bleeding volume, postoperative hospitalization time of observation group were lower than control group, cases of hormone levels return to normal and improve were more than control group, complication cases were less than control group. (2)compared with the existing research on nerve endoscopic surgery, operation time, intraoperative bleeding volume, postoperative hospitalization time and cases of hormone levels return to normal, improve and complications of observation group had no statistical difference. Conclusion:microscope assisted nasal transsphenoidal pituitary tumor resection is helpful to reduce surgery trauma, relieve stress condition and can achieve equal operation effect and complications.

Defibrillators, Implantable ; Electric Countershock

Objective To discuss the way of treatment of bile duct stone with laparoscope and choledochoscope. Methods Forty six patients with bile duct stones admitted in our hospital from July 2001. to July 2008 were selected in this study. The 46 cases were divided into two groups:the control and observation group.The control group included 22 patients who were performed cholecystectomy and choledochotomy with T tube drainage. The obeservation group included 24 patients who were performed laparoscope and choledochoscope operation.We used the Mann-Whites statistics and compared the incidence of complications, the amount of bleeding and hospitalized days in patients between two groups. When P<0.05, the difference between the two groups was considered statistically significant. Results The incidence of complications after operation, amount of bleeding and hospitalized days in patients had no statistically significant difference between two groups. The time of operation in observation group was longer than control group. The bile stones eradication rate in observation group was higher than control gourp. and the bile stones recurring rate in observation group was lower than control gourp. Conclusion It is better to treat the bile duct stones by using laparoscope with choledochoscope than the way of traditional cholecystectomy and choledochotomy with T tube drainage, the former has advantages such as higher bile duct stones edarication rate, lower recurring rate, safer and more reliable operation and fewer complications.

OBJECTIVETo investigate the feasibility and advantages of total auricular reconstruction with single big expander at dual plane through incision at remnant ear.

METHODS52 patients with microtia were treated. Through incision at remnant ear, one big expander (150 ml) was implanted in the post-auricular area beneath the superficial facial in the hairless area, and above the superficial fascia in the area with hair. In the second stage, total auricular was reconstructed with autologous cartilage framework and expanded skin. Skin graft was not necessary. Another 32 paitents with single big expander above the superficial fascia were used as control. The downward shift distance of expanders, the appearance of auriculocephalic sulcus and complication were recorded in order to assess the effect of these two methods.

RESULTSThe downward shift distance of expanders in the dual plane group (0.7 ± 0.3) cm were lower than that in the control group (1.3 ± 0.4) cm, showing significant difference (P < 0.05). After a follow-up period of 6-12 months, shallow auriculocephalic sulcus was presented in 5 patients of the dual plane group and 12 patient of the control group. The shallow auriculocephalic sulcus was cut to make it deeper and covered with full skin graft.

CONCLUSIONSDual plane skin expansion could reduce the downward shift distance of expander. Adequate skin on the upper part of expander could make satisfactory auriculocephalic sulcus.

Cartilage ; transplantation ; Congenital Microtia ; surgery ; Feasibility Studies ; Hair ; Humans ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Subcutaneous Tissue ; Surgical Flaps ; trends ; Tissue Expansion ; methods ; Tissue Expansion Devices