OBJECTIVE:To evaluate the economic effectiveness of different pharmacotherapentic schemes of Prazoles for helicobacteria pylori (Hp) infection. METHODS: 102 patietns with peptic ulcer were randomly assigned to receive Omeprazole +amoxicillin + Colloidal bismmth pectin (Group A), Rabeprazole + Amoxicillin + Colloidal bismmth pectin (Group B) or Rebeprazole + amoxicillin + Colloidal bismmth pectin (Group C). The cost-effectiveness analysis was conducted on the three schemes. RESULTS: The cost-effectiveness ratios of groups A, B and C on Hp clearance rates were 1 027.31, 976.79 and 967.40, respectively, and on peptic ulcer healing rates were 921.05, 915.77 and 936.16, respectively. CONCLUSION: Scheme B is the best one for Hp infection.

It has been a novel clinical way to repair damaged articular cartilage with autologous chondrocytes cultured in vitro using cartilage tissue engineering technique. There have been many articles about the techniques of chondrocytes culture in recent years. After summarizing and analyzing the involved articles,factors on chondrocytes cultured in vitro were reviewed,including dimension,stress,cell density and oxygen tension,etc. Chondrocytes cultured in three-dimensional with multi-factors in vitro can promote quality and quantity of cartilage in tissue engineering. But factors on chondrocytes culture are so complicated that further researches will be needed.

Adipose-derived stem cells(ADSC) can be easily obtained in large quantities and with minimal discomfort.As seed-cells,ADSCs may be well suited to tissue engineering and regenerative medical applications.This article presents an overview of the isolation,expansion,characterization,differentiation and application prospects of ADSCs,as well as the existing challenges in their studies,in an attempt to promote their clinical applications.

ObjectiveTo investigate the clinical epidemiologic characteristics of chronic subdural hematoma and risk factors for its recurrence so as to offer scientific basis for treatment and prognostic evaluation. MethodsA retrospective study was done on clinical data of 150 adults with chronic subdural hematoma from the Traumatic Brain Injury Database of Neurosurgery Department of General Hospital of Tianjin Medical University to analyze the clinical characteristics and the postoperative recurrence factors of the chronic subdural hematoma.ResultsHematoma volume of the patients in the recurrence group was more than that in the non-recurrence group.Age ＞ 80 years and brain atrophy were two independent risk factors for postoperative recurrence of the chronic subdural hematoma.The recurrence rate was declined with the decrease of hematoma density on CT.The recurrence rate of the chronic subdural hematoma in the high-density group was significantly higher than that in the low-and iso-density groups. ConclusionsPreoperative hematoma volume,onset age,brain atrophy and hematoma density on CT are significantly correlated with the postoperative recurrence of the chronic subdural hematoma.A detailed clinical and radiological evaluation is of great importance for the treatment and prognostic evaluation of the chronic subdural hematoma.

Early brain injury (EBI) in spontaneous subarachnoid hemorrhage (SAH) plays an important role in prognosis and it become a key target period for clinical treatment and basic research. There were many pathophysiological change in the first few minutes after intracranial aneurysm ruptured. These include increased intracranial pressure (ICP) followed by in?tracranial circulation disorders, calcium overload and sodium, magnesium level fluctuation, ion steady-state disorders in mi?croenviroment of brain cells, serious brain edema due to blood brain barrier (BBB) damage, and changes in other molecules levels, all of which will aggravate SAH. EBI in SAH is one of the important factor that leads to poor prognosis. With the ad?vancement of understanding its pathogenesis, new approach would be available to treat SAH in clinic.

Objective To observe if endothelial progenitor cells (EPCs) and bone marrow mesenchymal stem cells (BMSCs) could home to the injured region and study the effect of BMSCs-derived EPCs on traumatic brain injury (TBI) in rats.Methods BMSCs were isolated from 3-month-old SD male rats weighing 150 g,and induced to EPCs.EPCs were identified by surface markers CD133,CD34 and FLK-1.A total of 120 female adult SD rats were divided into 3 groups (n =40 each) according to the random probability table method:EPCs group,BMSCs group and 3T3 cells group.The model of moderate to severe TBI was induced by the fluid percussion device.All the cells (i.e.EPCs,BMSCs and 3T3 cells) were injected with BrdU before transplantation to the tail vein of rats.On days 2,7,14 and 28 after transplantation,rat neurological function was evaluated using the modified neurological severity score (mNSS),and injured brain tissue was harvested to detect CD34 and brain-derived neurotrophic factor (BDNF) positive cell density using the immunohistochemistry method.Sry-positive cells were evaluated using the fluorescence in situ hybridization (FISH).Results The positive rate of CD133,CD34 and Flk-1 was 52％,33％ and 38％,indicating BMSCs differentiation towards an EPCs phenotype.On days 7,14 and 28 after transplantation,the mNSS in EPCs group [(10.2 ± 1.5),(8.7 ± 1.0) and (4.9 ± 1.0) points] and in BMSCs group [(10.8 ± 1.7),(10.1 ± 1.7),and (7.2 ± 1.3) points] were lower than that in 3T3 cells group [(12.4 ± 1.5),(1 1.7 ± 1.8),(10.3 ± 1.5) points] (P ＜ 0.05).On 14 and 28 days after transplantation,BrdU-positive CD34 and BDNF in EPCs group were significantly more than those in BMSCs group (P ＜ 0.05).Instead,there were no positive cells in 3T3 cells group.The method of Sry probe to trace the transplanted cells could detect more positive cells compared to the BrdU labeling method.Conclusion Both BMSCs and EPCs can home to the injured region,but EPCs have much better therapeutic effect.

To probe the effect of transsphenoidal microsurgical removal on large pituitary adenomas (LPA), a total of 1 520 patients suffering from LPA were diagnosed by skull X ray plain films, CT, or MRI scanning. Operations were performed via a transsphenoidal approach under microscope. The results showed that gross total removal of an adenoma in 1 264 cases ( 83 2% ) and subtotal removal in 195 cases ( 12 8% ) were achieved; partial removal was carried out in the remaining 61 cases ( 4 0% ) of fibrous or dumbbell shaped adenomas. Death occurred in two patients (0 1%) after surgery. Long term follow up review( median: 3 5 years ) in 1 240 patients revealed that 1 219 cases( 98 3%) of those with preoperative diminished visual acuity had postoperative improvement; 21 cases (1 7%)had no change, and none deteriorated significantly. Among the 1 226 patients with preoperative visual field defects, postoperative improvement was good in 1 186 (96 7%), and poor in 40(3 3%).It is concluded that microsurgical removal of pituitary tumors by transsphenoidal approach is safe and very effective even for very large or giant adenomas except for fibrous and dumbbell shaped ones, since it allows rapid and adequate decompression of the optic nerves and chiasm.

To sum up the experience of microneurosurgical treatment of cavernous sinus tumor, an retrospective analysis was made for 26 cases of cavernous sinus tumor admitted to our hospital from January, 1990 to June, 2001. All the patients received the modified microneurosurgical operation, and the operation was performed in 6 of them by the help of nerve guidance.The tumors were totally removed in 19 patients, and partially removed in the other 7 patients. No patient died, and cranial nerve injury was ameliorated in 14 cases, and some new cranial nerve injuries were found in 6 patients after operation. No recurrence or regrowth of tumor was found during the following up from 8 months to 12 years. It is crucial to master the microneurosurgical techniques for the reduction of operative complications.

Objective To discuss the principles of surgical treatment of closed spinal cord injury. Methods The treatment and outcome of a series of 210 patients with closed spinal cord injury admitted to our department from Jan, 1990 to Jan, 2003 were retrospectively analyzed. Results Of the 210 patients, 113 cases (53.8%) were classified as grade A, 49 cases (23.3%) as grade B, 37 cases (17.6%) as grade C, and 11 cases (5.2%) as grade D, respectively, according to Frankel's classification. After treatment and followed-up for 3 months to 10 years, 42 cases (20.0%) were re-classified as grade A, 15 cases (7.1%) as grade B, 45 cases (21.4%) as grade C, 61 cases (29.0%) as grade D, and 47 cases (22.4%) as grade E. Conclusion Surgical treatment for a patient with closed spinal cord injury depends on findings of examination of the nervous system, tomographic examination of the spinal cord, indications for decompression of the spinal cord, stabilization of the spine, early ambulation and rehabilitation. Principles of the treatment of closed spinal cord injury include early treatment, decompression of the spinal cord with operation, reduction and fixation, prevention of complications, and rehabilitation.

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