Objective To discuss the surgical complications secondary to decompressive craniectomy as well as the clinical factors related to these complications. Methods We reviewed a series of 83patients undergone surgical decompression and analyzed the incidence of surgical complications as well as the relationship of the complications with GCS score and operation opportunity selection. Results There were 51 patients (61%) with surgical complications after decompression, among whom 30 patients ( 36% ) had more than two kinds of complications. The trauma severity would increase with the incidence of surgical complication, with statistical difference between groups. The late operative group ( ≥ 12hours) showed higher incidence of complication than the early operative group ( < 12 hours), with no statistical difference. Conclusion The procedure of decompressive craniectomy develops kinds of complications which should be prevented, detected and treated early for an optimal prognosis.

Objective To investigate the correlation between vitamin D receptor gene and bone mass and obesity phenotypes in patients with type 2 diabetes mellitus.Methods 318 patients with type 2 diabetes were chosen as diabetes group,and 50 healthy people were selected as healthy control group.Vitamin D receptor gene Apa Ⅰ type was detected in the two groups.Height,weight and body mass index(BMI)biochemical index,fat content(FM),lean tissue content(LM)and bone mineral density were detected in patients with type 2 diabetes mellitus.The relationship between vitamin D receptor gene(Apa Ⅰ)polymorphism and BMD and obesity phenotypes in type 2 diabetes was analyzed.Results The VDR gene distribution between the diabetes group and healthy control group showed no signif-icant difference(Z =0.561,P >0.05).The vitamin D receptor genotype in the diabetes group included AA 31 cases (9.7%),Aa type 108 cases(34.0%),aa type 179 cases(56.3%),while the vitamin D receptor genotype in the healthy control group comprised AA 7 cases(9.3%),Aa type 29 cases(38.7%),aa type 39 cases(52.0%).The percentage of AA in both groups was significantly less than that of Aa and aa(χ2 diabetic group =4.127,3.976,all P <0.05;χ2 healthy control group =5.129,4.213,all P <0.05).Proportion of normal bone mass and average bone density in AA,Aa,aa type decreased(χ2 =15.552,P <0.05;F =5.127,P <0.05),the genotype AA was not detec-ted in osteoporosis group.BMI and FM were the highest in AA,which were significantly higher than those of Aa,aa (F =4.319,4.263,all P <0.05).Conclusion Vitamin D receptor gene Apa Ⅰ type polymorphism is related with BMD and obesity in type 2 diabetes mellitus,and it has predictive value on bone mass changes.The increase of BMI and FMmay be beneficial to bone mineral density.

Objective:To study the eExecutive fFunctions Characteristics of Cchildren with Aattention dDeficit hHyperactivity Ddisorder in Cclock Ddrawing Ttest. Methods: 60 ADHD children and 60 normal children awere tested by CDT. Then analyze the data to detect the difference of Executive Functions of two growps. Results:ADHD group geot significant lower scores than control group on both time total score (data) and clock face structure score. (3.23?1.40/4.15?0.78,11.2?1.48/11.90?0.76,t=7.742、5.073,P0.05). Conclusions: the lower score in CDT showed that ADHD child have some weaknesses in planning , in attention regulating and in working memory. The core of these weaknesses is failing of execute function.

Objective To investigate the changes in serum levels of nitric oxide ( NO) and endothelin ( ET) in type 2 diabetes patients with vascular complications, and to analyze the relationship between these levels and risk factors.Method We selected 98 cases of type 2 diabetes patients.Based on the grouping criteria, the patients were divided into diabetic patients with vascular complications ( group A,49 cases) and those without ( group B,49 cases) .In addition, 44 age-and body mass index-matched healthy cases were selected for control(group C).Height, weight, blood pressure, duration of diabetes, fasting blood glucose, hemoglobin A1c ( HbA1c), blood lipids, and serum levels of NO and ET-1 of all the patients were recorded.Results The NO levels of the two groups with diabetes mellitus were significantly lower than in group C[(43.87 ±12.05)and (53.29 ±11.75)μmol/L versus (66.08 ±16.48)μmol/L, P<0.01], while the ET-1 levels of the two groups with diabetes mellitus were significantly higher [(100.25 ±20.34) and (77.55 ±14.84) versus (53.62 ±8.40)ng/L, P<0.01] than those of the group C.The NO levels of group A were significantly lower than in group B [(43.87 ±12.05) versus (53.29 ±11.75)μmol/L, P<0.01].Moreover, the ET-1 levels of the group A were significantly higher than in group B [(100.25 ±20.34) versus (77.55 ±14.84)ng/L, P<0.01].Between the two diabetic groups, group A showed significantly higher systolic blood pressure(SBP), diastolic blood pressure(DBP), HbA1c, and course than group B (P<0.01).Correlation analysis showed a negative correlation between SBP, DBP, fasting blood glucose, HbA1c, and NO a positive correlation between high-density lipoprotein cholesterol ( HDL-C ) and NO, a negative correlation between HDL-C and ET-1, and a positive correlation between SBP,LDL-C, uric acid, fasting blood glucose, HbA1c, and ET-1.Conclusion The serum levels of NO and ET-1 in diabetic patients are evidently abnormal.Vascular endothelium injury will become more serious in patients with complications.Therefore, the serum levels of NO and ET-1 in diabetic patients are correlated with control of blood glucose, blood pressure, and blood lipid levels.

Objective To investigate the differential diagnostic features of subtypes of renal cell carcinoma(RCC) using dynamic contrast-enhanced MRI(DCE-MRI).Methods The MRI appearances of 77 RCCs, including 55 clear cell RCCs(CCRCC),14 papillary RCCs(PRCC) and 8 chromophobe RCCs(CRCC), were retrospectively analyzed and compared with findings of pathology. DCE-MRI was conducted in each case after intravenous administration of contrast agent. Region of interest measurements (cortical, nephrographic and delayed Phases) of signals within tumor and uninvolved renal cortex were used to calculate percentage signal intensity change and tumor-to-cortex enhancement index, and the data was analyzed by AVONA and t test. Results On unenhanced and enhanced MRI, most CRCCs showed homogeneous signal(7/8). CCRCC and PRCC often show inhomogenous signal with necrosis(36/55, 7/14). Hemorrhage and cystic degeneration were often found in PRCC (9/14). On the cortical, nephrographic and delayed phase images, CCRCCs showed greater signal intensity change[(296.15±60.27)%, (236.33±58.31)% and (216.83±46.72)%,respectively than PRCCs (79.70±18.84)%, (122.81±27.35)% and (117.55±20.63)%, respectively], and CRCCs showed intermediate change [(119.56±40.76)%, (163.06±33.91)% and (179.72±32.89)%, respectively].A phenomenon of quick staining and quick fainting was observed in CCRCCs. Both of CRCCs and PRCCs showed delayed enhancement. The tumor-to-cortex enhancement index at the cortical, nephrographic and delayed phases was highest for CCRCCs (1.26±0.34, 0.92±0.23 and 0.76±0.14, respectively), lowest for PRCCs (0.33±0.12, 0.41±0.23 and 0.35±0.11, respectively), and intermediate for CRCCs (0.54±0.10, 0.62±0.15 and 0.69±0.12, respectively,P＜0.01). The degree of enhancement was significantly different among the 3 subtypes at the every contrast enhanced phase (F=940.931, 124.515 and 38.194, P＜0.01), so was the tumor-to-cortex enhancement index(F=798.625,78.308 and 73.699, P＜0.01). There was a good consistency between MR appearances of the 3 RCC subtypes and pathological characteristics. Conclusion DCE-MRI could distinctly show imaging features of CCRCC, PRCC and CRCC, which were related to their pathological characteristics, and these features were helpful in predicting a specific subtype of RCC.

The aim of this study is to investigate the protection effect of tanshinone IIA (Tan) against triptolide (TP)-induced liver injury and the mechanisms involved. Acute liver injury was induced by intraperitoneal injection of TP (1 mg x kg(-1)) in mice. The activities of AST, ALT and LDH in serum and the levels of GSH, GST, GSH-PX, SOD, CAT and MDA in liver tissue were detected. The histopathological changes of liver tissues were observed after HE staining. Nrf2 translocation in liver tissue was detected by Western blotting, and real-time PCR was used to measure the expression levels of GCLC, NQO1 and HO-1 mRNA. The results showed that pretreatment with Tan significantly prevented the TP induced liver injury as indicated by reducing the activities of AST, ALT and LDH (P < 0.01). Tan pretreatment also prevented TP-induced oxidative stress in the mice liver by inhibiting MDA and restoring the levels of GSH, GST, SOD and CAT (P < 0.05). Parallel to these changes, pretreatment with Tan could attenuate histopathologic changes induced by TP. Furthermore, the results indicated that Tan pretreatment caused nuclear accumulation of Nrf2 as well as induction of mRNA expression of antioxidant response element (ARE)-driven genes such as GCLC, NQO1 and HO-1. These results indicated that Tan could protect against TP-induced acute liver injury via the activation of Nrf2/ARE pathway.

Objective To explore the relationship between disorders of lipid metabolism and avascular necrosis of femoral head after operation of femoral neck fracture .Methods 160 patients with a diagnosis of fresh femoral neck fractures treated with AO cannulated compressed screws in orthopedic department of our hospital from January 2007 to January 2012 were involved .All the patients were divided into two groups :ANFH or non ANFH group according to the features of femoral head .The levels of blood lipid were examined .Then ,Logistic regression was used to screening risk factors and evaluate the influence of blood lipid factors ac-cording to βrisk factor .Results The levels of TC ,TG ,LDL and Apo B in ANFH group were (5 .99 ± 1 .05)mmol/L ,(2 .63 ± 0 .85)mmol/L ,(4 .16 ± 1 .21)mmol/L ,(0 .99 ± 0 .28)g/L respectively ,which increased remarkably compared with the control group ;while HDL ,Apo A1 levels in the ANFH group were (0 .88 ± 0 .19)mmol/L ,(1 .20 ± 0 .17)g/L ,which was remarkably lower compared with the control group ,and there were statistically significant difference (P=0 .000) .Serum TC and LDL levels were risk factors impacted on postoperative ANFH .Conclusion Postoperative ANFH was related to disorders of lipid metabolism .Serum TC and LDL levels could be diagnostic values on postoperative ANFH .Early control of blood lipid levels may prevent the development of ANFH in patients treated with AO cannulated compressed screws .

Objectives To study the psychological characteristics of children with attention deifcit hyperactivity disorder (ADHD). Methods Human ifgure drawings (HFD) as a projective technique was performed in 107 children with ADHD aged (8.69 ±1.48) years old (6.5~11.5 years), and 107 matched healthy children. Characteristic features of the HFDs in children with ADHD, and correlations between emotional indicators of the HFDs and factors of child behavior checklist (CBCL) were assessed and com-pared with the control group. Results Signiifcant differences in emotional index were found between ADHD and healthy chil-dren, including bad body composition, short arms, long arms, big ifgure, omission of hands and omission of feet (P<0.05). Nega-tive correlation was found between the HFDs emotional index and the factors of activity and social ability in the CBCL (P<0.05), but a positive correlation was found between the HFDs emotional index and behavioral problem (P<0.05). Conclusion Human ifgure drawings can relfect some emotional characteristics of children with ADHD, and when combined with CBCL, it can pro-vide evidence for diagnosis and intervention for ADHD.

Objective To explore the clinical characteristics of children with serious pneumonia with ventilatory support,and combined with heart failure,encephalopathy,hyponatramia,acute respiratory distress syndrome(ARDS) and multiple organ dysfunction syndrome(MODS).Methods One hundred and fifteen children(81 males,34 females) with serious pneumonia in ICU from Jul.2005 to Jul.2007 were reviewed,The duration of ventilation support was over 48 h.And blood electrolyte,blood gas,cerebrospinal fluid and CT were detected.Results Ninety-three cases had a good outcome,7 cases were given up,15 cases were dead.The complications included heart failure in 60 cases(52.17%);encephalopathy in 40 cases(34.78%),in which tics type in 38 cases(95%),apnea type in 11 cases(27.5%);hyponatremia in 42 cases(36.52%),of which tics type in 31 cases(73.81%),syndrome of inappropriate secretion of antidiuetic hormone in 27 cases(72.97%)resulted in hyponatremia;ARDS in 8 cases(6.96%),pa(O2)/FiO2

OBJECTIVE:To study the intervention mechanism of puerarin on expressions of HSP70 and Fas proteinum in rats with acute cerebral ischemia injury.METHODS:12 rats with acute cerebral ischemia injury were randomly divided into ischemia control group(saline) and puerarin treated control group,with 6 in each group,each rat under took own control by ischemia side(exp.group) and non-ischemia side(control group);And rats with acute cerebral ischemia injury were randomly divided into control group (saline,ischemia side),puerarin treated control group and normal group (non-ischemia side),with 6 in each group.And then the expressions of HSP70 and Fas proteinum is determined by HE staining and immunochistochemistry SP.RESULTS: The expression of HSP70 was negative or weakly positive in ischemia control group and puerarin treated control group, while that in ischemia experiment group and puerarin treated experiment group was significantly increased(P0.05);The numbers of dead cells in control group and puerarin group were found to be significantly larger than that in normal group(P