Objective To investigate the changes of vertebral-basal artery and regional cerebral blood flow(rCBF) in patients with olivopontocerebellar atrophy(OPCA).Methods 10 patients with OPCA were examined by digital subtraction angiography(DSA) and single-photon-emission-computed tomography(SPECT),and compared with the control group(patients with vertigo or transient ischemic attack).Results In OPCA group,there were 5 cases with small vertebral artery(50%),4 cases with single vertebral artery(40%),9 cases with small and little vessels(90%),10 cases with poor stain in later arterial phase(100%) could be seen by DSA.The lower rCBF in cerebellum and brain stem were seen in 8 cases(80%)by SPECT.In control group,there were 3 cases(15%),4 cases(20%),4 cases(20%),3 cases(15%) and 7 cases(35%) respectively.There were significant differences between the two groups(all P

Objective To analyze the changes of serum amyloid A (SAA) ,C reactive protein (CRP) ,procalcitonin(PCT) and trypsin activated peptide(TAP) in the patients with acute pancreatitis (AP) ,and to evaluate the above 4 indexes combined detection in the diagnosis and treatment of AP .Methods The levels of SAA ,CRP ,PCT and TAP were detected in 21 cases of severe AP (SAP) and 49 cases of mild AP(MAP) .The detection results were compared with those in the healthy control group (n=50) .Re‐sults The levels of SAA ,CRP ,PCT and TAP had statistical differences between the patients with acute stage of SAP and MAP groups with the healthy control group(P<0 .01);the levels of SAA ,CRP ,PCT and TAP in the SPA group were significantly high‐er than those in the MAP group with statistical difference(P<0 .01) .The diagnostic efficiency of 4‐index combined detection was higher than that of single index detection .Conclusion The combined detection of SAA ,CRP ,PCT and TAP is conducive to early diagnosis and disease condition judgement of AP ,and has an important significance to the diagnosis and treatment of SAP .

Objective To compare the difference in pharmacokinetics characteristics of vancomycin in cerebrospinal fluid between administration by continuous infusion and interim infusion.Methods Twenty postoperative patients in the Department of Neurosurgery of Beijing Tiantan Hospital, Capital Medical University admitted into intensive care unit (ICU) to receive vancomycin for prophylaxis of intracranial infection were enrolled, and they were randomly distributed to a continuous intravenous infusion group and a interim intravenous infusion group, each group 10 cases. In continuous intravenous infusion group, the patients received a loading dose of vancomycin (15 mg/kg) by continuous intravenous pump infusion for 1 - 2 hours followed by 30 mg/kg vancomycin in a constant pump infusion rate for 24 hours; while in interim intravenous infusion group, the patients received 15 mg/kg vancomycin administered by intravenous pump infusion for 1 - 2 hours, once every 12 hours. The concentration of vancomycin in the cerebrospinal fluid at different time points was measured by two-dimensional liquid chromatography (2D-LC) method, the parameters of pharmacokinetics were calculated in the two groups, and the adverse reaction was observed.Results The comparison between the ratio of areas under the concentration-time curves (AUC) and minimum inhibitory concentration (MIC) of the continuous and interim groups showed no significant difference (19.7±14.0 vs. 16.1±6.4,P > 0.05). However, in the continuous intravenous infusion group, the drug concentration reached the peak value (0.96± 0.77)μg/mL at 12 hours, and later revealed a plateau concentration 0.91-0.93μg/mL for 12 hours; while in the intravenous infusion interim group, the drug concentration reached the peak value (0.92±0.47)μg/mL at 16 hours, in the later 2 hours declined to (0.84±0.45)μg/mL, and afterwards still had a tendency of persistent declination. In all the patients, no any adverse reaction related to the drug occurred.Conclusion Continuous intravenous infusion and interim intravenous infusion of vancomycin for the postoperative neurosurgical patients without intracranial infection have the similar efficacy of medication, but the former can achieve the peak concentration faster and later the fluctuation of drug concentration in cerebrospinal fluid is smaller than those in the latter.

Objective To investigate the chemical constituents of Baoyuan Decoction.Methods Many chromatographic techniques and spectral analysis means were employed for isolation and identification of the constituents.Results Fifteen flavonoids were isolated from Baoyuan Decoction and their structures were identified as licuraside(1),formononetin-7-O-?-D-glucoside(2),formononetin(3),isomucronulatol(4),davidigenin(5),2',4'-dimethoxy-3'-hydroxyisoflavan-6-O-?-D-glucoside(6),(6aR,11aR)9,10-dimethoxypterocarpan-3-O-?-D-glucoside(7),calycosin(8),liquiritigenin(9),5-dehydroxykaempferol(10),liquiritin(11),isoliquiritin(12),isoliquiritigenin(13),7,3'-dihydroxy-5'-methoxyisoflavone(14),and odoriflavene(15).Conclusion All fifteen compounds are isolated from Baoyuan Decoction for the first time.

in order to maintain a normal temperature range.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

BACKGROUND:Recently, the clinical repair methods of irregular wound on fingers primarily include local pedicled flap and free mini-flap of upper extremities or lower extremities.
OBJECTIVE:To discuss the application of free mini-flap derived from upper limb in repairing the wound on fingers.
METHODS:From December 2010 to February 2014, 12 patients with irregular wounds on 12 fingers were selected from Department of Traumatic Orthopaedics and Hand Surgery, First Affiliated Hospital of Guangxi Medical University, China. The size of wounds ranged from 1.5 cm × 2.0 cm to 3.0 cm × 4.5 cm with different degrees of bone or tendon exposure. After the debridement, 12 patients were treated by free mini-flaps of upper limb. The donor sites were directly sutured.
RESULTS AND CONCLUSION:Among the 12 patients, al the wounds at recipient and donor sites were healed at stage I, and the free mini-flags survival completely. Al of patients were fol owed up for 3-6 months (average 4.5 months). Free mini-flags had good appearance and needn’t undergo secondary trimming. The active motion of fingers was improved dominantly. According to the criteria of Hand Surgery Association Society of Chinese Medical Association Society for the function evaluation of upper limb, three cases were excellent, eight were good, and only one was bad. The excellent and good rate was 91%. Free mini-flaps of upper limb are an ideal method for repair of wounds on fingers. It has no injury to normal tissue in hands, donor site is very secluded, and the short-term curative effect is good.

Objective To find new way to reduce non-recurrent laryngeal nerve (NRLN) injuries by applying intraoperative neuromonitoring(IONM) to identify NRLN in thyroidectomy. Methods Records of 279 patients who underwent complex thyroidectomy by applying IONM to identify and monitor RLN from Mar. 2009 to Jan. 2010 were veviewed. We proposed the skills to identify and monitor NRLN and predict RLN varition through exploring vagus nerve and RLN before RLN dissection. Results 6 cases NRLN located on the right side were all accurately identified by IONM, thus no injury of NRLN occurred during thyroid operations. Conclusions NRLN is difficult to be predicted preoperatively and identified by naked eyes. The application of IONM to predict, identify and monitor NRLN could remarkably reduce the possibility of NRLN injury.

Objective:To investigate the syndromes distribution in patients with dysfunctional uterine bleeding(DUB) related to kidney deficiency, and to provide the basis for standardizing the DUB syndrome differentiation of kidney deficiency. Methods: DUB Patients with kidney deficiency were chosen and accepted epidemical survey through the questionnaire, then the frequency and constituent ratio of each syndrome were calculated. Results: In 612 cases of DUB patients with kidney deficiency, there were 102 patients with simple syndromes covered 16.67%, and 510 patients with compound syndromes covered 83.33%. In patients with simple syndromes, the common syndromes were kidney-yin deficiency(45,44.12%) and kidney-qi deficiency(45,41.18%). And the syndromes of kidney-qi deficiency and kidney-yin deficiency were often respctively complicated with liver stagnation(68,11.09%; 113,18.43%), blood defi ciency(57,9.30%; 99,16.15%) and blood stasis(57,9.30%; 99,16.15%), the syndrome of kidney-yang deficiency usually complicated with spleen-qi deficiency(75,12.23%). The syndrome of kidney-qi deficiency(186,57.23%) was commonly-seen in the patients with ovular DUB, while the syndromes of kidney-qi(146,50.69%) and kidney-yin deficiency(111,38.54%) were frequently-seen in the patients with anovular DUB. Conclusion: In clinic, the compound syndromes were commonly seen in patients with DUB due to kidney deficiency, the complicated syndromes of kidney deficiency were liver stagnation, spleen-qi deficiency, blood deficiency and blood stasis..

Objective The aim of this study was to evaluate the prognosis of resection followed by chemotherapy compared with chemoradiotherapy for limited-stage small cell lung cancer .Methods The clinical data of 230 limited-stage small cell lung cancer patients with curative treatment between January 2006 and December 2011 were retrospectively analyzed .All patients divided to two group: the resection plus chemotherapy ( S +C ) and chemoradiotherapy ( R +C ) .And the prognostic factors were further analyzed with limited stage small cell lung cancer .The Kaplan-Meier method was used for the survival analysis.Results The overall survival rates of 1-year, 3-year and 5-year were 87.0%, 38.9%, 25.4%, respectively and the media survival time ( MST) 26.0 months.When patients were stratified by clinical stageⅠ+Ⅱ, the 1-year , 3-year and 5-year overall survival rates of S +C group and R +C group were 92.6%, 63.2%, 47.3%and 76.2%, 42.9%, 30.6%, respectively (χ2 =7.851, P<0.05), while those were 88.5%, 26.9%, 10.6% and 86.0%, 25.1%, 25.1%, respectively in stage ⅢA with no significant difference ( P >0.05).In univariate analysis, tumor location, tumor stage, lymph node metastasis, TNM stage, the cycle of chemotherapy , treatment modalities were significantly associated with survival ( RR=1.735, P<0.05).The multivariate analysis only showed TNM stage were independent factors of prognosis .Conclusions The results suggested that resection plus chemotherapy could improve the prognosis of early-stage(stageⅠ+Ⅱ) small cell lung cancer, but patients in ⅢA stage should received the definitive chemoradiotherapy .The TNM stage was still the independent factor of prognosis .