Objective To investigate the prognostic related factors in the patients with ruptured intracranial aneurysm treated by surgical treatment and their clinical significance .Methods The medical record data in 218 cases of ruptured aneurysm treated by operative treatment were performed the retrospective analysis ,including th egeneral data ,Hunt‐Hess grade on admission ,surgical procedure ,etc .The patient′s prognosis situation adopted the Glasgow outcome scale(GOS) as the evaluation standard when dis‐charge from hospital .Firstly the possible factors were performed the single factor analysis ,then the factors with statistic signifi‐cance in the single factor analysis were performed the multiple factors logistic regression analysis .Results The single factor analy‐sis indicated that the age ,Hunt‐Hess grade on admission ,hypertension ,operation mode ,CT Fisher grading and symptomatic vaso‐spasm were significantly correlated with the prognosis ( P < 0 .05) .The multiple factors analysis indicated that age ,Hunt‐Hess grade on admission ,symptomatic vasospasm ,CT Fisher grading were the independent risk factors affecting the prognosis of patients (P< 0 .05) .Conclusion The patients′ age ,Hunt‐Hess grade on admission ,symptomatic vasospasm and CT Fisher grading can sig‐nificantly affect the prognosis of the patients with ruptured intracranial aneurysm after surgical treatment .Paying attention to the predictive value of these predictors has important clinical significance to reduce the postoperative mortality rate and disability rate in the patients with ruptured intracranial aneurysm .

Objective To investigate the clinical characteristics of invasive pneumococcal disease (IPD) and its drug resistance among children under the age of 5 years.Methods Clinical characteristics of 45 children of IPD admitted to the Shengjing Hospital of China Medical University from 2009 to 2010 and antimicrobial non-susceptibility results were analyzed retrospectively.Results Forty-five cases of IPD were confirmed by positive culture of sterile body site,most of which occurred between April and June.Most of the IPD children were below the age of 2 years,which accounted for 66.7％ (30/45).The disease spectrum included bacteremia in 32 cases (71.1％),encephalitis in 9 cases (20.0％),empyema in 23 cases (51.1％),necrotizing pneumonia in 10 cases (22.2％).Pneumococcal non-susceptibility to erythromycin were found to be 100％,to clindamycin were 95％,to tetracycline were 95.12 ％,to trimethoprim-sulfamethoxaole were 80.49％,to chloramphenicol were 18.18％,while pneumococcal resisitanse to rifampicin,quinolones and vancomycin were 0.Eight of eleven and 18/24 were found to be pneumoccal resistance to penicillin and cephalosporin respectively and their minimum inhibitory concentrations were high.Twenty five cases were cured (55.6％).Fifteen cases were improved (33.3％).Four cases died (8.9％).One cases was retreated.All cases of death were under the age of 2 years.Conclusion IPD is more common with a high mortality rate among those under the ages of 2 years.Poor outcome is associated with Streptococcus pneumoniae resistance to antibiotics.

Objective To investigate the therapeutic effect and safety of microneurosurgery associated with Gamma Knife radiosurgery on the large meningiomas in sellar region, and to clarify its clinical curative effect. Methods The clinical data of 34 patients with large meningiomas in sellar region underwent microsurgery were retrospectively analyzed.All of them underwent microsurgery,and then treated with Gamma Knife radiosurgery in one month after operation if there were residual tumors.The tumor removal of situation,complication,rate of symptom remission,and recurrence rate were analyzed.Results Among the 34 patients,total resection (7 cases of Simpson grade Ⅰ and 12 cases of Simpson grade Ⅱ)was achieved in 19 cases (55.9%),subtotal resection (Simpson grade Ⅲ )in 14 cases (41.2%), and partial resection (Simpson grade Ⅳ )was achieved in 1 case (2.9%).The major complications were cranial nerve injuries (such as oculomotor nerve, trochlear nerve and abducens nerve,n=6),the contralateral limb paresis (n = 2),postoperative bleeding (n = 1),CSF leak with infection (n=3),and secondary epilepsy (n = 3 ); no death occurred postoperatively. All these patients were followed up for about 3 to 48 months.Postoperative headache disappeared in 24 cases (80%),and 6 cases were alleviated (20%);postoperative vision improved in 12 cases (80%),remained unchanged in 2 cases (13.3%)and deteriorated in 1 case (6.7%); postoperative olfactory function improved in 5 cases (62.5%) and 3 cases unchanged (37.5%); 5 cases recoverd from the ocular motility disorder (71.4%), and 2 cases unchanged (28.6%);7 cases recoverd from thehemiplegia (100%).One of the total resection cases (5.2%)and two of the non-total resection (13.3%)suffered from tumor recurrence.All of the non-total resection cases were treated with Gamma Knife radiosurgery.Conclusion The clinical effect of microneurosurgery associated with Gamma Knife radiosurgery in treatment of large meningiomas in sellar region is satisfactory.

Objective To investigate the effects of bone mesenchymal stem cells(BMSC) on the expression level of inflammatory factors IL-1beta and IL-10 from young rats with acute lung injury(ALI).Methods Seventy-two SPF male SD young rats were randomly divided into three groups:control group,disease model group(model group),disease model + BMSC(treatment group).Each group was then randomly divided into four subgroups according to the treatment phages.The juvenile rat ALI models were established.BMSC was injected into the treatment group,and DMEM was injected into the model and the control groups.Then,the pathological changes of lung tissues were observed.The W/D ratio,the neutrophil count and protein content in bronchoalveolar lavage fluid(BALF) were measured.The changes of IL-1beta and IL-10 contents were detected.Results Compared with the control group and the treatment group,the number of neutrophils,total protein content and W/D ratio of BALF lung tissue in the model group increased significantly in each period(P ＜ 0.05).The degree of lung injury in the treatment group was significantly weaker than that in the model group.The levels of IL-1beta and IL-10 in serum decreased in different treatment periods(48 hours vs 6 hours,P ＜0.05).In model group,IL-1beta was abundantly expressed in the cytoplasm and wall of alveolar epithelial cells,while in treatment group,the expression intensity of IL-1 beta protein was significantly decreased.The levels of IL-1 beta and IL-10 protein in lung tissues of model group were significantly higher than those of control group(P ＜0.05).Conclusion BMSC has an important effect on the expression of inflammatory factors IL-1beta and IL-10 in ALI young rates.BMSC can alleviate the inflammatory reaction of long injury and participate in the repair of lung iniury.