Objective To assess the value of embolization of intracranial aneurysms with GDC.Methods 17 patients with 18 intrtacranial aneurysms were treated with GDC.15 patients presented SAH with the following classifications of Hunt and Hess grading:grade Ⅰ and Ⅱ with 10 patients respectively,Ⅲ with 3,Ⅳ with 2.Results 13 patients had excellent clinical outcomes,and 3 patients suffered from transient parlysis after embolization,but recovered following medical treatment medical treatment and one patient died.Conclusion Endovascular treatment of intracranial aneurysms with GDC is a better alternative but a long-term follow-up is necessary.

Objective To observe and analyse the application effect and value of problem based learning (PBL) combined evidence-based learning (EBL) in emergency medicine clinical teaching.Methods A total of 53 clinical medicine students were selected.The combined teaching method was applied in emergency clinical teaching.After the end of the teaching,the teaching effectiveness survey and theory test of the combined teaching group was performed,and the theory test scores was compared with the traditional teaching group.Results The combined teaching method could stimulate learning enthusiasm,improve learning efficiency,the abilities of selfstudy,literature retrieval,and the ability to analyze and solve problems.77.4％ of students thought this new teaching method had good application value in clinical teaching.Furthermore,the excellent rate of the theory test scores combined teaching group was better than traditional teaching group (41.5％ vs 15.6％,x2 =7.868,P =0.007).Conclusions The PBL joint EBL pedagogy can overcome diadvantages of tradional teaching and provide higher interest,ability of self-study as well as higher teaching quality of the medical students.It will be worth to spread in medical clinical teaching.

Objective: To construct the packaging plasmid pSNAV-hEndostatin-CMV-EGFP of adeno-associated virus vector (AAV) encoding human Endostatin (hEndostatin) cDNA. Methods: The hEndostatin eDNA obtained from plasmid pCD-sEndostatin was subcloned into the packaging plasmid pSNAV of AAV by molecular clone ways. The recombinant plasmid pSNAV-hEndostatin-CMV-EGFP was identified by PCR analysis, restriction enzymes analysis and sequencing analysis.Results: The recombinant pSNAV-hEndostatin-CMV-EGFP was correctly constructed and confirmed by PCR analysis, restriction enzymes analysis and sequencing analysis. Conclusion: The constructed AAV-hEndostatin packaging plasmid pSNAV-hEndostatin-CMV-EGFP could be the packaging plasmid of rAAV-hEndostatin-EGFP.

Objective To investigate the relationship between the amplification of human telomerase reverse tran-scriptase (hTERT) gene and high-risk human papillomavirus (HR-HPV) infections in cervical intraepithelial neoplasia (CIN) and cervical carcinoma. Methods The cervical epithelial cells were collected from 34 samples of normal cervical epithelium, 31 samples of CIN (gradeⅠ), 33 samples of CIN (gradeⅡ), 34 samples of CIN (gradeⅢ) and 20 samples of cer-vical carcinoma. HPV DNA was detected by polymerase chain reaction-reverse dot blot hybridization (PCR-RDB) and the amplification of hTERT gene was detected by fluorescence in situ hybridization (FISH). Results Twenty subtypes of HR-HPV were detected including HPV16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 67, 68, 69, 73 and 82. The inci-dence of HR-HPV infection was higher in CINⅡgroup (72.73%), CINⅢgroup (85.29%) and cervical carcinoma group (90.00%) than that of normal cervical epithelium group (20.59%). There was no significant difference in the positive rate of HR-HPV DNA between CINⅠ group (54.84%) and normal cervical epithelium group (P < 0.005). The positive rate of hTERT gene amplification was higher in cervical carcinoma group (80.00%) than that of normal cervical epithelium group (0). There were no significant differences in the positive rates of hTERT gene amplification between CINⅠgroup ( 3.22%), CIN Ⅱ group (18.18%), cervical carcinoma group and CIN Ⅲ group (41.18%). There was positive correlation between hTERT gene amplification and HR-HPV infection (r=0.238, P<0.05). Conclusion The incidence of HR-HPV infection was positively correlated with hTERT gene amplification in cervical lesions. HR-HPV infection may be an early event of ab-normal amplification of hTERT gene. The detection of HPV-DNA and hTERT gene can be used in the clinical diagnosis of early cervical lesions.

Objective To study the expression of pericyte and the association between pericyte and angiogenesis in the endometriosis. Methods the endometriosis group is consisted of 20 ectopic endometrium, 20 eutopic endometrium dur-ing proliferation phase, 20 eutopic endometrium during secretory phase of patient with endometriosis. The control group (non-endometriosis ) include 20 normal endometrium during proliferation phase and 20 normal endometrium during prolifer-ation phase of women without entometriosis. The histological morphology parameters such as mean density of microvessel (MVD), pericytes number(PN)as well as the average ratio of pericyte to endothelial cells in microvessels were measured by immunohistochemical and morphological assesses. Results The expression of MVD was lower in the normal endometrium and eutopic endometrium compared with it in ectopic endometrium tissue. The difference of the MVD among the different groups was statistical significant (P＜0.05). The expression of MVD in secretory phase endometrium was higher than it in proliferative phase endometrium (P＜0.05), and it shows no significant difference between eutopic endometrium and normal endometrium. The expression of PN and PN/MVD in ectopic and eutopic endometrium in EMs group were lower than those in control group. However, we also found that the difference of PN and PN/MVD was not statistically significant. Conclusion Pericytes play an important role in angiogenesis of the endometriosis ,and pericyte coverage contribute to maturing of func-tional vasculature of endometriosis.

During the installation of a pipe pile, the soil around the pile will be squeezed out. This paper deals with this squeezing effect of open-ended pipe piles using the cylindrical cavity expansion theory. The characteristics of soil with different tension and compression modnli and dilation are involved by applying the elastic theory with different moduli and logarithmic strain. The closed-form solutions of the radius of the plastic region, the displacement of the boundary between the plastic region and the elastic region and the expansion pressure on the external surface of the pipe piles are obtained. When obtaining these solutions, the soil ping in the open-ended pipe pile is considered by employing an incremental filling ratio to quantify the degree of soil plugging. Moreover, the effects of the ratio of tension and compression moduli, angle of dilation and incremental filling ratio on the radius of the plastic region and the expansion pressure on the external surface of the pipe pile are investigated. The parametric analyses show that it is necessary and important to consider the difference between the tension modulus and compression modulus, dilation angle and incremental filling ratio for studying the squeezing effect of open-ended pipe pile installation. It is concluded that the analytical solutions presented in this paper are suitable for studying the squeezing effect of open-ended pipe piles.

Traumatic coagulopathy is a serious complication of tissue damage caused by trauma.In clinic,it easily develops into multiple system organ failure and results in high mortality.Traumatic coagulopathy is a plurality of blood coagulation disorder,its pathogenesis is extremely complex and involves tissue damage,blood coagulation,anticoagulation and fibrinolysis,inflammation and many other pathophysiological aspects.An in-depth study on the pathogenesis of traumatic coagulopathy is very important to improve clinical effect.This paper tries to do a review of recent study progress from pathophysiological mechanisms and hopes to provide reference for clinical work.

Objective To evaluate the efficacy and safety of CT-guided 125I radioactive seed implantation combined with gemcitabine and Gio (gemcitabine and S-1, GS scheme) chemotherapy in treating advanced pancreatic carcinoma. Methods Sixty-eight patients with inoperable advanced pancreatic carcinoma were randomly divided into two groups. Patients in group A(n=38) were treated with CT-guided 125I radioactive seed implantation combined with GS chemotherapy scheme, while patients in group B (n=30) received GS chemotherapy scheme only. The short-term effect, the median progression-free survival time, the median survival time and adverse reactions of the two groups were determined , and the results were compared between the two groups. Results The objective response rate (ORR), disease control rate (DCR) and clinical benefit rate (CBR) of the group A were 57.9%, 73.7%and 84.2%respectively, while those of group B were 26.7%, 46.7% and 60.0% respectively. The differences between the two groups were statistically significant (P<0.05). In group A the median progression-free survival time and the median survival time were 8.00 months and 11.84 months respectively, which were strikingly higher than those in group B (5.63 months and 10.40 months respectively), the differences between the two groups were statistically significantly (P<0.05). No significant differences in gastrointestinal reactions, blood toxicity, liver toxicity and other adverse reactions existed between the two groups (P>0.05). Conclusion For advanced pancreatic carcinoma, CT-guided 125I radioactive seed implantation combined with GS program is a safe and effective treatment.

Objective To systematically review the efficacy of hypotensive resuscitation for traumatic-hemorrhagic shock.Methods Randomized controlled trails (RCTs) or quasi-Randomized controlled trails (qRCTs) were searched in Pubmed,Embase and the Corchrane Library from inception to August 2015.Two reviewers respectively picked out the useful data and performed quality evaluation.Metaanalysis was carried out with RevMan 5.3 software,risk ratio (RR) and its 95％ confidence interval (CI) were pooled to estimate the enumeration data,and GRADE 3.6.1 software was used to rate the level of evidence.Results The results of meta-analysis and GRADE rating system which included 4 studies showed that:compared with conventional resuscitation,hypotensive resuscitation was associated with lower total mortality [RR =0.77,95％ CI:0.62-0.95,P =0.01;n =984,GRADE rating:moderate],and 24-hour mortality [RR =0.47,95％ CI:0.24-0.91,P =0.03;n =281,GRADE rating:moderate],but the subgroup analysis of total mortality showed that there were no significant differences in mortality between the subgroup of blunt or penetrating trauma and the subgroup of penetrating trauma.Conclusions Hypotensive resuscitation reduced total mortality and 24-hour mortality,and the quality of the evidence was moderate.The future studies should do further research to explore the efficacy of hypotensive resuscitation for different types of trauma.

Objective To study the role of endoscopic retrograde cholangiopancreatography (ERCP) in diagnosing and treating iatrogenic bile duct injury after laparoscopic cholecystectomy (LC).Methods A retrospective study was conducted on 45 patients with iatrogenic bile duct injury after LC who were investigated and treated by ERCP from December 2002 to August 2015.Results Using the StrasbergBismuth classification,there were 14 patients with type A and 4 with type C who were managed successfully using endoscopic nasobiliary drainage (ENBD) and interventional ultrasound abdominal localized puncture and drainage ; 7 patients with type D were managed successfully using endoscopic sphincterotomy (EST) and endoscopic retrograde biliary drainage (ERBD).For the 5 patients with type E Ⅰ and 3 patients with type E Ⅱ who were treated by EST and ERBD,one patient who had common bile duct transection required cholangioenteric Roux-en-Y anastomosis.For the 6 patients with type E Ⅲ and 6 patients with type EⅣ who were treated by EST and ERBD,a patient required a cholangioenteric Roux-en-Y anastomosis to achieve good results.Conclusions When iatrogenic bile duct injury is suspected after LC,correct assessment with ERCP should be taken immediately.ERCP when combined with ENBD and (or) ERBD could reduce bile duct pressure and dilate stenotic bile ducts to avoid further operation.