Objective To investigate the effect of Dl-3-n-butylphthalide on acute cerebral infarction.Methods In Department of Neurology in the Fifth Hospital of Wuhan from March 2013 to June 2014,100 cases of patients with first onset of acute cerebral infarction were recruited.The participants were divided into 2 groups (control group and treatment group) randomly,with 50 participants in each group.Besides general treatment,the patients of treatment group received intravenous injection of Dl-3-n-butylphthalide in acute phase and orally took soft capsule of Dl-3-n-butylphthalide in recovery phase.All the patients were followed up for 24 weeks.Neurological function and general cognition were assessed separately by national institute of health stroke scale (NIHSS),and mini mental state examination (MMSE) was applied to assess overall cognitive function.Results NHISS score was gradually decreased and MMSE score was increased in both groups.As compared with the control group,NIHSS score and MMSE score were changed significantly in the treatment group.From first onset to 24 weeks after treatment,NHISS score was decreased by 30％ in the control group and 44％ in the treatment group;MMSE score was increased by 17％ in the control group and 32％ in the treatment group.Conclusion Sequential therapy with Dl-3-n-butylphthalide improves neurological function and general cognition faster and more significant for patients with acute cerebral infarction.

BACKGROUND:To achieve the stability of the fracture reduction and try to keep the integrity of the cervical vertebra activity, domestic and foreign scholars have carried out the clinical and experimental research on the limited internal fixation of single segment, and achieved good clinical curative effect. There was no obvious discomfort symptoms caused by the instability of the atlantoaxial joint. OBJECTIVE:To perform biomechanical analysis of fixed atlas fractures by single phase with three-dimensional motion experiment. METHODS:Six fresh upper cervical spine specimens (C0-C5) were used, and made into models of double fracture of the anterior arch of the atlas. Single segment fixation was conducted with metacarpal bone reconstruction plate system simulation. Data of each specimen in intact state, fracture state and internal fixation state were measured. The neutral zones in fracture state, internal fixation state and intact state were compared, and the difference of three-dimensional motion range and intact state were compared. RESULTS AND CONCLUSION:(1) There was statistical y significant difference between the neutral zones and range of motion with those of fracture status and intact status (al P<0.05). No significant difference was found between the result of fixation status and intact status (al P>0.05). (2) Results verify that simulation of single-segment fixation of unstable atlas fractures with metacarpal bone reconstruction plate system can obtain good stability, restore the stability of the upper cervical spine, and simultaneously ful y avoid adverse effects of fusion.

Objective To evaluate the initial clinical application value of placing the Freka R Trelumina guided DSA. Methods The Freka(R) Trelumina was placed guided by DSA in 10 patients with disease of digestive tract post operation complicated with stomal leak or/and stomal stegnosis or various kinds of patients with gastric emptying disorder. Results The Freka(R) Trelumina could be put 20 cm away from Treize anadesma guided by DSA. The achievement ratio was 90%. The putting time was 1 to 3 weeks. The localization of the Freka(R) Trelumina was well. The process of feeding was successfully. The effectiveness of decompression of stomach intestine was also good. Stomal leak healed up quickly. The appearance of gastric emptying disorder disappeared. Conclusion Placing the Freka(R) Trelumina guided by DSA is a simple, safe and reliable method for jejunum nourishment and gastrointestinal decompression.

Objective To explore the relationship between DLG value and planning dose distribution and actual treatment dose distribution.Methods IMRT and VMAT plans were generated in Eclipse TPS for a typical whole pelvis case,separately.For IMRT plan,MLC position and actual fluence were calculated for each DLG value with the same optimal fluence.Plans with different DLGs of 0 cm and 0.3 cm were compared by several dosimetric indexes.For exploring the PTV mean dose difference between planning dose and actual IMRT or VMAT treatment,planning dose was recalculated with fixed MLC position and different DLGs.Results Dosimetric differences of PTV V50,rectum V40,bladder V40,small bowel V35,left and right femoral head Dmax were 1.49％,0.72％,0.82％,0.68％,0.02 and 0.14 Gy respectively,the average leaf pair width of MLC segments was correlated with DLG (R2 =0.996,P ＜0.05) and reduced with the increase of DLG.In actual treatment,3.95％ and 1.5％ mean dose reduction in PTV were observed while DLG increased per 0.1 cm in the typical pelvis case,in IMRT and VMAT treatment respectively.Conclusions DLG can result in the change of MLC position and the dose difference between planning and actual treatment.

OBJECTIVE: To prepare lornoxicam chitosan gel and to study its quality control method. METHODS: Lornoxicam chitosan gel was prepared with chitosan as excipient. The content of lornoxicam was determined by HPLC. The stability of the preparation was studied by accelerated test and centrifugation. RESULTS: The prepared gel was well-spread, with linear range at 12.5～125.0?g?mL-1 and average recovery at 100.02%(RSD=1.18%). The indexes of stability all met the standard. CONCLUSION: The preparing technology of lornoxicam chitosan gel is simple, and its quality is stable reliable.

Background To establish the ideal animal model of retinitis pigmentosa (RP) is very important for onward relevant study.Previous research determined that N-methyl-N-nitrosourea (MNU) can selectively damage photoreceptors via intravenous injection in mammal.However,whether MNU can be used to create an RP model needs to be investigated.Objective This experiment was designed to evaluate the toxic effect of MNU on photoreceptor cells of cats.Methods MNU was injected into 20 2-year-old cats via femoral vein and randomized into 20mg/kg, 25mg/kg, 30mg/kg, 35mg/kg and 40mg/kg MNU groups,and equal amount of normal saline solution was used in the same way in 4 normal cats as the control group.The activity,pupil size and light reflex were observed after injection of MNU.The cats were sacrificed and eyeballs were enucleated for histological examination to evaluate the structural and morphological changes of photoreceptors at 24 hours,72 hours,7 days and 14 days after the administration of MNU.This experimental study complied with the Statement for the Use of Animals in Ophthalmic and Vision Research.Results Dilated pupil and inertia of light reaction were found in experimental cats on the 7th days in the various groups.In 24 hours after MNU injection,the damage of photoreceptors was primarily characterized by pyknosis and disorder.In 72 hours after MNU injection,attenuation of the outer nuclear layer and disruption of cells were seen.Loss of photoreceptors and disappearance of the outer nuclear layer were observed on the 7th and 14th day.The extent of retinal photoreceptor cell damage was dependent on the dose of MNU.Conclusion MNU can selectively induce serious damage of the photoreceptor cells in cats retina in a time- and dose-dependent manner.

Objective To evaluate two kinds of anterior screw fixations in the treatment of odontoid fractures. Methods A total of 36 patients with D' Alonzo type Ⅱ odontoid process fractures were treated with anterior screw fixation in our department from 1999 to July 2009. There were 28 males and 8 females at mean age of 42.3 years (rang 17-59 years). According to time and surgery procedures, the patients were divided into Group A ( from 1999 to June 2005, n = 11 ) and Group B ( from June 2005 to July 2009, n = 25 ). Patients in Group A received anterior hollow screw fixation of the odontoid process monitored under G-arm or C-arm, while those in Group B received anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system. The operation time and blood loss in two groups were compared by Student' s t test and analyzed with SPSS 13.0 statistical software. X-ray examination was performed in all patients 3, 6 and 12 months after operation to observe fracture union and stability of the upper cervical spine. Results The operation time was ( 102 ± 12) min ( range, 77-148 min) in Group A and ( 104 ± 14) min ( range, 71-150 min) in Group B, with no statistical difference ( P =0.21 ). The blood loss was (465 ± 5) ml (range, 20-130 ml) in Group A and (42 ± 6) ml (range, 26-150 ml) inGroup B, with no statistical difference (P = 0.16). All patients received reexamination three months after operation, which showed no bony union or dislocation but average 40% restriction of neck rotation. One year after operation, 30 patients (83%) got fracture union and six ( 17% ) got fiber healing, with average 24% restriction of neck rotation. Conclusions There is no statistical significant differences between two groups in aspects of operation time, blood loss and fracture healing. But anterior screw fixation of the odontoid process assisted by Iso-C 3D navigation system can reduce exposure to radiation of both patients and surgeons. Furthermore, solid screws can be applied to augment the fixation intensity and thereby reduce the complications caused by non - union.

Objective To evaluate mesenteric muhidetector row CT angiography (MDCTA) in the diagnosis of acute mesenteric ischemia (AMI).Methods In this study,43 cases of AMI proven by clinical criteria,or operation and pathology underwent whole abdomen MDCT precontrast,arterial phase and venous phase scan with 0.6 mm collimation.The mesenteric arteries and veins were reconstructed by using volume rendering (VR),maximum intensity projection (MIP),thin slab maximum intensity projection (TSMIP) techniques,and abnormal CT angiography findings as well as abnormal bowel and mesentery were analyzed.Results It was found that AMI was caused by superior mesenteric artery (SMA) embolism (n =4),SMA thrombosis (n = 6),mesenteric and portal venous thrombosis (n = 13),SMA dissection (n =5),strangulated bowel obstruction (n = 10) and vasculitis (n = 5).MDCTA showed clearly the position,shape,severity and extent of the vascular occlusion,narrow and dissection.It could also demonstrate the abnormal course and direction of the vessels including vascular gathering,shift,tortuosity,retortion,and twist.Furthermore,the pathogenesis of various conditions including atherosclerotic plaque,emboli,thrombosis,dissection,tumorous invasion,strangulated bowel obstruction and vasculitis could be identified by MDCTA.Conclusion MDCTA can clearly demonstrate direct signs leading to AMI,and identify AMI and its etiology at early stage,with the combination with its indirect findings.

Objective To observe the effect of parecoxib sodium on relieving acute postoperative pain and inflammatory fac‐tors in laparoscopic cholecystectomy .Methods Totally 96 cases of laparoscopic cholecystectomy were randomly divided into 3 groups :experimental group (group A ,group B) and control group(group C) ,32 cases in each group .Group A received intravenous infusion of parecoxib sodium 40 mg (diluted to 5 mL ) intravenously at the induction of general anesthesia and intravenous injection of 5 mL normal saline 15 min before surgery .In group B ,anesthesia induction ,15 minutes before surgery were given 5 mL of normal saline ,parecoxib sodium 40 mg (diluted to 5 mL) intravenously .In group C ,5 mL of normal saline was given intravenously at the time of general anesthesia induction and 15 min before operation .The total number of PCA and the number of effective compres‐sions and VAS scores at 12 h postoperatively ,the levels of serum TNF‐α,IL‐6 and IL‐12 before operation ,immediately after opera‐tion ,at 2 ,12 ,24 h after operationwere compared .Results The PCA press times and effective press times of patients in group A within 12 hours after the operation were much less than those in group B ,C(all P<0 .05) .The VAS scores of group A at 1 ,2 ,4 ,6 , 8 and 12 h were lower than those in group B and C (P<0 .05) ,but there was no significant difference between group A and group B after 24 h(P>0 .05) .The changes of serum IL‐6 ,TNF‐αlevel in three groups of patients at the end of the operation ,2 ,12 ,24 h after operationwere :group A < group B < group C .While the changes of serum IL‐12 were:group A > group B > group C . Conclusion Parecoxib sodium has a good analgesic effect of laparoscopic cholecystectomy in the induction of general anesthesia than before the end of the operation and application effect is better ,and its analgesic effect can reduce the production of inflammato‐ry factors IL‐6 and TNF‐α,and increase the level of IL‐12 ,which is beneficial to postoperative recovery .

Objective To investigate the efficacy of external fixators in the treatment of unstable pelvic fractures( Tile B and Tile C ). Methods The different results of 78 patients who had been treated with or without external fixator were compared. Results In 38 cases who were treated without external fixator, the cure rate for hemorrhagic shock was 76%, the mortality 10.6%, and the average ISS score 11.6. In 40 cases who were treated with external fixator, the cure rate for hemorrhagic shock was 90%, the mortality 2.5%, and the average ISS score 9.8. Conclusion The treatment of unstable pelvic fracture with external fixator is simple and reliable, and can reduce the mortality significantly.