Cerebral vasospasm is a common complication after subarachnoid hemorrhage, and its pathophysiological mechanism is poorly understood. A growing body of research suggests that free radicals play an important role in inducing cerebral vasospasm. In recent years, the research about free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage is continuing to increase, This article reviews the roles of many types of free radical scavengers in the prevention and treatment of cerebral vasospasm after subarachnoid hemorrhage.

Fractalkine is a new member of chemokine family, which exists in membrane-boundd form and soluble form. It has both adhesion molecular and chemokine activities. CX3 CR1 is its specific receptor. Both of them were expressed in many diseases of the nervous system. At present, fractalkine and its receptor CX3CR1 polymorphism and the research of cerebrovascular diseases mainly involve in the risk factors for cerebrovascular diseases, cerebral ischemia-reperfusion and bone marrow stem cell transplantion, which are expected to become a new target for clinical treatment.

As an important inflammatory cytokine, tumor necrosis factor-α (TNT-α) plays an important role in the process of cerebral ischemia-reperfusion. The discussion of the dynamic changes, the mechanism of neurotoxicity and antagonizing the therapeutic effect of TNF-α in the process of cerebral ischemia-reperfusion injury will provide theoretical basis for the treatment of cerebrovascular diseases.

OBJECTIVE:To study the adhibition of misoprostol combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section. METHODS:214 patients who received painless abortion after cesarean section were ran-domly divided into group A(71 case),group B(71 case)and group C(72 case). After all patients were given conventional intrave-nous anesthesia,Group A was given misoprostol 0.6 mg for oral administration in preoperative 2 h. Group B was given Misoprostol tablet 0.2 mg abrasive powder put in posterior fornix in preoperative 3 h. Group C did not give any drugs. All the groups used dis-posable suction curettage tube. The efficacies of sedation and cervical dilatation,operation time,intraoperative blood loss,recovery time,dosage of propofol and incidences of complications and adverse reactions in the 3 groups were observed. RESULTS:The op-eration time,intraoperative blood loss in group A were lower than group B and lower than group C,the differences were statistical-ly significant(P<0.05);recovery time and dosage of propofol in group A were lower than group B and C,the differences were sta-tistically significant(P<0.05),howerer,there was no significant difference between group B and C(P>0.05). The total effective rates of sedation and cervical dilatation in group A and B were significantly higher than group C,and the difference was statistical-ly significant(P<0.05),however,there was no significant difference between group A and B(P>0.05). The incidence of compli-cations in group A was lower than group B and lower than group C,and the difference was statistically significant (P<0.05). There was no significant difference in the incidence of adverse reactions among 3 groups(P>0.05). CONCLUSIONS:The efficien-cy and safety of misoprostol for oral administration or medicated vaginal suppository combined with palace cavity attraction tube in the treatment of painless abortion after cesarean section is similar,but oral administration can reduce the dosage of anesthetics,op-eration time and smaller intraoperative blood loss volume.

Objective To investigate the clinical pathological features of IgA nephropathy with nephrotic syndrome and risk factors for impairment of renal pathology.Methods 121 cases of IgA nephropathy with nephrotic syndrome were selected,all patients had been diagnosed with biopsy.The clinical pathological features wer analyzed, they were divided into two groups according to different kidney disease.The minor pathological changes which Leeˊs classification grade Ⅰ and grade Ⅱ patients belong to group A,with a total of 36 cases,while Leeˊs pathology heavier grade for grade Ⅲ,Ⅳ and Ⅴ grade level in patients belonging to group B,with a total of 85 cases.Clinical character-istics and clinical laboratory indicators of two groups were compared,and risk factors for renal pathological damage were analyzed in multivariate analysis.Results The average duration of group B was significantly longer than the average duration of group A,the difference was statistically significant (t =12.74,P <0.05).Mean arterial pressure of group B was significantly high than that of group A,the difference was statistically significant (t =5.31,P <0.05).Patients with hypertension,urinary erythrocytes with full vision and renal failureof group B were significantly more than those in group A,the differences were statistically significant (χ2 =14.29,9.74,8.26,all P <0.05).Total cholesterol and 24 h urinary protein excretion of group B were significantly lower than those in group A,the differences were statistically significant (t1 =8.75,t2 =6.73,all P <0.05).Serum albumin and hemoglobin levels of group B were significantly higher in group A,the differences were statistically significant (t3 =7.42,t4 =9.15,all P <0.05). Multivariate Logistic regression analysis showed,in IgA nephropathy with nephrotic syndrome,hemoglobin was a protective factor,the mean arterial pressure,24h urinary protein of red blood cells and microscopic urine >5.0 ×107 /Lwere dangerous aggravating factors.Conclusion Hemoglobin protective factors for IgA nephropathy with nephrotic syndrome,the mean arterial pressure,24h urinary protein excretion and urine red blood cells are their risk aggravating factors,they can make a more accurate judgment of the patientˊs condition.

Objective:To compare the marginal fit changes between after-and before-veneering of the copings using three kinds of materials:gold alloy,cp titanium and Ni-Cr alloy,so as to determine whether the fit changes was influenced with the veneer and their clinical significance.Methods:24 maxillary incisor acrylic resin PFM abutments fabricated by machine with the consolidated standard were divided into three groups,each abutment was waxed-up,invested,and casted with three kinds of materials:gold alloy,cp titanium and Ni-Cr alloy.For all groups,the copings were repositioned on their respective abutments,the marginal fit values of four points of each coping were measured.Furthermore,after three groups of copings were veneered with recommended porcelain,marginal fit values of same point of each abutment were remeasured.SAS software was used to carry out statistical analysis.Results:One way analysis of variance of marginal fit values revealed significant differences between before and after veneering in three groups,and the marginal fit value enhanced after veneered.Among three groups,cp titanium group had a significant difference when compared with other two groups(P

There are more prognostic factors affecting the patients with cerebral hemorrhage, including bleeding volume, bleeding site, cause of bleeding, and blood pressure regulation during acute phase. Among them, the regulation of blood pressure during acute phase is a man-controlled important factor. However, the ideal blood pressure level has not yet to he determined at present. Therefore, more clinical trials are needed to determine the exact time window of blood pressure management in patients with intracerebral hemorrhage during acute phase and the range of blood pressure control.

Objective To evaluate the feasibility and principle of direct reduction and fixation through the pedicle of fractured vertebra in treatment of thoracolumbar burst fractures.Methods Between June 2001 and November 2005,24 cases of one level thoracolumbar burst fracture,16 males and eight females,were treated in our department.Their average age was 32.5 years old.The fractured vertebrae were as follows:T11 in two cases,T12 in nine cases,L1 in 11 cases and L2 in two cases.According to the ASIA(American Spinal Injury Association) neurological function grading system,there were one grade A,two grade B,five grade C,three grade D anti 13 grade E.The vertebral canal area blocked was rated as gradeⅠ(＜1/4)in three cases,gradeⅡ(1/4～1/2)in nine cases,gradeⅢ(1/2～3/4)in 10 cases and gradeⅣ(＞3/4)in two cases.The pedicle-screws were im- planted into the pedicles of the fractured vertebra and its adjacent ones.The connective rod was pre-bent according to the normal sagittal curvature of the fixation segment.After necessary decompression of the vertebral canal,the pedicle-screws stabilized the rod which was rotated to prop open upper and lower pedicle screws and push the burst vertebra so that the kyphosis and lateral dislocation were corrected.The graft bone was implanted between the transverse processes.Results On average,the height of fractured vertebra was restored from 48.3% of the normal value before operation to 93.6% after operation,the lateral dislocation from 17.1% to 0.6%,the Cobb's angle on the sagittal plane from 26.5?to 3.1?,and the Cobb's angle on the frontal plane from 9.5?to 0?.The area of vertebral canal was enlarged from 44.6% of the normal value to 92.1%.There were no complications.For in- complete neurological injuries,improvement of one to two grades was made in neurological functions.Conclusion Direct reduction and fixation through pedicles of fractured vertebrae is a safe and effective therapeutic option to treat the thoracolumbar burst fracture,for it can improve the stabilization and stress distribution.

To improve the teaching of internal medicine,we analysed the results of clinical skill competition of interns on internal medicine and the current state of intern clinical skill learning including advantage and disadvantage.

Objective To investigate the efficacy of adhesive negative pressure suction apparatus in treatment of wound infection after colorectal surgery.Methods From January 2010 to November 2011,consecutive patients with wound infection after colorectal surgery were randomized to the experimental group (n =24 ) and the control group (n =24).The patients in experimental group were treated with the adhesive negative pressure suction apparatus.The patients in the control group were treated with traditional wound therapy.The results of treatment were evaluated.Results Time from debriding the wound infection to secondary suture was significantly shorter in patients of the experimental group ( P ＜ 0.05 ).The total number of dressing changes was very significantly less in patients of the experimental group ( P ＜ 0.01 ).The total cost of dressing in experimental group was significantly less than the control group (P ＜ 0.05 ).Conclusions The application of adhesive negative pressure suction apparatus in treatment of the wound infection after colorectal surgery can shorten the wound processing time,reduce the number of dressing changes and the total cost of dressing,thus has a high clinical value.