Objective To investigate the influence of anticoagulant drug warfarin on chronic subdural hematoma (CSDH) and the role in CSDF recurrence.Methods 136 patients with CSDH hole drainage surgery were selected.The clinical data were analyzed and the patients were followed up.INR level and the correct time in patients only used VK or used VK + PCC were compared between the two groups before and after treatment.The history of trauma,the recurrence rate,time to recurrence in patients received warfarin therapy or not were compared.Results The time of anticoagulated indicators INR dropped to normal was (6.4 ± 4.9)h in VK + PCC group,which was significantly shorter than in the VK group(14.5 ±7.6)h(P ＜0.05).In patients not received warfarin preoperatively,52 cases(57％) had a history of traumatic brain injury.12 patients (27％) had the history of traumatic brain injury in patients received warfarin preoperatively.The proportion of patients with a history of traumatic brain injury in without warfarin therapy group was significantly higer than the anticoagulant therapy group (P ＜ 0.05).A total of 18 cases(13％) had postoperative recurrence,they were given the CSDH drilling drainage again.The recurrence rate be tween the warfarin anticoagulant group (18 ％) and non-anticoagulant group (11％) had no significant difference P ＞0.05).Time to relapse in patients with preoperative use of warfarin therapy and without anticoagulant therapy was (20.5 ±8.1)d,(24.4 ± 13.2)d (P＞0.05).Conclusion Warfarin increased the possibility of non-traumatic CSDH,VK + PCC shortened the corrective warfarin anticoagulation time required.

Objective To observe 125I seed treatment effect and environmental radiation in the treatment of recurrent glioma.Methods 64 patients with recurrent glioma patients,according to the wishes of patients and their families were divided into observation group of 30 cases and a control group of 34 patients.Clinical outcomes and follow-up of 125I seeds around radiation were compared between the two groups.Results The treatment efficiency of observation group and control group was 60.0％ (18/30),and 35.3％ (12/34),respectively,which was statistically significant(x2 =8.39,P ＜0.05).Follow-up from 0 to 6 months,the ambient radiation rapidly decreased as the distance increaseing with the implantation point,radiation dose in a distance of 40cm has been close to the natural basis of radiation dose;125I seeds measured radiation dose continued to decay with increasing time after implantation.Four months later,it was close to the natural basis of radiation dose.Conclusion Conclusion 125I radioactive particles in the treatment of recurrent glioma have good curative effect.The effects of radiation on the surrounding environment crowd are easily protected.

Objective:To study the protective effect of alendronate combined with Lactobacillus rhamnosus on bone loss in ovariectomized mice.Methods:Fifty female C57BL/6 mice were divided into 5 equal groups ( n=10). Ovariotomy was performed in groups A, B, C and D while a sham operation was performed in group E. Group A was subjected to combined administration of alendronate and Lactobacillus rhamnosus, group B to administration of alendronate, group C to administration of Lactobacillus rhamnosus, and groups D and E to administration of physiological saline only. At 3 months after operation, all the mice were sacrificed to harvest their femurs. Micro CT scanning was performed to detect the bone mineral density (BMD), trabecular relative volume, bone surface area/bone volume, and trabecular thickness and number of trabecular bone. Three-point bending test was used to detect the maximum load, stiffness, ultimate load, Young＇s modulus, and fracture energy. Osteocalcin and alkaline phosphatase levels were measured using blood samples from the mice eyeballs. The 2 groups were compared in terms of all the above indexes. Results:The BMD [(669.87±67.87) mg/cm 3], maximum load [(14.35±0.75) N] and fracture energy [(1,497.43±38.29) J/m 2] in group A were significantly higher than those in group B [(520.07±9.01) mg/cm 3, (11.94±0.82) N and(1,277.61±35.12) J/m 2] and group C [(388.15±25.61) mg/cm 3, (11.10±0.93) N and (1,115.27±63.24) J/m 2] (all P<0.05). The osteocalcin level in group A [(22.25±1.78) ng/mL] was significantly higher than that in group B [(19.08±1.45) ng/mL] and group D [(19.33±1.66) ng/mL] (both P<0.05). The alkaline phosphatase level in group A [(83.21±9.69) ng/mL] was significantly lower than that in group C [(113.16±14.44) ng/mL] and group D [(137.96±14.01) g/mL] (both P<0.05). Conclusion:Alendronate combined with Lactobacillus rhamnosus may play a synergistic role in prevention of bone loss in ovariectomized mice, because combined administration of the two is more effective than administration of either of the two.

Objective To explore the effect of controlled low central venous pressure(CLCVP)on venous congestion and postoperative acute kidney injury(AKI)in cardiac surgery under cardiopulmonary bypass(CPB).Methods A total of 137 patients scheduled for elective cardiac surgery under general anes-thesia with CPB were selected,including 73 males and 64 females,aged 18 to 70 years,with a BMI of 20 to 28 kg/m2,and ASA physical status Ⅱ or Ⅲ.The patients were randomly assigned into two groups:the controlled low central venous pressure group(group CL,n=68)and the control group(group C,n=69).In group CL,CLCVP was applied by pumping nitroglycerin to reduce CVP to below 10 mmHg after 20 minutes of CPB cessation until the end of surgery.If necessary,norepinephrine was applied to maintain MAP≥65 mmHg.Patients in group C received standardized anesthesia management.Urine samples were collected before anesthesia induction and 12 hours postoperatively to detect the concentration of kidney injury molecule-1(KIM-1).Urine samples were also collected before anesthesia induction and 2 hours postopera-tively to detect the concentration of neutrophil gelatinase-associated lipocalin(NGAL).Cumulative time a-bove 10,12,16,and 20 mmHg and time-weighted average CVP were used to assess venous congestion.The occurrence of postoperative AKI,stage 2 or above AKI,renal replacement therapy(CRRT),postoperative low cardiac output syndrome(LCOS),acute kidney injury following cardiac surgery(AKICS)score when arriving in ICU,in-hospital mortality,ICU stay,and postoperative hospital stay were recorded.Results Compared with group C,the cumulative time of CVP above 10,12,16,and 20 mmHg after CPB in group CL was significantly shorter,and the time-weighted average CVP was significantly lower(P＜0.05).AKI occurred in 9 patients(13.2%)in group CL and 15 patients(21.7%)in group C postoperatively,and there was no significant difference between the two groups.One case(1.5%)of stage 2 or above AKI oc-curred in group CL and 2 patients(2.9%)in group C,with one patient in group C requiring CRRT.Com-pared with group C,the concentrations of KIM-1 at 12 hours postoperatively and NGAL at 2 hours postoper-atively were significantly lower in group CL(P＜0.05).There were no statistically significant differences between the two groups in LCOS,AKICS score,in-hospital mortality,ICU stay,and postoperative hospital stay.Conclusion Controlled low central venous pressure in cardiac surgery under cardiopulmonary bypass can reduce venous congestion and decrease the occurrence of postoperative renal injury,thereby exerting a certain renal protective effect.