Objective To evaluate the effect of tranexamic acid (TXA ) in medical treatment of chronic subdural hematoma (CSDH) .Methods A total of 19 patients with CT-confirmed CSDH in our department from Mar 2014 to Aug 2015 received an in-travenous dose of 1g TXA in the first week ,and followed by a maintenance oral dose of 250 mg TXA three times a day for 1 - 5 months (2 .73 ± 1 .05) months .These patients received a follow-up period of 6 - 10 months .Hematoma volume and neurological functions were compared before and after treatment .Results The therapeutic outcome was divided into effectiveness and ineffec-tiveness .Thirteen cases (68 .4% ) were effective ;six cases (31 .6% ) were ineffective .Among them ,three patients (15 .8% ) whose neurological functions deteriorated underwent surgery ,one patient (5 .3% ) who did not show any improvement with initial one month of TXA underwent surgery ,one patient (5 .3% ) stopped the treatment due to the side-effect of drug ,one patient (5 .3% ) lost .Conclusion Results of this preliminary study show that the administration of TXA is effective and safe in treating CSDH .

Objective To explore the shape change characteristics of Oncomelania hupensis snail shell after the snails being passively migrated into Shandong intake area of the South-to-North Water Diversion Project. Methods The snails raised on the Dushan island in Weishan Lake region were captured,and 115 the first filial generation snails and 107 the second filial generation ones were selected. The length and width of shells and apertures,and the labial ridge thickness of those snails were measured,the longitudinal rib number of snail spiral was counted,and 107 parental snails were chosen as controls. Results The labial ridge thickness of the filial generation snail was significantly reduced with the increase of algebras,and the labial ridge thickness among the 3 generations had a significant difference(P<0.01). Both the length of snail shell and the width of snail apertures were de-creased,while the width of snail shell,the length of snail apertures,the multiplication product of snail aperture’s length and width and the longitudinal rib number of snail spiral were all increased. Conclusion The body size of Oncomelania snails in Weishan Lake region becomes smaller,and their shells become thinner,which indicates that the environment of the lake region is not suitable for snail breeding,and the snails have natural decay tendency with the extension of time.

Objective To understand the achievements of clonorchiasis sinensis control in Shandong Province during the past forty years. Methods The data of the previous annual clonorchiasis sinensis investigation in Shandong Province were collected and analyzed. Results From 1960s to 1970s, there were 107 counties existing the prevalence of clonorchiasis sinensis in Shandong Province. The infection rate of population was 1.51%, and 85.70% of the infected people were children below fifteen years old. Through the forty years' control, the decreasing of intermediate hosts such as various kinds of fishes and water-snails due to 85. 00% of ditches and ponds dried up by the lasting drying weather after 1980s, and 90. 00% of rivers polluted by increasing liquid waste, as well as the decreasing of infective chances due to 97. 90% of people breaking off the habit of eating not-well-cooked fishes by popularizing health knowledge, to 2003, the population infection rate dropped to 0.04%, 95.60% of the village where residents had the infection dropped to below 1. 00% , and 60. 00% of counties where no Clonorchis sinensis infection was found. Conclusion The clonorchiasis sinensis transmission areas reduce gradually, the infection rate of population decreases to the lowest in the history and the transmission has been controlled in Shandong Province.

Severe acute pancreatitis (SAP) is a common gastrointestinal disease, often accompanied by systemic inflammatory reactions and organ dysfunction. SAP has an acute onset, severe condition, rapid progression, and poor prognosis. The development of SAP is closely related to the excessive release of inflammatory factors. In the comprehensive treatment of SAP, continuous blood purification (CBP) can clear inflammatory mediators, improve the stability of Internal environment, improve organ function, reduce blood lipids, regulate immunity, and significantly improve the condition of SAP patients. It is an important means of treating SAP. This article reviews the research progress of CBP in the treatment of SAP.

This study was aimed to illustrate the interaction mechanism between Chinese herbal medicines and CASP3 target,and to analyze the structural characteristics of CASP3 inhibitors.Molecular docking,molecular dynamics and binding energy were employed to analyze the interactions and mechanism between CASP3 target and ligands which were screened from a series of nature products.The results showed that the binding forces of tanshinone ⅡA and scutellarin with CASP3 target were stronger than others.And the theoretical stable structures of tanshinone ⅡA and scutellarin combined with CASP3 target were obtained by molecular dynamics method.It also can be found that hydrophobic interaction was crucial for tanshinone ⅡA binding to amino acid residues of CASP3 such as Phe256,Ser205 and Trp206.Meanwhile,one hydrogen bond was formed between ligand and receptor.The main interactions between scutellarin and CASP3 target were found to arise from hydrophobic effect in ligand and nine amino acid residues of receptor (such as Ser249,Trp214,and Trp206),four hydrogen bonds with different stabilities and electrostatic interaction.It was concluded that tanshinone ⅡA and scutellarin can form stable structures with CASP3 target.And their similar structures may be useful to screen effective CASP3 inhibitors.

Objective:To analyze the influence of factors before initiation of extracorporeal cardiopulmonary resuscitation (ECPR) on the prognosis of patients, so as to explore the intervention timing and improvement strategy of ECPR.Methods:A retrospective analysis was performed on 29 patients who underwent ECPR in the First Affiliated Hospital of Hunan Normal University (Hunan people's Hospital)from July 2018 to April 2021. Patients were divided into the survival group ( n = 13) and death group ( n = 16) according to whether they survived at discharge. The duration of conventional cardiopulmonary resuscitation (CCPR), initial heart rate before ECPR, the ratio of out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA), and the ratio of transported cases outside the hospital were compared between the two groups. According to different CCPR time, the patients were divided into the ≤45 min group, 45-60 min group and >60 min group to compare the hospital survival and sustained return of spontaneous circulation (ROSC) rate . According to the location of cardiac arrest, the patients from emergency department and other department were divided to compare the survival of IHCA. Results:The total survival rate was 44.83%, the average duration of extracorporeal membrane oxygenation (ECMO) was 114 (33.5, 142.5) h, and the average duration of CCPR time was 60 (44.5, 80) min. The duration of ECMO was longer in the survival group than in the death group ( P = 0.001). The duration of CCPR (the time from CPR to ECMO) in the survival group was significantly shorter than that in the death group ( P = 0.010). Patients with defibrillatory rhythm had higher hospital survival rate ( P = 0.010). OHCA patients had higher mortality than IHCA patients ( P = 0.020). Mortality of patients transferred from other hospitals was higher ( P = 0.025). Hospital survival and ROSC decreased in turn by CCPR duration ≤ 45 min, 45-60 min, and > 60 min ( P = 0.001). The location of CA occurrence had no impact on the hospital survival rate of IHCA patients ( P=0.54). Conclusions:Hospital survival of ECPR is higher than that of CCPR. ECPR is effective for refractory cardiac arrest. The prognosis of ECPR is significantly related to the duration of CCPR, initial heart rate, and location of CA. Education and team training should be strengthened to improve the survival rate of ECPR.